Why Don't Moose Get Ulcers? pamela.rowland@dartmouth.edu

Why Don’t Moose Get Ulcers?Pamela A. Rowland, PhDDirector, Office of ProfessionalDevelopmentDartmouth Medical Schoolpamela.rowland@dartmouth.edu

Sources:Dr. Rob Ferguson&Dr. Jim White, author of Stress Control

What is stress ?

Stress is the mobilization of physicaland cognitive resources of the body/brainto cope with a perceived or actual threat.

Summary of workplace conflict• They are interdependent.• They blame each other.• They are angry.• Their behavior is causing a businessproblem.

1. Cognition/Thoughts

2. Actions/Behavior

3. Physiology

Common ManagementStrategies

Common ManagementStrategiesStart with Self-Assessment

Know Your StressWhy Self-assess and monitor stress–something I don’t t like?Assure accuracy•Reduce avoidance –subtle and•obvious

Common ManagementStrategies•Inventory life events, changes•Inventory work changes•Inventory Cognitions: Attitudes,beliefs, especially about personalcoping resources and the intentof others

Causal FactorsGenetics•Modeling– Social Learning,•learning hxPerception or cognitive schema•Life events—•“piling on”

“Life is 10% whathappens to me and90% how I react toit.”

ThoughtsBodyActions

Two quick challengesWhat are the chances....?l* probability estimationWhat is the worst thing....?l* Decatastrophizing

The Court CaseStep 1l Write down your thoughtsStep 2l Look for evidence forStep 3l Look for evidence againstStep 4l The summing up- identify the coping thought

Breaking stress upl Preparing to face the stressl Facing up to the stressl Reviewing what happened

Preparing

Facing upl“Relax muscles, breathing…”l“Don't make more out of this than I have to..”l“Focus on the moment, process…”l“Don't jump to conclusions…”l“Take things one step at a time. I can cope withthis…”

Reviewingl“I I did it. Was it as bad as anticipated?”l“It didn't work. What did I learn?”l“When I control my thoughts, I control mystress…”

2 Time Managers•Keeping a Schedule•Stimulus Control(and a note on procrastination)

Keeping a Schedule• Prioritizing• Realistic Goals• Task Time-Limits• Using the Schedule• Assuring its Accuracy

Keeping a Schedule-Prioritizing

Keeping a Schedule-Realistic Goals

Keeping a Schedule-Task Time-Limits

Keeping a Schedule-Using the schedule

Keeping a Schedule- Assuring itsAccuracy

Stimulus Control

Stimulus ControlMethod of breakingstimuli associationsbetween conflictingactivity (eg(eg., work,home activity)

Stimulus Control• Separate home, work• The creeping ivy ofcommunications technology

Stimulus ControlNote onprocrastination:• Avoidance behavior– set up small timeintervals- stick to them!– Do unpleasant tasks first– Stay with time limits!

Sleep•Why do we sleep ?•Stages of sleep

Sleep StagesTwo basic types of sleep:- REM (Rapid Eye Movement)- Non- REM

Sleep StagesDistribution of Sleep Stages Through the NightAwakeREM1234• REM getslonger withsuccessivestages• Deep sleepshorter•70 to 120 minper cycle1 2 3 4 5 6 7 8

Sleeping problems• problems getting to sleep• problems of wakening during the night• problems with early wakening

Sleep Medications

Evidence-BasedBehavioral Procedures•Stimulus control•Progressive MuscleRelaxation

Retraining your sleep•don't go to bed until you feel sleepy•your bedroom is only for sleeping & sex•25 minutes - then out of bedroom•repeat (and repeat if necessary)•same bed & wake times•don't try to “catch up” on sleep

Sleeping tipslllllllbedroomnoisepartnerexerciserelaxexpectationslllllcaffeinesmokingalcoholwarm milkfood/drink

So……….Why don’t moose have ulcers?