Managing Reactions Dealing with Stress, Anger and Depression and Finding Happiness

1. Managing ReactionsDealing with Stress, Anger and Depression and Finding Happiness Dr. Elena Klaw Raymond McDonald Captain, US Army

2. Goals for Today Warriors ethos Warriors and happiness Survival response effects Addressing anxiety Addressing anger Addressing depression When to get professional help

3. Is a Warrior Allowed to be Happy? Warriors have a learned tradition of stoicism • Repression of emotion • Indifference to pleasure • Indifference to pain • Indifference to external things beyond our control • Man or woman, how does the masculine stoic archetype (the ultimate warrior) influence attitudes and behaviors? Stoicism isolates: • From selves? (mind from body) • From others? • From our environment?

4. Stoicism: The Warrior Ethos*We leave the military…but the military never leaves us (McDonald,2011) No Mission Too Difficult. No Sacrifice Too Great. Duty First. Motto of the First Infantry Division (“The Big Red One”) Stoicism helped get through this At what cost? Happiness? How hard are you on yourself to live these values? How hard are you on others to live these values? There is another way… Military Values Duty Honor Country Loyalty Commitment Respect Selfless Service Integrity (Say-Do Correspondence) Excellence Personal Courage Military Strength *the fundamental character or spirit of a culture

5. The Warrior Suffers Alone The warrior has been defined by stoicism and sacrifice (McDonald, 2011). Historically, the warrior placed self apart from society. SelflessnessSelf-sacrifice/Martyrdom; Moral Superiority Problems: • Dissociation: Mind separate from body • Contempt for non-warriors; isolation (loneliness) • Anger: inability to be with others or alone with one’s self.

6. Survival Response Effects • General Adaptation Syndrome • Alarm (Fight, Flight, or Freeze) • Resistance (Stoicism – separate mind-body) • Exhaustion • Engineering: When do things break? When the applied load (stress) exceeds the design strength. • prolonged stress leads to plastic change. • Brief periods of warrior stoicism followed by periods of recovery can be adaptive; • prolonged or repeated periods of stress and/or insufficient recovery is maladaptive and can lead to changes in the mind and body e.g. memory, focus, cardiac, digestive, sleep.

7. Accepting and Overcoming Anxiety Reactions • Resilience - overcoming stressors • Systematic Desensitization – gradual habituation to triggering stimuli • In-vivo Exposure – immersion or confrontation with the real stressor, pair with relaxation or reward • Imaginal exposure – training to tolerate memories without having threat response • Results in less avoidance

8. Anxiety Treatment • Think about your triggers for anxiety or overreaction • Pair imagined steps or repeated exposure with relaxation • After multiple attempts, body will be less reactive

9. Steps for Dealing with Anger • Use an anger ruler (thermometer) to identify feelings and level • Identify attributions • Identify physical responses • Identify one’s own behavior • Use I statements • Don’t blame others for one’s reactions • Take a physical or mental time out • Use physical activity • Get help

10. Steps for Dealing with Depression Identify maladaptive pattern of thoughts (“stinking thinking”) • Global/stable/internal – depressive triad Identify Attributional Errors • Dichotomous thinking • Catastrophic thinking • Overgeneralization from a single incident • Challenge the evidence for the thought.. • What else could you think??

11. When to Seek Professional Help If you experience significant distress or impairment (in daily life, work, relationships, or physical health) as a result of your symptoms If you feel unsafe, “crazy,” or overwhelmed as a result of your symptoms If coping strategies may or do lead to harm to self or others If you have suicidal or homicidal thoughts If others that care about you feel afraid or worried as a result of your coping patterns e.g. substance abuse