Stress and Coping
prof.Elham Aljammas14th 0f April 2014
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Stress
A state of physical and/or psychological arousal
Often brought about by a perceived threat or challenge
May be expressed differently by different cultures
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Stress Reaction Phases
• Acute phase
• Reaction phase
• Repair phase
• Reorientation phase
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Acute Phase
Lasts minutes, hours or days
“Fight or flight” response: preparation for physical activity
Narrowing of focus: decreases ability to think properly
Emotional reactions: disbelief/consternation/fear/grief
Rigid behavior: irritability, anger, etc. affects communication
Panic is rare but if present, requires immediate attention
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Reaction Phase
Lasts one to six weeks
Delayed reactions: previously repressed or denied feelings will surface
May be overwhelming, bringing feelings of powerlessness
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Reaction Phase: Characteristic reactions:
Fear of returning to the site of the event
Dreams or nightmares
Anxiety, restlessness, insomnia
Muscular tension, tremors and exaggerated startle response
Increased irritability and isolation, depression
Disturbing thoughts about survival, relief, guilt and grief
Perceived images of how others suffered in the disaster, i.e. how they died, how they injured
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Repair Phase
Lasts one to six months
Reactions are less intense, and not so overwhelming
Feelings of hurt continue, but are more manageable
Renewed interest in everyday life
Makes plans for the future
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Reorientation Phase
Approximately six months after a distressing event and continuing
Heightened stress reactions are substantially reduced
Grief reaction may not be resolved but is accepted
Most reactions will diminish gradually
Assessing ongoing needs is important
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Coping with Stress
Coping is a way to prevent, delay, avoid, or manage stress
Coping mechanism categories:
Changing the source of stress
Changing the view of the situation
Tolerating the stressor until it passes or becomes less troublesome
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Loss and Grief
Loss is a common theme in most disaster settings
Common reactions to loss:
Denial, numbness or shock
Bargaining
Depression
Anger
Acceptance
Reorientation
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Loss and Grief – Signs of Trouble
Avoiding or minimizing emotions
Using alcohol or drugs to self-medicateUsing work or other distractions to avoid feelings
Hostility and aggression toward others
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Emotional Numbness or Extreme Agitation
Immediate attention is needed
Possible referral for professional care
When referring:
Inform the person of your intention
Recognize that the referral may cause a negative reaction
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Guiding Principles in Providing Psychological Support
First protect from danger
Focus on physical and material care
Be direct, active and remain calm
Focus on the “here and now” situation
Provide accurate information about the situation
Assist with mobilization of resources
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Guiding Principles in Providing Psychological Support (cont)
Do not give false assurances
Recognize the importance of taking action
Reunite with family members
Provide and ensure emotional support
Focus on strengths and resilience
Encourage self-reliance
Respect feelings and cultures of others
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Crisis Intervention
Observe safe practices by showing concern for your own safety
Remain calm and appear relaxed, confident and non-threatening
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Crisis Intervention Steps
• Assess the situation
• Establish rapport
• Identify the main problem (s)
• Deal with feelings and emotions
• Generate and explore alternative coping strategies
• Formulate an action plan
• Follow up