Stress/Distress Coping with Change
We live our lives each day somewhere on this curve. It is the way that our heart and mind work. Change is stress and continuous moment to moment. To the degree that we have the coping capacity to address and accommodate change homeostatic balance is maintained. When the stress of change exceeds our coping capacity distress occurs. Mathematically expressed
Change/Stress - Coping Capacity= Distress
Ideally, the sum of forces results to O Distress. When stress exceeds coping capacity chronically, distress leads to dysfunction and symptoms of upset homeostatic balance. "I'm stressed out" is a frequently lament. In the distressed domain, mistakes are more likely to happen. Empathy, even for one's self, diminishes. Risk of burnout increases.
The stress of change is not just the change that feels upsetting or challenging. It is any change that calls us to respond, or cope, appropriately. Getting married, job promotion, having a new baby, caregiving, leadership initiatives, and so many other changes considered to be salutary are included in the equation.
Even how we language our experience reflects our intrinsic knowing of this relationship.
"And when that happened, it was the straw that broke the camel's back."
"My plate is full and overflowing, tasks keep dropping off, sometimes forgotten."
"This Job, (project, initiative, ___ ) is breaking my back / is such a headache / is such a pain in the ass."
When chronically distressed, symptoms occur-sleeplessness, headaches, GI distress, and others wherever one's peculiar vulnerabilities lie. Anxiety increases. Depression too. Overall energy wanes.
Take a moment to pose these questions to yourself:
"If I was flying to vacation along with my family, where would I want to pilot to be on this curve? On the ascending side of the "break" point or on the descending side of coping (and implied performance)?"
Take this mindset and mental musing to other contexts:
--Your surgeon anticipating a surgical intervention on yourself, spouse, or child?
--Yourself as a leader at work? Caregiver at work?
--Yourself as spouse or parent?
Where would you want anyone to be, and most importantly, your own primary caregiver, your Self? You are your own most precious instrument of change in your life.
Some medical clinicians reading this may recognize Coping/Stress relationship graph as quite similar to the familiar Starling Curve of Cardiac Contractility.
Starling Curve of Cardiac Contractility
Stress/Change = Left Ventricular End Diastolic Volume.
Coping = Contractility.
Stress/Change= Left Ventricular End Diastolic Volume.
As cardiac demand and venous return increases, so does cardiac contractility. But only up to a point, after which cardiac muscle loses contractility, LVEDP continues to increase and heart failure eventually follows. Those living in the domain of chronic
Distress feel the emotional "heartache" of overwhelm.
Similarly, some psychological clinicians reading this may recognize the graphic as the Yerkes Dobson Stress Performance Curve.
Yerkes Dobson Stress Performance Curve
Coping = Performance
Stress/Change = Arousal
The emotional valence of arousal increases as the importance, complexity, and/or number of tasks increases. But only up to a point after which performance decreases due to strong anxiety, even up to immobilizing panic. Those of you of a certain seasoned age, may recall Lucy and Ethyl at the chocolate factory episode.
(Google I Love Lucy and Chocolate factory for a delightful laugh)
Often, when someone finds themselves on the distressing downslope of the coping curve, we "dig deep" into reserves to catch up to ourselves and our commitments. Doing so is like transferring money from our savings account to cover checks and prevent overdrafts-a temporary strategy and limited to savings reserve. Self nourishing and restorative activities that build reserves in coping capacity are frequently short changed.
--Meals skipped or wolfed down bites while completing medical records, or responding to emails and phone calls.
--"Burning the midnight oil" to complete important tasks.
--Missing exercise routines.
--Decreasing family, social, and relationship connections.
--And personal time.
Contemplating these realities one of my colleagues remarked, "The faster I go the behinder I get." Another executive leader kept a filled fruit bowl, trail mix bars, and a pitcher of fresh water on his office conference table for his own benefit and to offer so many team mates meeting "on the run".
This territory is familiar and the attendant problems clear. So, how does one create a balance of coping and stress and sustain high performance excellence. The literature is abundant with studies and strategies for "stress management" and "avoiding burnout". Even reading this may feel like just one more thing. Remedies to distress and moving one's Self to the left side of the coping curve reside in the domains of fulfillment and nourishment. They are the things that your mother likely advised you and that you advise your children.
SLEEP. Go to sleep at a reasonable hour for 6-9 hours.
EXERCISE. Exercise daily. Include aerobic, strength, and flexibility activities in your week routine. Use stairs, walk around, get off your bum at least every hour.
FOOD. Eat regularly and don't skip or rush meals. Eat predominantly a whole foods plant based diet. Follow Michael Pollen's advice: Eat real food, mostly plants, just enough.
RELATIONSHIPS. Plan for and schedule time to be with the people you love- spouse, children, family, and friends.
PERSONAL TIME. Schedule time with yourself and fill it with soul nourishing activities -prayer, meditation, reading, hobbies, music, and other activities that enliven. Take yourself out to lunch. Savor being with yourself.
MEDITATION. Meditation is getting increasing validation as the positive physiological and psychological benefits are studied. There are many methods: Mindfulness, Relaxation Response, Transcendental Meditation to name a few popular ones. Headspace and Insight Timer are excellent apps to support your practice. Use these strategies to take 1-2 minute "mindful moments" opportunities through the day to visit the calm center of your essential Self. 20-30 minute meditations elicit even better benefit.
GRATEFULNESS. Be grateful for the goodness in your life. Reflect and appreciate 3 things you are grateful for each day.
APPRECIATION. Appreciate the goodness others bring to you. Tell them how important they are to you.
PARTNERSHIPS. Access the power of "twoness". Partner with resonant partners in your personal and professional life around shared values and goals.
COACHING. Coaching is a special partnership that engages clients in a thought provoking and creative process that inspires them to maximize their personal and professional potential. Coaching can help embrace and implement any of the above.
Now, pause a moment to reflect on where you are on most days on the
Stress/Distress Coping Curve. Where would you like to be? I caution you to not pick "the top of the curve" because to sustain peak performance there everything must go perfectly as expected. And when did everything go perfectly day after day? So give yourself some slack margin to accommodate the unexpected.
What are 3 things that come to mind that click for you and you feel drawn to that would help you sustain this balance?
What can you do to structure this into your life?
What support will you need?
Who can help? Who needs to know?
What barriers may arise to draw you off track?
How will you get back on track?
Write down your plan.
Pause a moment now to appreciate yourself for reading this and for making a plan to healthfully benefit yourself.
Certified Physician Development Coach
Diplomate—American Board of Family Medicine
Fellow—American Academy of Family Practice