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  • I'm doctor make events welcome to this visual lecture answering the question

  • what is the single most important thing we can do to manage your stress

  • a few years ago we moved her family to France for three months was a time the

  • European Cup football championships and So we would take our kids to a local bar to watch

  • the game on TV

  • watching the moods of people from different countries

  • swing from pure joy to total anxiety to despair and back again

  • was as entertaining as the game itself and I wondered if there is any scientific

  • analysis so how this can a stress affects people

  • it turns out there has been a study in the quarterfinal the 1996 championship

  • between the French and Dutch teams

  • a draw at the end of overtime resulted in a sudden death penalty shoot out

  • which is won by the French when researchers look back to see if there were health changes

  • on that day

  • it turned out there was a relative increase in the risk of death from a

  • heart attack by about

  • 50 percent among the Dutch men on the day and the match compared with the five

  • days on either side in the match

  • there is no such effect on French men or woman from

  • either country for that matter so this story striking because it it's about one

  • event end and really one negative health outcomes

  • stress but in reality stress is very complex

  • multiple factors multiple outcomes physiologists sees stress increase blood

  • Heart rate or changes in the chemicals that modulate the immune system

  • pressure

  • the social worker sees vulnerability with the compromised social networks coping

  • and problem solving skills

  • the doctor sees increase visits estimated that up to 70 percent a

  • primary care visits are stress-related

  • worse health outcomes bad self treatment with alcohol and drugs

  • gateways to depression and anxiety and of course the worst quality of life

  • these perspectives represent the standard negative picture stress but

  • I believe we also see a positive side distress athletes were able to find a

  • stress level that is high but

  • but not too high for optimum performance executives are mothers or aid

  • workers who manage stress like a bicycle tire

  • they regulate enough pressure to keep rolling but not too much so that if

  • they hit a bump they explode

  • And to me this is really the most interesting question when we look at

  • stress and health under some people undergoing intense stress remain healthy

  • and even thrive in and what makes them stress resistant well I think the

  • answer it big include factors like how much control people feel they have in

  • their lives

  • their social network and I mean that the old sense of the word

  • openness to change attitudes like optimism self-care skills such as

  • exercising and

  • and humor and so on research on mental health

  • shows that we are sort of a bento box more severe mental health issues

  • in trying to figure out what works and what doesn't which is great but we've

  • done much less research and most common problem

  • stress and when it is steady its usually in the context of other diseases

  • so based on a current literature my pick for the single most effective treatment

  • for managing stress

  • is actually kind of a simple one change your thinking style

  • most people think stress is something that happens to us like a piece a steel

  • on a bridge that is constantly being stressed and then eventually stretched

  • this is a physical model but it's it's actually not a human model

  • that differences is stressed passes through a two-pound piece a tissue on

  • the top your face called your brain

  • so we see things like my job is stressful or my friend Sylvia is stressing

  • me out

  • but in fact we create the stress in our brains

  • your work or Sylvia isn’t stressful what you're thinking that brings a

  • stress your brain is

  • is a volume dial that can turn to stress out but

  • I think you can also track people think we're born a certain attitudes and and i

  • think is down but the truth is stress management is a skill that can be

  • Learned

  • doctor Mat Gulliksson and his colleagues and hoops

  • Sweden published a trial in 2011 in the Annals of Internal Medicine

  • falling over 400 people loosely woman that had significant her heart events such as

  • her attacker or bypass surgery

  • half the group received usual care and the other half got usual care plus

  • cognitive behavioral therapy or CBT

  • CBT has become an umbrella term

  • where you learn practical techniques such as problem solving relaxation and

  • and challenging common thinking trapped so for example

  • a negative filters so if five people say great job and one says nothing

  • and you think you blew it fortune-telling

  • I'm not going to that job interview that just reject me mind reading

  • a friend walks by without noticing any you assume he dislikes you now

  • polarizing are black and white thinking I feel might die if I bite into that piece a

  • cake

  • now I might as well eat the whole thing and so on

  • the thought record is then used to reframe your automatic thinking and a more

  • healthy thinking

  • as the American psychologist William James said over 100 years ago

  • the greatest weapon against stress is our ability to choose one thought

  • over another so the researchers want to see people could use these techniques to

  • reduce the daily experiences stress

  • time urgency and hostility in this so could that lead to better outcomes

  • so so not a drug not a diet not a stent

  • just changing the way you think the participants were followed for over seven

  • years

  • those that got the CBT had a forty-one percent reduction heart attacks

  • and at 28 percent lower death rate

  • the more CBT session a person attended the better they did

  • now another way to change your thinking style in order to reduce stress is

  • through the use of mindfulness techniques

  • mindful used to be more through it I will call the king by crowd but

  • the programs have actually become much more mainstream in fact my patient have

  • Heart attacks and chronic diseases now often taken mine from this course part

  • their treatment

  • and there's a growing evidence about its effectiveness a recent trial following

  • clinically depressed patients by doctor Zindel Segel College University of

  • Toronto is a good example

  • when the patient experience remission they were randomized to an

  • antidepressant

  • or placebo or mindfulness-based cognitive therapy

  • the results show that mindfulness was as protective against relapses medications

  • my sense is that the success from mindfulness is probably due to the fact that

  • combines many useful techniques for stress reduction

  • such as increased self-awareness involving a physical component like

  • breathing or muscle relaxation meditation

  • and perhaps most important in our busy world an emphasis on letting go of

  • distractions in being in the moment

  • mindfulness can give us ability to let go of worry and not get trapped in the anxious

  • leaped

  • perhaps less about changing the thought and in really more about choosing where

  • to place your attention

  • as a famous Austrian psychiatrist Victor Frankel pointed out between stimulus and

  • response

  • there's a space and I think mindfulness teaches us awareness so that space in

  • and that we have the power choice so another factor that the

  • research tells us that impacts your thinking style is your attitude

  • your outlook on life doctors Suzanne Kobasa and her colleagues from the University

  • Chicago look at this by following a natural experiment in the nineteen

  • eighties break up of the Ma Bell Telephone Company

  • the followed who coped well and who didn't and identified three key trait of those

  • who coped well

  • the first motion was commitment the stress resistant executives were

  • committed a different aspects of their lives

  • so even while facing uncertainty they stay committed to quality work in

  • engaging with family and friends their communities there

  • faith hobbies they saw

  • and I think we're committed to the bigger picture success

  • and this allowed them to weather the turbulence in in a specific area of

  • their lives

  • the second motion was control this is interesting

  • in that because its restructuring these executives actually had little control

  • in fact you might see their skill fighting stress is more about being a

  • let go of control

  • they could see that the sands were shifting and if they were too rigid in their

  • control over territory or department the main actually lose a bigger opportunity

  • or even their job other psychological research is focused on locus of

  • control or self efficacy

  • which is really the extent to which individuals believe they can control

  • events effected

  • and their competence or or ability to make change

  • the executives may have understood that a lot what was happening was out of their

  • control but they could adapt in

  • and I think you can choose and feel confident about what they could control

  • the third notion was change the stress resistant execs were able to limit their

  • self-importance and and see the change happening around them as a potential

  • stepping-stone

  • not a stumbling block

  • so as we come to the end of our story about what reduces stress

  • might be helpful to know that the research has shown that simply rating 0

  • distressed story

  • to make a big difference the act of giving coherence in

  • and I think reading your own personal narrative too stressful event in a

  • letter

  • can be an effective way of negating the stresses those events the classic

  • therapeutic letter writing exercise is writing a letter to somebody who

  • stresses you out

  • and then not posting it

  • finally like to leave you with this advice to improve your thinking style

  • think basics when I play tennis and things are going badly

  • which is often the case I forget about everything else to say

  • move your feet watch the ball that it

  • when things are stressful sometimes you need to keep it simple save yourself

  • I will keep a regular sleep routine I will avoiding crap

  • I will walk will mingle and and I think there's some early evidence for altruism

  • we're doing good as Abe Lincoln said

  • when I do good I feel good when I do bad I feel bad

  • and that is my religion and I’m often reminded about the power simplicity from

  • a

  • a lesson one of my patients taught me I did deliver bad news to him

  • and when I did he kind of shrugged his shoulders and said I’ll be ok

  • I followed the 90/10 rule 10 percent of how we do in life is based on what happens

  • to us and and ninety percent is how we respond

  • I think the same may be true stress to take a deep breath

  • think about your big picture commitment your sense of control

  • Your openness to change consider doing some homework on yourself refrain rethinking

  • redirect your attention maybe read a letter repeatedly the evidence shows

  • that people manage their stress well

  • they're better health outcomes for virtually any disease a may suffer from

  • and remember the challenges will always be out there that's life but

  • remember too that your thoughts and your added to our the key holders for the

  • stress you experience

  • not the traffic not your boss not your job not you neighbour

  • but you something you can improve your thinking

  • hope this helps thanks for listening

  • just

  • just

I'm doctor make events welcome to this visual lecture answering the question

Subtitles and vocabulary

B1 INT stress mindfulness control thinking health stressful

90:10 The Single Most Important Thing You Can Do For Your Stress

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    VoiceTube   posted on 2016/07/03
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