Managing Stress

1. Irrational thinking
   1. Awfulising
      1. Can't-stand-itus
         1. Musterbating
2. Cognitive Restructuring

   Annotations:

   • A - Activating Experience (cause of upset) B - Beliefs and thoughts (response to the upset) C - Consequences (results of irrational thought)  D - Disputing (irrational thought logically examined) E - Effect (restructuring beliefs to be rational)  
3. Meta analysis
   1. by Engels
      1. effective therapies score 0.8+
         1. RET scored 1.62

1. irrational beliefs

1. STRESS <-

1. Facing the fear

   Annotations:

   • 1) construct a hierarchy of feared situations 2) train the patient in relaxation techniques; deep breathing, muscle relaxation, and visualisation 3) introduce patient to each situation, from least feared to most feared.
2. Lucy

   Annotations:

   • 9 year old girl, under average IQ, fear of sudden loud noises. Not depressed or anxious. 10 therapy sessions Parental consent 
   1. 1) Hierarchy
      1. balloons
      2. party poppers
      3. cap guns
   2. 2) Training
      1. visualisation

         Annotations:

         • at home on bed with toys
      2. deep breathing
   3. 3) Confrontation

      Annotations:

      • Had a 'fear thermometer' Could measure fear from 1 to 10 
      1. introduced to balloons

         Annotations:

         • First session: didn't want balloon burst at end of corridor Fifth session: Lucy could pop a balloon herself 
         1. 7/10 to 3/10
      2. introduced to party poppers

         Annotations:

         • Beginning: didn't allow them in consulting room End: Lucy could use a popper if therapist held it. 
         1. 9/10 to 3/10
      3. introduced to cap guns

         Annotations:

         • Agreed to have one fired in consulting room
         1. 8/10 to 5/10

1. desensitisation: pairing feared situation with something neutral or pleasant

1. 133 women with breast cancer

   Annotations:

   • All under 55 (pre-menopausal) Vancouver, Canada Confirmed cancer 
   1. -> QUASI <-

Annotations:

• Checked medical files for cancer diagnosis JUNE 1980 Checked survival and recurrence JANUARY 1985 

1. responsibilites
2. support network
3. marital status
4. home life

Annotations:

• factors affecting survival; marital status, support and contact from friends,  total support, social network, employment 

1. survival also dependent on cancer stage