Transcript DEPRESSION AND ANXIETY in GENERAL PRACTICE

STRESS AND THE LAW
Ian M Chung
Principal Counsellor since 1991
Lawcare - Law Society of NSW
Stress
Does it exist?
What is it?
The word “stress” is vague
Defining stress:
• the response of a person, system or object when it
is exposed to pressures that may be physical or
psycho-social and which, when excessive to the
capacity of the person to withstand, may cause
harm or dysfunction
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Stress is a process
Event/crisis/pressure
+
Person
Reaction
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Is all stress bad?
Distress is bad
PERFORMANCE
Eustress is
good
YERKES-DODSON CURVE
STRESS
AROUSAL
ANXIETY
PEAK
PERFORMANCE
STRESS OR EMOTIONAL AROUSAL
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Life events and crises
Whether a life event constitutes a
crisis/pressure depends on:
• Nature of event
• Magnitude of event
• Reactivity of person to the particular type of
event, sensitivity/vulnerability issue
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Stressors
Interpersonal
Load
Responsibility
Resources
Loss
Perceived “threat”
Reactions to stress itself
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The person and their development
Genetics: general/specific
Potential
Life/conditioning/learning/trauma
Outcome: the person
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What constitutes the person?
Personality/neuroticisms
Values/preferences
Beliefs/prejudices
Fears
Attitudes
Priorities
Deficits/disorders/impairments
Talents/strengths/skills/knowledge
Human nature is complex
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The role of our nature
“Nature”
“Life rules”
Perspective
Perception
Interpretation determines how we “see” things
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Stress is in the eye of the beholder
 ‘Tis
not the bump that causes the fright but
what you imagine caused the noise in the
night
The cause:
•
•
•
•
Catastrophising
Worry
Fear
Imagination
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How our head turns a life event into a
crisis
Cognitive distortion
Negative attribution causes:
• Perception of “threat”
• Distress
Unawareness or denial of unconscious processes
Inability to deal with these processes
Lifestyle not conducive to stress management
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Interpretation style determines response
 Functional response
 Dysfunctional response
Resilient style
Sensitive style
Modified response
Stress “alarm” response
Cognitive/neocortical
Primitive/limbic
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A pause for perspective
Classification is a theoretical or academic
activity
Real life is not black and white
Nature is diverse and dimensional
Categories allow for diversity
Each and every snowflake under the
microscope is entirely unique and individual
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Another perspective
People must be seen in their context
Times, circumstances, conditions change
Different eras have different values,
prejudices, economics, societies
These differences change all determinants that
mould the individual
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Stress response: three phases
general adaptation syndrome (Hans Seleye)
Alarm
Resistance
Exhaustion
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Alarm phase: “fight or flight”
Mediated by stress hormones: adrenaline and
cortisol
Purpose:
• physiological preparation for escape from threat
or protection of territory
Causes:
• physical symptoms, cognitive impairment,
emotional distress
Misinterpretation of above factors perpetuates
distress
Type As fight (angry); Type Bs fly (scared)
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Resistance phase:
maladaptive stress management
Misinterpretation of stress response: adapts
Reaction to stress response itself
Attempts to escape:
• chemical, behavioral, avoidance/procrastination,
geographic
Illness develops:
• physical and psychological
Performance deteriorates
Relations deteriorate
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Exhaustion phase: “loss of hope”
“Burn out”
“Break down”
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There is only one choice:
take responsibility for our life
Self-care is not selfish
We are responsible for the way we react
Our response cannot be left to instinct or
intellect
Control over our response to life’s
vicissitudes requires insight, honesty,
discipline, skill and a balanced life
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The foregoing presentation is copyright. Except as permitted by
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copyright owner, Ian M Chung.
Email [email protected]
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