Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT July 11, 2003 "A man loves his sweetheart the most, his wife the best, but his mother the longest." - Irish Proverb
LINKS Mental Health Moment Online
CONFERENCES AND WORKSHOPS:
Extension Disaster Education Network (EDEN)
September 30 - October 4, 2003
The Australasian Critical Incident
Stress Association Conference
The Right Response in the
Location: Carlton Crest Hotel
Friday October 3, 2003 thru
Sunday October 5, 2003
For further information
please contact the conference organisers:
6th Annual Conference
The University of South Dakota
Disaster Mental Health Institute
"Innovations in Disaster Psychology:
Time for a New Paradigm?
Reflecting on the Past:
Looking to the Future"
Rapid City, SD
September 18-20, 2003
Asian American Psychological Association
August 6, 2003
Location: Toronto, Ontario
111th Annual Convention of
the American Psychological Association (APA)
August 7 - 11, 2003
Location: Toronto, Ontario
Contact: Convention Office, APA
750 First Street NE
Washington DC 20002-4242 USA
Minnesota International Counseling Institute:
Global Mental Health in a Turbulent World
July 27-August 1, 2003
Minneapolis, Minnesota, USA
Minnesota International Counseling Institute
CSPP/Department of Education Psychology
University of Minnesota
178 Pilsbury Drive, SE
Minneapolis, MN 55455, USA
COOPERATIVE EXTENSION GEARS UP TO ASSIST IN HOMELAND SECURITY
The cooperative extension system has a tradition of responding to agriculture-related emergencies and natural disasters, but in the aftermath of the 9/11 terrorist attacks, extension is turning its sights to homeland security issues. "Cooperative extension is uniquely positioned to respond to emergencies," says David Filson, coordinator of the Pennsylvania organization's statewide emergency response efforts. Emergency response contacts have been named in every county extension office and in each of extension's eight regions. A task force of Penn State faculty and extension specialists also has been assembled to lend expertise in response to a wide variety of potential emergencies. Read the full story at http://live.psu.edu/index.php?cmd=vs&story=3453
The Extension Disaster Education Network (EDEN) links Extension educators from across the U.S. and various disciplines -- so they can use and share resources to reduce the impact of disasters. From food safety to field safety, from the physical to the psychological, and from governmental process to community development, EDEN has resources you can use. Go here for details and further information about EDEN: http://www.agctr.lsu.edu/eden/default.aspx
The Great Midwest Floods: A Decade of Recovery
In 1993, the Midwest saw nearly unprecedented flooding. A total of nine states were affected to varying levels, with floodwaters closing numerous bridges, wreaking havoc on transportation and commerce. More than 50,000 homes were damaged or destroyed and 50 lives were lost. Now, ten years later, FEMA has compiled stories of massive recovery and documented some of the steps taken to try and prevent a similar catastrophe in the future. This historical record is now available. For the full anthology with photos, go to: http://www.fema.gov/nfip/voices.shtm
ANNAN URGES AFRICAN LEADERS TO END ARMED CONFLICTS CRIPPLING CONTINENT
United Nations Secretary-General Kofi Annan today told Africa's leaders gathered in Mozambique for the African Union's annual summit that only they could end the devastating armed conflicts that were taking an unconscionable toll on their people and on the overall development of their continent. For the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=7683&Cr=African&Cr1=Union
ANNAN TO MEET BUSH IN WASHINGTON ON MONDAY FOR WIDE-RANGING TALKS
United Nations Secretary-General Kofi Annan plans to travel to Washington on Monday to meet with United States President George W. Bush and his advisers for wide-ranging discussions including Africa, which both are currently visiting, and the Middle East. Fo the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=7686&Cr=annan&Cr1=
THE MEDICAL MINUTE: MEN'S HEALTH NEEDS MORE ATTENTION
On average men die sooner than women and are more likely to suffer from more serious diseases. But the causes might not be biological. In 1920, life expectancy was almost equal for men and women. For babies born in 2001, however, life expectancy for males is 74 years and 80 years for females. Today, men are almost twice as likely to die from heart disease, one and one-half times more likely to die from cancer, and have two and one-half times more accidental deaths. They are also three to four times more likely to die by suicide or homicide. Read the full story at http://live.psu.edu/index.php?cmd=vs&story=3365
FOCUS ON ADHD
Attention-deficit/hyperactivity disorder (ADHD) affects 3% to 5% of all children and possibly as many as 2 million American children, and ADHD often continues into adolescence and adulthood. Medscape's ADHD Resource Center provides the latest news and clinical information on diagnosing and treating this disorder. For more information, go to: http://www.medscape.com/pages/editorial/resourcecenters/public/adhd/rc-adhd.ov
Psychiatrists Debate New Diagnosis and Treatment Guidelines
As they prepare to compile the next edition of the Diagnostic and Statistical Manual of Psychiatric Disorders, psychiatrists from around the world are meeting in Vienna to discuss ways of reforming the current system of diagnosing and classifying psychiatric disorders, which some say is no longer relevant to the day-to-day practice of psychiatry. For more information, go to: http://www.medscape.com/viewarticle/457666?mpid=15325
Individuals can learn to manage stress adaptively and to enhance wellness. Life can be enjoyed as a challenge, rather than being viewed as a threat (Charlesworth & Nathan, 1984). The brain centers which trigger the alarm response can also slow these processes through the relaxation response, returning the body to a natural, balanced state (Davis et al., 1982).
There are four general ways in which stress can be reduced. Each involves some practice as well as a personal committment. These are techniques for stress reduction. They do not purport to eliminate stress nor to totally mitigate all aspects surrounding disaster-related or traumatic or post-traumatic stress. Those are topics for another article.
Breathing is an act performed thousands of times each day without much attention paid to how it is done. However, breathing too fast or too slow causes the body to have trouble working properly. It causes uncomfortable feelings, dizziness tiredness or depressed feelings. The general stress reaction causes the breathing process to accelerate. Over time it can contribute to the stress symptoms discussed above. But, it is also possible to use breathing as a method for reducing the effects of stress by maintaining a good oxygen balance and making the way clear for relaxation to take place.
There are two types of breathing techniques which can be used to help relieve immediate tension. Both can be applied in any situation in which one begins to feel tense and anxious. The are PAUSING BREATH and REGULATED BREATHING.
PROCEDURE FOR PAUSING BREATH1. Before taking a Pausing Breath, you should make sure that your posture is as good as you are able to make it under the circumstances. Your back should be straight and your shoulders squared but slightly elevated.
2. Focus as much attention as possible on the breathing process itself. Then, breathe in through your nose deeply and steadily until your lungs are as full as possible.
3. Hold the breath in your lungs and count slowly to three. Gradually and evenly, release the air through your nose until your lungs are completely empty. (Another way is, after holding your breath to a count of three, let it out in three equal exhalations through your mouth, blowing slightly between your lips while exhaling.)
Practice the Pausing Breath four or five times a day until you are able to do it almost automatically. Then each time you feel the symptoms of a stress reaction starting, pause to breathe.
The advantage of the Pausing Breath is that it can be used in just about any situation, even when there are other people present. It accomplishes two things: 1) It gives the body an extra shot of oxygen, and 2) it gives you a specific moment in which to consider why you are beginning to experience a stress response. The Pausing Breath gives you a chance to stop the reaction before it has actually begun.
This technique is often used as part of relaxation training. Its purposes are to ease tension and allow you to rid yourself of the effects of stress. Regulated Breathing is something that needs to be done in a quiet place, by yourself. One of the reasons for using this technique is to allow you to get away from it all.1. Place yourself in a relaxed, comfortable position. The best position is lying on your back with a pillow under both head and knees. However, there are still beneficial effects to the process even if you are sitting in an easy chair. The location you choose should be as quiet as possible and free from other disturbances.
2. Using your nose, inhale a slow, deep breath which completely fills your lungs.
3. Count silently to three, and then exhale the breath slowly through your nose until your lungs are empty.
4. Count to three again, and then repeat steps 2, 3, and 4 over and over.
People who use Regulated Breathing often do so during a lunch break, as soon as they get home from work, or at some other time when the effects of stress are likely to be greatest. The key to
is to create a rhythm which becomes almost automatic and will let you concentrate on relaxing and reducing tension.
It is important to let the three count control the rhythm of breathing, at least until the Regulated Breathing technique becomes a habit. It is also important to count during the starting period to avoid hyperventilating.
Practicing Regulated Breathing once or twice a day for at least 10 minutes will result in it becoming easier and easier to relax during the period. Many people report that Regulated Breathing is particularly useful either right before or right after, a stressful activity (e.g. an important meeting or before a disaster-related activity), because it keeps their tension level down.
RELAXING YOUR BODY
There are many ways to relax. When most people think of the word Relaxation, it brings to mind a vacation in the mountains, or at least a week getting away from it all. The type of relaxation discussed here is similar - getting away from daily problems and stressful situations, but lasting for a much shorter time than most vacations.
FULL BODY RELAXATION is a means of reducing tension and overcoming the effects of stress. Body Relaxation involves learning to relax skeletal muscles completely by thinking about each part of the body in turn and making an effort to relax it piece by piece. This is one of the surest ways to achieve a relaxed state in a short period of time. With some practice, the entire procedure can be accomplished within 20 minutes. The best results are probably achieved if Body Relaxation is practiced at about the same time, twice a day, for about half an hour. The times should be chosen carefully so there will be a minimum of interference, and so that a schedule can be followed.
Meditation is a general word which is used to describe a wide variety of mental relaxation techniques, many of which have strong religious or cultural overtones. The central purpose, however, of meditation activities is the focus of attention on the inner self, decreased thoutht patterns having to do with daily activities, and steering attention away as much as possible from the environment. However long that meditation lasts, it should be a period in which there is an attempt to separate from daily routines and to concentrate on achieving a mentally relaxed state. While relaxation training acts to ease tension in the body, meditation works in exactly the same fashion for the mind. Therefore, since many stressors are constantly with us because we continue to think about them, meditation provides a means of eliminating, or at least reducing, these sources of stress.
Just as with the relaxation process, meditation should be performed in a quiet location which has a minimum of outside distractions. Everything possible needs to be done to ensure remaining undisturbed during the meditation process.
There are many positions to choose from for meditation. However, it is important that you should be situated in a fashion such that you will not fall asleep during the meditation process. Complicated positions are probably not good for a beginner. As an example, the classic lotus position in yoga is quite difficult to properly accomplish without a great deal of practice. The best position for a beginner is probably either sitting tailor fashion on the floor with legs crossed, or relaxed in a straight-backed chair with feet on the floor and hands resting on the thighs. Once a position has been selected and assumed, it's a good idea to make sure that body weight is evenly balanced and you are generally relaxed and comfortable.
There are literally dozens of ways in which to meditate. Keeping in mind that the purpose of meditation is to relax the mind, then any technique that allows you to think about something other than daily stress sources is likely to be a successful one.
One of the most common methods of emptying the mind is to count numbers in some fixed sequence, over and over. Count breaths, heartbeats, or simply repeat a group of numbers time and time again (a social security number might be used for this purpose). The act of counting should serve to keep the mind empty of thoughts which are likely to be stress-producing.
Choose a picture that you like. Study it mentally each time you are meditating. When you concentrate so closely on the picture, your mind becomes blank to most other thoughts. Be sure to select a picture you know well (a real picture or simply an image of a place or activity you have experienced). Use the same picture each time.
A regular, industrious program of Physical Activity is one of the most common forms of stress management used. It is often used without being aware that it is reducing stress. Many games like handball, tennis, bowling, jogging, etc. are done because one feels better afterward - mentally and physically.
Muscular tenseness is one of the most common components of a stress reaction. Vigorous physical activity reduces, and often eliminates, this tenseness. This is because it forces the muscles to perform their usual functions. It uses up excess metabolic materials that were needed to maintain a constant state of tension. People who partake regularly in demanding physical activity report feelings of relaxed calmness after an exercise period. These feelings, together with the stress-reducing nature of physical activity, make exercise a major candidate for the control of local symptoms following stressful interactions. Physical activity works through the normal function of muscles and requires little preparation or training, whereas systematic relaxation does.
STRESS BY-PRODUCT ELIMINATION
Stress reactions cause a numbers of changes in body chemistry. These are what is primarily responsible for the unpleasant side effects surrounding and following stress-producing experiences. Rigorous physical activity utilizes these by-products of stress responses and brings the operating chemistry of the body back to normal pre-stress levels.
The onset of stress responses release sugars, hormones, and other materials into the bloodstream. There it prepares the individual to fight or to flee. When the individual sit tight, doing nothing, these stress-produced materials can become detrimental to health. But, engaging in demanding physical effort rapidly uses up these stress by-products, relieving at least the local symptoms of the stress syndrome. This quick elimination of stress-response components decreases both the amount and intensity of the reaction, speeding up the regaining of control over the syndrome.
Stress responses can be quite harmful when they affect one to the degree that just thinking about a stressful situation intensifies or prolongs the reaction. Physical activity has the advantage of re-directing one's thoughts away from stress-provoking circumstances toward acts which are more directly concerned with the physical effort. By forcing the focus on the action itself, physical activity provides a means for breaking up habit patterns of reviewing stressful situations and reacting to them, even when they are in the past.
The above are most likely to occur when physical activity meet the following criteria:
Exercises should be strenuous and demanding enough to require an effort by the whole body and should engage attention and concentration for the duration of the activity. Choose an activity that you personally like but which still meets the criterion of vigorous application. For your own safety, it is important to have a complete physical exam prior to beginning a regular program of physical exercise.
A particular activity should be performed on a regular basis. Since many stress- producing situations appear more or less constantly, it is important that the physical outlet you select be worked into your day such that there is always a block of time in which to complete the activity. A stress reduction strategy which includes a physical activity component will have its greatest positive effect under conditions where the above described advantages of exercise are regularly available.
Individuals do not normally feel or experience stress when:1. they feel they can handle the demands in their environment, because they feel they have the personal and/or material resources to meet all demands or opportunities; or
2. they alter the demands to balance their available resources.
How an individual responds to stress is partially determined by their perceptions, coping skills and strengths, and the adequacy of their support system.
Emergency and disaster workers are highly motivated and highly trained individuals. They perform strenuous, stressful, and often dangerous work. They try to ease the suffering of victims. However, at the same time they place themselves at considerable emotional risk for stress responses which may be harmful to them, their work life and their family life.
Beehr,T.A. & Newman, J.E. Job stress, employee health, and organizational effectiveness: A facet analysis, model and literature review. Personnel Psychology, 1978, 31, 665-699.
Beehr, T.A., Walsh, J.T., & Taber, T.D. Relationship of stress to individually and organizationally valued states: Higher order needs as a moderator. Journal of Applied Psychology, 1976, 61, 41-47.
Charlesworth, E.A. & Nathan, R.G. Stress management: A comprehensive guide to wellness. New York: Atheneum, 1984.
Cox, T. Stress. Baltimore: University Park Press, 1978.
Davis, M.; Eshelman, E.R.; & McKay, M. The relaxation and stress reduction workbook. Oakland, CA: New Harbinger Publications, 1982.
Farberow, N.L. & Gordon, N.S. Training manual for human service workers in major disasters. National Institute of Mental Health, Rockville, MD, 1978.
Garaventa, D. "Role conflict and stress for emergency service workers". Paper presented at the American Psychological Association, National Institute of Mental Health, and Federal Emergency Management Agency Conference on Role Conflict and Support for Emergency Workers, Washington, DC, 1984.
House, J. S. Occupational stress and coronary heart disease: A review and theoretical integration. Journal of Health and Social Behavior, 1974, 15, 12-27.
Ivancevich, J.M. & Matteson, M.T. Stress and work: A managerial perspective. Glenview, Ill.: Scott, Foresman, 1980.
Kahn, R.L.; Wolfe, D.M.; Quinn, R.P.; Snoek, J.D.; & Rosenthal,R.A. Organizational stress: Studies in role conflict and ambiguity. New York: Wiley, 1964.
Kahn, R. Stress research and its implications: The United States. Proceedings of the Industrial Relations Research Association, 1981.
Mitchell, J.T. & Resnik, H.L.P. Emergency response to crisis. Bowie, MD: Robert J. Brady Co., 1981.
Schein, E.H. Organization psychology. Englewood Cliffs, NJ: Prentice-Hall, 1965.
Selye, H. Stress without distress. New York: New American Libraries, 1975.
Selye, H. Stress in health and disease. West Yarmouth, Mass.: Butterworths, 1976.
Selye, H. The stress of life (2nd ed.). New York: McGraw-Hill, 1978.
Selye, H. Guide to stress research: Volume I. New York: Van Nostrand Reinhold, 1980.
Warheit, G.J. Fire departments: Operations during major community emergencies. American Behavioral Scientist 13(3): 363-367, 1970.
To search for books on disasters and disaster mental
health topics, leaders, leadership, orgainizations,
crisis intervention, leaders and crises, and related
topics and purchase them online, go to the following url:
Although the sheer size of this dense workbook might cause initial hyperventilation--280 full-size sheets of text--take heart (and a deep breath!): the many self-assessment tools and calming techniques presented in this fifth edition can help overcome anxiety and promote physical and emotional well-being. First introduced in 1980, the book received praise for presenting a comprehensive look at stress, its physical manifestations, and the multiple ways it can be managed. Twenty years later, its well-organized chapters on breathing, relaxation, meditation, thought stopping, and body awareness still guide the reader through copious self-help techniques to try and, eventually, master. Other chapters, including job stress management, goal setting and time management, and assertiveness training, focus on daily scenarios people often find distressing. Lessons in identifying key elements that trigger unpleasant responses and in reacting differently to these elements are designed to defuse perceived conflicts. For this edition, coauthors Martha Davis (psychologist in the Department of Psychiatry of Kaiser Permanente Medical Center, Santa Clara, CA), Elizabeth Robbins Eshelman (licensed clinical social worker with Kaiser Permanente Online), and Matthew McKay (clinical director of Haight-Ashbury Psychological Services, San Francisco, CA) have added topics on worry control, anger management, and eye-movement therapy. New diagrams and a more reader-friendly format should appeal to readers, despite a few typos and graphical mishaps. This is a valuable tool for therapists, their patients, and the stressed-at-large. --Liane Thomas
Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
George W. Doherty
Rocky Mountain Region
Disaster Mental Health Institute
Laramie, WY 82073-0786
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