Report on Stress Management

Submitted to

Dr Prabhakar Pokhrel

Visiting Faculty

Institute of Crisis Management Studies

Samarpan Academy, Affiliate to Tribhuvan University (TU)

Kathmandu, Nepal

Submitted by

Ambika Khanal

Second Semester

Crisis Management Studies

July 2018

i
 ACKNOWLEDGEMENT

This Report "Stress Management” is prepared for the partial fulfillment of the
requirement for the Master's degree in Crisis Management Studies in Institute of Crisis
Management Studies (ICMS). The study would not have been initiated without the
supervision, guidance, cooperation and assistance of several individuals and the institution.
First and foremost, I would like to acknowledge the contribution of ICMS for providing an
opportunity to participate in the one-day seminar on stress management.

Similarly, I am deeply indebted to Prof Dr. Ram Thapaliya and Gen Balananda Sharma
(Retd Nepali Army) the Chairman and coordinator of ICMS respectively, for imparting
academic and practical insights in understanding dimensions of crisis and contemporary
security paradigms and crisis interventions.

I express my sincere gratitude to our lecturer respected Dr. Prabhakar Pokhrel, visiting
faculty of ICMS, for his warm, deliberate lecture and discussion on stress management,
without whom this report would not have been possible. I also grateful to the Sirjana
Adhikari M.Phil. Clinical Psychology (IOM, TU), Dr. Chintamani Yogi Founding principal
– Hindu Vidyapeeth-Nepal for providing the wonderful presentation on the seminar which
emphasized on facts about the stress management.

Last but not the least, we are equally indebted and highly obligated to all the staffs of
ICMS college and our colleagues for their inspiration, cooperation and remarkable
suggestions regarding this report.

Ambika Khanal

July, 2018

ii
 Abstract

This report provides an overview of the one-day seminar on stress management. This
seminar gives an idea on stress, its consequences and its relation with the crisis managers at
the time of crisis situation. Different perspective of managing stress at the time of crisis is
the main theme of the seminar.

Stress is the subjective feeling of being under too much mental emotional pressure.
Different signs of stress are problems in the sleeping patter, eating habits, Behavioral
problems like an increase or decrease in activity level, substance use or abuse iterability
etc. physical problems like gastrointestinal problems, headaches, body pains, sweating,
weight loss or gain, headaches etc. psychological and emotional like feeling euphoric,
denial, anxiety or fear, depression, grief, apathy etc. social problems like blaming, isolation
etc.

Stress can be managed by going through the different religious philosophy, for example
Hinduism and Buddhism. Brief solution focused therapy is very effective during the time
of crisis. Crisis Psychological first aid is also very effective during crisis intervention.

Key words: Stress, Stressors, Stress Management, Crisis, Crisis Managers, Physical,
Psychological.
 III

TABLE OF CONTENT

Description Page No.

Title Page i
Acknowledgement ii
Abstract iii

CHAPTER-1 INTRODUCTION
1.1 Background of the Study 1-2
1.2 Objectives 2

CHAPTER-2 REVIEW OF THE LITERATURE 3-6

CHAPTER-3 METHODOLOGY 7

CHAPTER-4 RESULTS 8-13

CHAPTER – 5 CONCLUSIONS 14

REFERENCES 15-16
 CHAPTER 1 INTRODUCTION

1.1 Background of the Study

The word ‘Stress’ is not new for everyone. This is used in our day to day life, household
works, office work, child rearing, political situation, marriage, divorce, even in school
activities. These all are the different form of stress and everybody have some form of it. If
stress is effectively handle it helps to handle the situation effectively and vice versa. Stress
is subjective and it is unique reaction to events.
According to Hens Selye “Stress is a nonspecific response of the body to any demand made
on it.” In 1975 Dr. Selye published a model of eustress and distress and also explained that
stress is not a purely a negative phenomenon. If the stress which increase the functions like
mental, physical through strength training or challenging work, it is eustress. On the other
hand, the stress which cannot be resolved through adaptation and coping skills, they are
distress.

Crisis refers to "an upset in the steady state." It often has five components: a hazardous or
traumatic event, a vulnerable or unbalanced state, a precipitating factor, an active crisis
state based on the person's perception, and the resolution of the crisis. Roberts (2005,)

Crisis is any transient situation that requires the reorganization of one’s psychological
structure and behavior, it causes a sudden alteration in the person’s expectation of self, and
that is unable to handle with usual coping mechanism.

Crisis management includes identifying the real nature of a current crisis, intervening to
minimize damage and recovering from the crisis. It provides sense of understanding and
some sense of control that the crisis is reduced to something manageable.
During a crisis, normal ways of dealing with the world are suddenly interrupted.
R eactions and responses to crises are time-limited, but it may persist as symptoms of
post-traumatic stress. Crises are universal and can affect people from all cultures; but
culture plays a strong role to react and cope with the crisis.
 1

The recovery process is speedy if the support system is strong and help an individual to
cope the situation that is offered by their communities.

Before 1970s stress was termed as psychological disorder which would be normal in
certain time duration and the disorder was termed as mental illness. During that periods it
was believed that the psychological disorder heals on itself leaving no long-term effect in
certain time period. After 1970’s the paradigm shifted and the psychological trauma or
stress was seen differently and managed accordingly.

1.2 Objectives of the Study

The general objective of the study is to describe the stress explain its consequences in
relation to the crisis manager. However, the specific objectives are as follows: -

1.2.1 To describe the stress phenomenon.

1.2.2 To find out the symptoms of stress.

1.2.3 To know about the stress management in terms of Buddhism and Hinduism

1.2.4 To suggest the ways for stress management

 2

CHAPTER 2 REVIEW OF THE LITERATURE

2.1. A 32 pages article under the title of “Stress in crisis managers: Evidence from self-
report and psychophysiological assessments” authored by A.Janka, C. Adler, L. Fischer,
P. Perakakis, P. Guerra, and S. Duschek published in Journal of Behavioral Medicine

Key words.
Crisis management, stress, major incident, electrodermal activity, respiratory

Empirical review.
The aim of the article is to investigate self-reported stress and psychophysiological stress
responses in crisis managers. For this purpose, 30 crisis managers were compared
with 30 managers from other disciplines, in terms of self-reported stress, health status
and psychophysiological reactivity to crisis-related and non-specific visual and acoustic
aversive stimuli and cognitive challenge. The authors have based their analysis done to
determine self-reported stress, by using the German version of the Perceived Stress
Questionnaire, Experimental Stress Induction method was applied. Along with this,
Psychophysiological r e c o r d i n g s were done by using a Biopac system (MP 150,
Biopac Systems Inc., USA). In this system the authors were assessed heart rate and
electrodermal activity (EDA). Heart rate was taken using ECG, which was recorded
from two electrodes placed at the right mid-clavicle and lowest left rib.
This study revealed evidence of lower stress levels, a more positive strain-recuperation-
balance, greater social resources, reduced physical symptoms, as well as more physical
exercise and less alcohol consumption by crisis managers. They exhibited diminished
electrodermal and heart rate responses to crisis-related and non-specific stressors. The
results indicate reduced stress and physical complaints, diminished
psychophysiological stress reactivity, and a healthier lifestyle in crisis managers. This
study showed that stress resistance may limit vulnerability to stress-related performance
decline and facilitate preparedness for major incidents.
 3

2.2 A journal article written by the authors, Mirjam Haus, Christine Adler, Maria Hagl
and Markos Maragkos, on the topic of “Stress and stress management in European crisis
managers”, published in the International Journal of Emergency Services, Vol. 5 Issue: 1,
pp.66-81.

Keywords: Leadership, Stress, Disaster response, Stress management, Crisis management

Empirical review
In this research paper, the authors examine the specific stresses and demands, perceived
control, received support and stress management strategies of crisis managers in the context
of large scale missions.
A qualitative study was used and data was collected from total 31 crisis managers by
interviewing the semi- structured questionnaire. The researcher collected data from five
European countries.
This research paper identified, event specific stressors, group specific and occupational
stressors are the major sources of stress to the crisis managers.
Regarding perceived control, study revealed that there were limited possibilities to fully
control the situation. The cause of stress was lack of control which was experienced in the
beginning of the disaster operation and also depends on scale of the disaster.
This research paper also explained that organization and peer support played a vital role to
reduce the sources of stressors to the crisis managers during the time of disasters.
This study also finds out that the crisis managers need to competently cope with the high
levels of stress related to disaster missions. They also addressed the importance of stress
management techniques to effectively manage a disaster. Several crisis managers
mentioned that they had not received any stress management training and would not apply
any specific strategies; or if they did, they had learned them by themselves: so, this study
emphasized for the comprehensive stress management training for the crisis managers.

2.3 On book name Nursing Concepts Theories and Principles written by Lalita Rai, “Stress
and Crisis”.

4
Key words: Stress, Crisis, Stressors, Intervention

Empirical review

In this book Writer explained about the term stress and crisis and talks about the stressors
and shows the way how to manage the stress during crisis situation.

Stressors: Stressors are the situation that are experienced as a perceived threat to one’s
wellbeing or position in life. It can vary from person to person stressor can be classified as
internal stressor like fever, pregnancy, menopause etc., which are originate inside a person
self. Another is external stressor like family role, social role, peer rejection, environmental
change etc., which are originate outside a person. Other forms of stressors are physical
stressors, psychological stressor, financial, spiritual, social stressors.

Crisis is the difficulty time at which the problem is uncertainty, this problem must be
solved and decisions should be made. It is the time when problem, bad situation or an
illness is at the peak of worst point.

Stress management technique during emergency

1. Familiarize yourself with signs of stress.

2. Get enough rest, exercise regularly, and maintain a healthy diet.
3. Have a life outside of your job.
4. Avoid tobacco, alcohol, drugs, and excessive caffeine.
5. Draw strength from faith, friends, and family.
6. Maintain your sense of humor.
7. Have a personal preparedness plan.
8. Participate in training offered at your workplace.
9. Get a regular physical checkup.
10. Ask for help if you need it.

5
2.4 Stress Management and Hinduism

According to Hindu approach, Crises or any tragedy are due to the will power of God.
Tragedy is due to the result of previous Karma. There is opportunity for recovery by acting
with strength and morality.

According to Bhagvad Gita, a holy book of Hind, Lord Krishna says that whatever the
human face or any things happens in the world is due to the will of God. So, everyone
should surrender the God and fate should be accepted calmly.

According to Yoga nanda Parmahansa in his “Autobiography of Yogi”, “Found solace in

the divine mother when his earth mother died: “It is I who have watched over the life after
in the tenderness of my mothers. See in my gaze the last beautiful eyes thou sleekest”.

Gurus are spiritual counsellor in Hinduism. Others forms are Gemology, Palmistry and
Astrology to find the solution to any problem even though these measures are irrational to
cope with stress, they serve as useful.

Friends, relatives are also providing informal support by visiting the family, offering
services etc. for example during the time of death relatives are visiting to the person and
they counsel them to stay stronger which is also one of the coping mechanism.

Individual with mental health problems couldn’t get support because these problems are
considered due to the fault of characters or the result of a lapse in a family’s child rearing
style.

6
 Chapter 3 Methods
3.1 Methods:
In order to write the report on stress management qualitative method is adopted to collect
relevant textual data from various sources.

This report is based on the seminar of “Stress Management”, one day seminar held in

Samarpan Academy, Institute of Crisis management studies. The report is prepared on

secondary data analysis and the data are collected from articles, journals, newspapers and

slides presented in seminar. This report is also the outcome of lecture discussion and

interaction of the seminar.

7
 Chapter 4 Results
The one-day seminar hosted by Dr. Prabhakar Pokhrel, Dr Bala Nanda Sharma, Dr. Patrice
Moulton and Srijana Adhikari presented the relevant topics related to stress and its
management process during crisis situation.
Dr. Prabhat prokhel holds an MBBS and an MD from PGIMER Chandigarh. He is
Psychiatry Lecturer at KISTMCTH, Gwarko, Lalitpur and also a Consultant Psychiatrist at
Rhythm Neuropsychiatry Hospital, Ekantakuna. His presentation focused on various aspect
of stress, Short and acute stress are having advantages on the other hand chronic stress
brings chaos in the life of any person. According to him stress was evolved from the period
of human evolution, human being had gone through many phases of development. The
survival of the fittest theory of the Charles Darwin fits in the evolution of human beings. Dr
also mentioned about the fight or flight mode in the stressful situation in the human being
helped the survival of the human civilization. The response of the human being in the
stressful situation like hyper alert state and the reaction of the body like fast respiration,
raise of heart beat etc. is the preparedness of the human mind and body muscles ready to
act of danger and it is also the coping mechanism of the human body. He further discussed
the impact of stress in the human body: -
 Dizziness

 Headache, muscle ache

 backache, tightness of chest

 Heaviness of limbs, tremors

 Palpitations

 Cold sensation of limbs

 Tingling sensation,

8
  Numbness of skin

 Poor digestion,

 loss of appetite

 Difficulty to concentrate

 Hyper vigilance /hyper alertness

 Fearful response to small stimuli

 Altered sleep

 Sight, hearing, and other senses become sharper

 Irritable, fearful, angry, quarrelsome

Stress as condition in which there is marked discrepancy between the demands made on
organism and the organism’s capability to respond (Bloom et al, 1985). Those events that
are either indicative of or require significant change in the ongoing life pattern of the
individual (Holmes and Rahe et al, 1967).

Dr. Pokhrel also explained about the coping skills need during stressful situation. Coping
strategies are the behaviors, thoughts, and emotions that are used to adjust to the changes
that occur in our life

He further highlighted about the newer definition of the mental/ defense mechanism.
Defense mechanisms are cognitive processes that function to protect the individual from
excessive anxiety or other negative emotions. They also protect the person from loss of
self-esteem and, in the extreme, the loss of self-integration. Different methods of defense
mechanism are denial Projection and he further elaborated the Post Traumatic Disorder
Syndrome (PTDS) and it’s about the stress full situation occurred in the victims of, rape,
torture, halluces, disasters etc.
9
Srijana Adhikari who holds an M.Phil in Clinical Psychology from IOM, Tribhuvan
university presented the intervention of stress, approaches and recovery methods in the
crisis situation. She discussed about the crisis intervention model including the seven stages
of crisis. The further elaboration of the psychosocial Well-being of Crisis Professional
explained about the reasons for stress at work. They are as follows.

 Day-to-day job stress

 Long working hours

 Overwhelming responsibilities

 Lack of a clear job description, poor communication

 Insecure environment
 Witnessing or even directly experiencing terrible things, such as destruction,
injury, death or violence.
 Secondary trauma
Before going to field as a crisis manager should consider the following things.
 Family and other household responsibilities
 Work responsibilities
 Community activities/responsibilities
 Other responsibilities and concerns
Miss. Adhikari mentioned about the seven stages of the crisis intervention model in
handling the stress in the crisis situation.

10
Fig: Seven stage of crisis intervention model
This model especially useful during the time of emergency.

Lt. Gen (Retd.) Bala Nanda Sharma, Principal Samarpan Academy ICMS, shared his
experienced as a manager while working in the different scenario. This discussion is very
fruitful and make us very aware how to handle the crisis situation without any burned to
oneself.

Dr. Patrice Moulton, Fulbright Specialist/ Psychology, Northwestern State University, La.
U.S.A, discussed on the topic “Brief Solution Focused Therapy.” It is a goal-directed
collaborative approach to psychotherapeutic change this is conducted through direct
observation of clients' responses to a series of precisely constructed questions.

11
During crisis situation this therapy is very useful because in short time frame we have to
managed a huge

number in short period of time it will not be solved by counselling. This lecture and
discussion session is very useful for the crisis managers.

Stress Management and Buddhist Philosophy

This session was taken by Shanta Ratna shakya, He explained about the Buddhism and its
importance in stress management during normal as well as in crisis situation. According to
the lecture and discussion in the seminar following are learned. Seven Buddhist coping
strategies are:

Meditation: Focusing in a relaxed, nonjudgmental way on one structured aspect of a

situation (e.g., breath, mantra).

Mindfulness: Nonjudgmental awareness and acceptance of the present moment.

Lovingkindness: Being nonjudgmental, compassionate, kind to oneself and others.

Morality: Practicing right speech, right action, and right livelihood, and doing these things
with good intention.

Impermanence: Realizing nothing lasts forever.

Comprehensive Karma: Acknowledgement that one’s past, present, and future actions

will have consequences, and that one has the ability to control his/her current actions.

Fatalistic Karma: Feeling a sense of helplessness, that one’s past actions have led to
one’s current state, and there is nothing one can do to avoid those consequences.

The most effective coping strategies are cultivating lovingkindness (metta), or being non-
judgmental, compassionate, kind to oneself and others; right understanding, or trying to see

12
the world as it truly is; and reflecting on impermanence.

Seven coping strategies are

1. Sangha support: turning to other Buddhists for advice, connection, and compassion.

2. Dharma: turning to study of Buddhist teachings for support.
3. No-self: recognizing that there is no separate self because everything is interconnected
and impermanent.
4. Inter-being: understanding that everything is interconnected and nothing is independent
5. Right understanding: trying to see the world as it really is.
6. “Bad Buddhist”: understanding that your problems arise because you are not practicing
correctly.
7. “It isn’t easy being Buddhist”: recognizing that Buddhism is not an easy path and that
the benefits of practice lie in the future while we must experience difficulties in the short-
term.

Stress Management and Hindu Philosophy

Dr Chintamani Yogi Founder principal – Hindu Vidyapeeth-Nepal and founder

Chairperson – Peace Service Centre and involved in many sectors. In this session Dr,
explore the reason of stress, method of solving stress, and the facts in terms of Hindu
philosophy.

Ati parishram, Anidra, Apathya Bhojan, Amarjodi Priwar, Avyavasthith Jeevan saili,
Aswastha Vatavaran, Ati Aakanchhaya, Aasakti, Ahamkar, Akalpaniya Ghatna, Aswastha
Awastha are the reason behind the stress. To resolve these reasons of stress a human have
to follow the following so that stress can be managed and a good quality of life can
manage. Pani, Pranayam, parishram, Prem, Parathana, Aahar, Vihar, Vyavahar, Vichal,
Satsang, Sankapla, Saha Jeevan.
 13

Chapter 5: Conclusion

Stress management is major and key issues during the emergency period. Stress can be
successfully managed if a manager self is managed firs and it is better to make a plan for
prevention and mitigation of different types of crisis. a solid understanding of roles and
responsibilities, support for colleagues, good self-care, and seeking help when needed is
very much important for managing the stress during crisis time.

Stressors may be different and unique while handling crisis so different cultural aspects
should be taken and manage the stress of general public accordingly for example while
handling stress of Hindu people, Hindu philosophy of managing stress is useful rather than
others.

An optimum level of stress can act as a creative, motivational force that drives a person to
achieve the desire goals and objectives. If stress is extreme and not managed, some
individuals may experience posttraumatic stress disorder (PTSD). Crisis managers are
always in a state of physical and emotional fatigue, during the time of crisis management
and some time they are unaware about the level of stress that they are bearing in their own
life. It is important to give time for self and to the other in a managed way so that crisis
managers could handle the situation effectively.
 14

References

A STUDY OF STRESS MANAGEMENT THROUGH YOGA.” ResearchGate. Accessed June

10, 2018.
https://www.researchgate.net/publication/285176206_A_STUDY_OF_STRESS_MANAG
EMENT_THROUGH_YOGA.

“A Guide to Managing Stress in Crisis Response Professions.” Accessed June 2, 2018.

http://webcache.googleusercontent.com/search?q=cache:wDBJRm4pMB8J:health.mo.gov/
living/lpha/volunteertraining/
A_Guide_to_Managing_Stress_in_Crisis_Rresponse_Professions.doc+&cd=3&hl=en&ct=
clnk&gl=np.

banna_mb. “Stress and Crisis Management.” Healthcare, 03:29:29 UTC.

https://www.slideshare.net/banna_mb/stress-and-crisis-management.

Bodhipaksa. “Buddhist Strategies for Coping with Stress.” Wildmind, June 4, 2008.
https://www.wildmind.org/blogs/on-practice/buddhist-strategies-for-coping-with-stress.

“Control Stress During a Crisis.” Everbridge, February 20, 2014.

https://www.everbridge.com/manage-stress-crisis/.

Dissanayake, A, S Dissanayake, and N Jayasinghe. “The Importance of Stress Management in

Buddhist Perspective,” n.d., 1.

Haus, Mirjam, Christine Adler, Maria Hagl, Markos Maragkos, and Stefan Duschek. “Stress and
Stress Management in European Crisis Managers.” International Journal of Emergency
Services 5, no. 1 (May 3, 2016): 66–81. https://doi.org/10.1108/IJES-12-2015-0026.

“Hindu Approaches to Handling Crisis.” Accessed June 10, 2018.

http://www.beliefnet.com/faiths/hinduism/2001/01/hindu-approaches-to-handling-
crisis.aspx.

Janka, A., C. Adler, L. Fischer, P. Perakakis, P. Guerra, and S. Duschek. “Stress in Crisis
Managers: Evidence from Self-Report and Psychophysiological Assessments.” Journal of
Behavioral Medicine 38, no. 6 (December 2015): 970–83. https://doi.org/10.1007/s10865-
015-9654-1.

Lalita Rai. Nursing Concepts Theories and Principles. Nabin Kumar Rai, 2010.

“Resilence Resources for Emergency Response | Managing Stress During A Crisis - A Guide for
Supervisors | Occupational Safety and Health Administration.” Accessed June 2, 2018.
 https://www.osha.gov/SLTC/emergencypreparedness/resilience_resources/
support_documents/supervisorintra/intradeployment_supervisors.html.

15

“Spirituality, Bhagavad Gita And Management, Hinduism, Vedas.” Accessed June 10, 2018.
http://1stholistic.com/Prayer/hol_bhagavad-gita-and-management.htm.

“Stress: Why Does It Happen and How Can We Manage It?” Medical News Today. Accessed
June 9, 2018. https://www.medicalnewstoday.com/articles/145855.php.
16