iCope Blog

Building Resilience Through Mindfulness Exercises

One popular strategy to enhance resilience to stress is “mindfulness training,which focuses on improved self-awareness, better attention skills, and deeper relaxation experiences. Research on mindfulness training methods has found numerous positive effects, including several improvements in health which suggests that this approach could provide a significant boost to overall resilience. Jon Kabat-Zinn, the founder of Mindfulness-Based Stress Reduction, describes this as a way of purposely and non-judgmentally paying attention in a particular way to what you are experiencing in the present moment. He and many other researchers have published extensively over the last 30 years on the benefits of mindfulness training.

In the most general terms possible, mindfulness training teaches us to pay attention to whatever we are experiencing. We all tend to tune out a considerable amount of mental information throughout any given day. In essence we go on “auto-pilot” as we engage in many activities. Many drivers will admit that when they are driving their cars, they can think of times when they would be miles down the road and suddenly be aware that they had not paid attention to what they saw or did over the prior few minutes – sometimes for many miles! Similarly, how common is it that we rushed through eating a meal and did not pay any overt attention to what we tasted or experienced in other ways during the meal? Some would call this “mindless” behavior versus a healthier “mindful” pattern. It has a been a cliché for many years, but the notion of “stopping to smell the roses” captures the essence and importance of what mindfulness encourages.

One way to understand this is to try to focus your attention (mind) on what you are experiencing right now. For example, if you closed your eyes and began to focus on your breathing, you would pay attention to the sensations, movement, and physiological reactions that you experience. Here, you would not want to judge the experience, such as: “Oh wow, my breathing is too fast or too slow.” You would just try to attend to your experience. A moment earlier before you focused on your breathing you were not even aware of each breath you took.

In mindfulness training you learn to become aware of your sensations and feelings, but want to avoid making any judgment about that experience. For example, if you focused on your breathing, you would not want to be thinking something negative like: “There must be something wrong since I cannot get calm or relaxed doing this.” Prior to this brief exercise you would be breathing without any conscious awareness or judgement of it. During the exercise you would become “mindful” of the breathing experience. Again, the purpose of mindfulness is to focus your attention on the experience in the present moment without judging it in any way. A potential, and very beneficial, byproduct of mindfulness is that when we focus attention on a current experience, we cannot be worrying or thinking about past or future problems. Obviously that could be helpful for dealing with certain sources of our stress. This may account for the general sense of “well-being” reported by many of those who go through mindfulness training programs.

Some of the basic exercises in mindfulness training are aimed at teaching a form of meditation to help you learn how to focus your attention. In this process, people can learn to achieve deep levels of relaxation. This part of mindfulness training clearly would help you with two of our iCope skills – self-awareness and physical relaxation. However, mindfulness training is much more than just relaxation training. You could practice mindful eating, walking, taking a shower, sitting at your desk, etc. Athletes, musicians, artists, and stage performers have used mindfulness training to enhance their health, relationships, productivity at work, as well as their performance skills. You can read many success stories of mindfulness training within professional sports teams. A recent web search for “mindfulness training in professional sports” produced over 8 million hits.

Here is a basic exercise that is often taught in most mindfulness classes:

This is quite different from the relaxation exercises in a previous blog where you were asked to focus on something like a word or a visual scene. In mindful breathing you are simply focusing your attention on the act of breathing and noticing what that experience feels like. It is described here, but if you have access to the internet, listen to a sample recording of the instructions that will definitely enhance the experience.

Get into a comfortable position, sitting up straight in your chair, or lie down if you prefer. It is helpful if you close your eyes during this practice, but if you do not feel comfortable doing that, you can keep your eyes open. Begin to focus on your breathing, paying attention to each breath as you inhale and exhale. You can breathe in and out through your nose if that is more comfortable, or inhale through your nose and exhale through your mouth.

As you settle into your mindful breathing, simply pay attention to what you experience. Notice any sensations throughout your body. It also helps to pay attention to how your breathing is being done. Check to see if you are using your belly as you breathe in and out. Using your belly (actually your diaphragm) does seem to help with relaxation. If you put your hands on your belly, you most likely will feel your belly expand as you breathe in and it will compress when you exhale. Sometimes emphasizing this type of breathing feels even more relaxing.

Focus on your breathing for about 4-5 minutes. A normal and expected part of this exercise is that you will find that your mind will wander. Your breathing will serve as an “anchor” to return to when you get distracted. You might start thinking about other things, typically from the past or things you need to do in the future. Noticing aches, pains, and physical sensations, or paying attention to sounds around you is also likely to happen. Again, this is normal and to be expected. You simply want to catch yourself when your mind drifts, and try to re-focus gently back on your breathing. Remember, this is a non-judgmental experience so there is not a good or bad experience. This exercise will give you a little sample of what mindful breathing is like. Try to do this at various times throughout the week to see if it leads to a sense of peacefulness, relaxation, or well-being. Regular practice is recommended for some of the health benefits of mindfulness training. Our website has links to some sites that have lengthier breathing exercises recorded.

Here is another easy exercise which only takes a couple of minutes at home:

Get a pleasant aromatic hand soap such as lavender or any other pleasant smelling one that you prefer. Wash your hands for two minutes in fairly warm but not hot water. Try doing this with your eyes closed, and as in the breathing exercise, focus your attention on whatever sensations that you experience. After 2 minutes, open your eyes dry your hands and see if you feel just a little more relaxed. Aside from getting good mindfulness practice by doing this exercise on some regular basis, is the physiological fact that warmer hands go along with the relaxation response and cooler hands typically indicate a stress response.

After you have had a little experience practicing these exercises, look for times throughout your normal daily routines where you can focus on your breathing and other activities, even if it is only for a minute or two. For example, if you drive to/from work you might practice your breathing exercise when you are stopped at some of the red lights; or focus on your breathing for a minute before any breaks you take away from your desk at work. These little practice exercises will help keep your awareness high to look for other situations in your daily activities where you can become more mindful and spend less time being on “auto-pilot.” If you take a mindfulness class, which is recommended, your teacher/leader will work with you to increase the amount of time that you can devote to the basic breathing exercise and add many other exercises to improve mindfulness.

Tony Ciminero, Ph. D. is an author and clinical psychologist based in South Florida. His consulting firm (Ciminero & Associates, P.A.) provides crisis intervention services world-wide. His most recent book publications include the iCope book series. For additional resources, explore iCopeWithStress.com.

Thoughts That Cause Stress

When we encounter most stressors we mentally process them quickly like a computer. Many times this processing seems automatic and unconscious. Unfortunately, many of us have been conditioned to process stressful events in a way that magnifies our stress. What could be neutral becomes worrisome and stressful. What typically would create some distress now creates a much more intense reaction. Significant stress can then create panic. The adage “we can make mountains out of molehills” summarizes how we do in fact increase our own stress.

Some specific beliefs or values that we have learned in our culture from our parents, teachers, peers, and religious authorities, act as magnifiers of stress to some degree in just about all of us. Fortunately, we can change how we look at, perceive, or interpret situations so that we do not overreact to stressful events. Rather than magnify our stress, we can learn to filter out some of its negative impact on us.

We can separate these cognitive/mental factors that magnify stress into two categories: mental habits and specific beliefs.

MENTAL HABITS

Four mental habits are very common in our culture. First, you might catastrophize or make things seem dramatically worse than they really are. If so, you often see situations deteriorating or leading to tragic conclusions. You would tend to exaggerate and blow things out of proportion. A second mental habit is where you tend to see things in absolute terms. Do you think in an all or none fashion? If so, you would see things in black and white and have a hard time seeing the gray in between. This would lead you to “over-generalize” in response to certain events and your language will reflect this. Words like “never,” “always,” “everyone,” “no one,” and “impossible” are frequently heard. A third common mental habit is when we have a strong tendency to focus on the negative and tend to ignore the positive. If this is true for you, you may operate as if you have tunnel vision and your attention is likely to focus on what is “wrong,” “bad,” “terrible,” etc. You can easily spot flaws in people, places, and things. Your negative attitude may set you up to be dissatisfied, and to get angry or depressed easily. A final mental habit is having excessive expectations of yourself and/or others. Thoughts such as “I must” or “you should” frequently will run through your mind and your vocabulary. If these expectations are not realistic, you are likely to be disappointed in yourself and others.

These processes are like any other habits in that they are hard to break unless we are highly motivated to change them. However, even when we want to change these mental habitswe still need a good approach to be successful. These methods will be presented in detail in a future blog.

SPECIFIC BELIEFS

In addition to learning what some of your mental habits are, you want to increase your awareness of whether you are magnifying your stressors by examining your specific beliefs and attitudes. We all are likely to have some strong beliefs that can cause us additional distress The iCope books provide an expanded list of irrational beliefs and the effects these have on your behavior and personality. Below are just a few common beliefs that are likely to magnify our stress. See if you identify with some of these troublesome beliefs:

  • I must have love and approval of everyone who is im­portant to me.
  • I must be thoroughly compe­tent at everything I do.
  • The world should be fair.

These beliefs are described by most psychologists as being essentially irrational. This does not mean that the thoughts are “crazy,” but maintaining them will increase your stress. As such, they are major culprits in causing you more stress than you need to experience at any given time. It should be noted that these just happen to be some of the most common beliefs in our culture that are stress producing. Each irrational belief serves as a magnifier of stress, and it would be to your benefit to modify those beliefs. For some quick examples, more rational thoughts to counter any of the irrational beliefs above are listed below.

  • Instead of: I must have love and approval…

More rational thoughts would beI wish I could be loved and approved by ________, and it really hurts that I am not able to get that, but I can survive this. This is not a life or death situation.

  • Instead ofI must be thoroughly compe­tent at everything I do.

More rational thoughts would be: I try to do the best I can at whatever I do. If I am not perfect, or even fail, that is okay because this is how we learn. I am human and none of us are perfect.

  • Instead of: The world should be fair.

More rational thoughts would be: I wish the world was fair, but I cannot expect that in life. Bad things do happen to good people. No one promised me fairness, but it still can be upsetting when this happens to me. My challenge is to get past the “unfairness” and not let this interfere with other aspects of my life.

As stated above, you can buffer yourself from some stress by modifying any irrational beliefs. Fortunately, this can be done by learning to challenge irrational beliefs and talking to yourself in a way that helps break any mental habits or beliefs that are increasing your stress. “Rational self-talk” methods can be a powerful psychological tool that will be extremely helpful in managing your stress in the future. These cognitive restructuring” steps, which will diffuse much of the unwanted stress you encounter, will be presented in the next blog.

Tony Ciminero, Ph. D. is an author and clinical psychologist based in South Florida. His consulting firm (Ciminero & Associates, P.A.) provides crisis intervention services world-wide. His most recent book publications include the iCope book series. For additional resources, explore iCopeWithStress.com.

Easy Steps to Relaxation

One of the core skills in any stress management or resilience program includes some type of relaxation training. The good news is that relaxation skills are very easy to learn with a little practice. The health benefits of just doing some form of relaxation or mindful meditation are very impressive and some of these benefits will be covered in future blogs.

Before we discuss this easy relaxation procedure it sometimes helps to understand one basic part of how our autonomic nervous system controls the fight-or-flight response. We are biologically wired for the protective fight-or-flight reaction in which our bodies go into high gear to defend ourselves or to escape. When activated through adrenaline and other hormonal changes our heart rate increases, blood pressure increases, blood vessels in the hands and feet constrict, breathing rate increases, and the bronchia in our lungs dilate to let in more oxygen. This stress reaction is controlled by the sympathetic nervous system. However, something has to turn the fight-or flight reaction off – otherwise we would all collapse with fatigue! Fortunately, we also have a braking mechanism in the parasympathetic nervous system, which counteracts the fight-or-flight reaction. Here your heart rate and breathing rate slows down, blood pressure decreases, and blood flow increases to the hands and feet. These two systems work together to maintain homeostasis, or balance, in our bodily functions. Other biological changes especially in the digestive system also occur in our body as can be seen on the diagram below.

Relaxation training or mindful meditation is vital to all stress management programs because it helps induce the parasympathetic nervous system sooner rather than later to counteract the stress response. Although your fight-or-flight response will eventually subside (as long as there is no continued threat), you can help speed this process up by physically relaxing.

Research has shown that anyone can relax physically under the right set of circumstances. This typically includes a few steps like getting into a quiet space in a comfortable position, and having something pleasant or even neutral to focus upon. Relaxation skills take some time to master and generalize to everyday situations but as with most skills, you will only get better with practice.

Our modified iCope relaxation procedure, which takes about 20 minutes, is as follows: Find a quiet place where you will not be interrupted for the time needed to try this procedure.

1) Get into a comfortable position lying down on your back. You can use a recliner type chair, or simply lie down in bed.

2) Try to loosen your muscles as best as you can. Briefly pay attention to the tension throughout your body, scanning from your head all the way down to your feet. You can roll your head gently side to side and stretch your arms and hands if that helps relax the muscles.

3) Make a mental note of your stress level by rating it from 1 (very relaxed) to 10 (very stressed).

4) Slowly take a very deep breath through your nose. Breathe in deeply enough to extend your stomach and hold it for a few seconds. Then breathe out slowly through your mouth. You can put your hand on your stomach to feel it rise with each deep breath.  Repeat this for three more deep breaths.

Now close your eyes and try to keep any other thoughts out of your mind. Allow your breathing to get into a natural and comfortable pace, breathing slowly in and out. Continue to breathe deeply in through your nose and out through your mouth.

In order to get more deeply relaxed, you will want something on which you can focus your attention. Try both of the following methods at different practice times.

a) Every time you exhale simply say a word such as “cope” or “calm” to yourself, and imagine tension flowing out of your body. Focus on your word as you breathe naturally. Do this for the remainder of your practice session.

b) The other method to try at a different time is particularly good for those who can “visualize” an image with their eyes closed. Instead of focusing on a word, imagine a very peaceful and calm scene such as a sunset or a peaceful place from your past.

5) Continue breathing naturally and focusing on your word or your scene for 15-20 minutesDo not be concerned if you get distracted. This is totally normal and expected. When that happens, and it will, try to bring yourself back to the procedure and remind yourself that you want to continue focusing on your word or scene.

6) When you finish, sit quietly for a few minutes, and make a mental note of your stress level (rating it again from to 10) and what your muscles feel like when you are more relaxed. Doing your pre- and post- stress ratings will help reinforce your relaxation practice. Over time you will see decreases in stress levels during your practice.

7) Open your eyes, but do not stand up suddenly. Remain calm in your body, but alert in your mind. When you feel alert and ready to get up, do so, but try to remember the calm relaxed feelings and sensations (muscle memory) you have just experienced.

To control stress levels in your day-to-day situations where you want something less than the 15-minute procedure, simply take a minute to take 5-6 slow deep breaths whenever you notice your stress level increasing. Also, try to recall your muscle memory of the relaxed feeling you had in your practice sessions.

If you are having difficulty with the 15-20-minute practice sessions after a few attempts at trying it, use some calming music (or one of the many recordings of nature sounds that are easily available on the internet) on which to focus for 15- 20 minutes. If that is not appealing to you, try some of the guided relaxation exercises or the mindful meditation exercises below:

  • You can find three different relaxation exercises by a sport psychologist ranging from a one-minute procedure up to a 14-minute guided procedure here.
  • And you can find a pleasant 5-minute mindful meditation exercise here.

Tony Ciminero, Ph. D. is an author and clinical psychologist based in South Florida. His consulting firm (Ciminero & Associates, P.A.) provides crisis intervention services world-wide. His most recent book publications include the iCope book series. For additional resources, explore iCopeWithStress.com.

© 2018 Anthony R. Ciminero.

Improving Your Overall Resilience to Stress

Although we cannot control all of the daily and lifetime events that can cause us stress, we can do things that can actually improve our general resilience to the negative effects of too much stress. Various assessment devices that test for vulnerability to stress generally focus on a few key factors. Personal factors that indicate higher resilience include your skills and positive habits, adequate social supports, good physical condition, a sense of well-being, assertiveness, and avoidance of ineffective coping methods such as using too much alcohol or drugs. Other resources available to you – such as family, friends, and a spiritual connection of some sort – can also increase your resilience. If your resilience to stress is relatively high, you will be better prepared to deal with the various stressful events that could impact upon you at any time. In contrast, less resilience suggests that you are more susceptible to the negative effects of stress. If you fall into this latter category, it is in your best interest to take additional steps to increase your resilience for better health and emotional strength. Check out some of the recommendations below to see what might work for you.

Healthy habits that will help build physical stamina and help you tolerate negative stress include:

  • Eating at least one well-balanced meal per day;
  • Getting adequate sleep most days of the week (6-8 hours);
  • Having physical exertion/exercise a few times per week;
  • Maintaining your weight at a relatively healthy level; and
  • Avoiding excessive consumption of caffeine, alcohol, cigarettes, and/or drugs.

Some social factors related to confidence and positive self-esteem will also help increase your resilience. This includes maintaining a network of friends, having at least one or more close friends or family members to confide in regarding personal issues, and being able to discuss problems and express feelings openly with significant others. We should all have at least one close friend that can be called in an emergency at 3:00 AM!

Finally, there are some lifestyle patterns that can also improve your resilience to stress. Maintain balance in your life with time to enjoy fun/leisure activities while you meet your normal responsibilities at school, at work, and at home. Try to attend important social events and to have some quiet time for yourself, even if it’s only a little time, to relax and defuse from your daily hassles and pressures.

In addition to these steps, you can improve resilience further by:

  1. Developing some sort of regular type of physical and mental relaxation such as meditation, yoga, mindfulness training, or relaxation exercises (see easy 5-minute relaxation and mindful meditations);
  2. Taking time to get away from heavy demands and pressures to unwind (e.g., develop weekend hobbies or interests, taking vacation breaks when possible etc.); and
  3. Trying to avoid taking on new challenges at work or home whenever you feel over-burdened by chronic stress. This means learning how to say “no.”

It is unrealistic for anyone to follow all of these recommendations. The important point here is to make as many of these changes as you can reasonably do at this time. Taking these preventive steps in the near future to improve resilience and regularly using positive coping strategies to manage typical stressors should provide a well-balanced approach to improving your coping skills and maintaining your health and well-being.

“All you need is love. But a little chocolate now and then doesn’t hurt.”
Charles M. Schulz

Tony Ciminero, Ph. D. is an author and clinical psychologist based in South Florida. His consulting firm (Ciminero & Associates, P.A.) provides crisis intervention services world-wide. His most recent book publications include the iCope book series. For additional resources, explore iCopeWithStress.com.

How Stress Can Damage the Immune System

Managing stress is very important to our emotional and physical wellbeing. However, it is also clear that a potentially dangerous situation that can arise if distress becomes a chronic problem. Researchers have known for many decades that chronic stress can cause serious physiological problems such as high blood pressure, gastro-intestinal problems, and neurological problems including headache pain. In more recent years, the evidence has been mounting that stress also causes damage at the cellular level. One interesting finding is that in addition to genetic factors, significant stress can contribute to gray hair. Although there is no suggestion that a traumatic event will cause gray hair overnight, there is evidence that the cells that produce melanin, which gives hair its color, are damaged by stress. As these cells die off, as they normally do with age, the hair does not have enough melanin to give it color. Stress appears to speed up the aging process of these cells to produce a visible sign of the damage. My own grey hair after surviving Hurricane Andrew, Katrina, Wilma, and Irma is testimony to this phenomenon!

The impact of stress on hair color is interesting, but certainly not life altering. However, a more serious threat of stress on our health provides us with more motivation to handle stress in proactive ways. Chronic stress does have an adverse effect on our immune system. Since our immune system is our primary defense against everything from the common cold and flu viruses to cancer cells, it is important to be aware of your risks if your immune system is compromised. Although short-term stress can activate your immune system in a positive way, long-term stress, which produces too much cortisol and other stress hormones, can be detrimental. The process is briefly summarized below.

We all have certain cells that the immune system uses to protect us by attacking virus-infected cells, mutant cells, and transplanted tissue. Two of the types of cells that get much of the research attention are T-cells and Natural Killer (NK) cells. Much of the research with both animals and humans shows that the biochemical changes during prolonged stress can prevent T-cells from maturing in the thymus gland and will also decrease NK cell counts. This could be harmful for anyone who has a compromised immune system (e.g., HIV+ individuals, anyone with an auto-immune disorder, and those receiving chemotherapy). Fortunately, considerable research indicates that meditation or relaxation methods, rational self-talk, exercise, a good social support network, and proactive stress management skills can all increase T-cell and NK cell counts. Many of these strategies are now being used in various medical settings where improved resilience to stress will help improve the success of other treatments.

Our next blog post will be on how to improve resilience to the effects of stress. Tony Ciminero, Ph. D. is an author and clinical psychologist based in South Florida. His consulting firm (Ciminero & Associates, P.A.) provides crisis intervention services world-wide. His most recent book publications include the iCope book series. For additional resources, explore iCopeWithStress.com.