Have you ever felt the stress of a deadline? Something had to get done, and you had to do it. As time passed, did you feel more stressed and your heart rate climbing? You may even get that feeling in the pit of your stomach. These are the physical effects of stress. This is due to activation of the sympathetic nervous system (flight-or-fight response of the central nervous system) and the release of stress hormones, such as cortisol, from the adrenal gland. The purpose of this response is physiologic, and it is intended to increase the person’s capacity and ability to rise to the occasion. However, excessive sympathetic discharge and physiologic stress response is detrimental to health, well-being, and quality of life.
On the other hand, have you ever had a time where you were under pressure and you were very effective, if not more effective? Have you ever felt the beneficial effects of having a deadline or working under pressure? If so, then you know that there is a way to channel stress into something that can be advantageous. We can turn distress into eustress, which is defined as, moderate or normal psychological stress interpreted as being beneficial for the experiencer. Then the question remains, how can we use stress to our benefit, and become more effective under pressure?
The key here is to attain a high level of self-awareness. For many people, they do not notice the extent to which stress is affecting their lives until they suffer a major illness and health breakdown. Often times I treat patients suffering bleeding stomach ulcers, only to find out that they are going through major life events such as a divorce, work-related stress, or studying for exams. The first step of self-awareness is to take a serious self-inventory. Take time to recognize anything in your mind or body that is bothering you. Evaluate where you have pain, muscle spasms, or other discomforts. Recognize which thoughts and thinking patterns affect you. Also, take notice how these factors change when pressure is applied. What is being amplified? What feelings are you having? It is worth noting that this is not a one-time exercise. Do not rush through this process. This must be practiced regularly, as this is a skill that can be continually improved upon.
The second step is to catch yourself. It is easy for our thoughts to spiral out of control or to lose sight of the big picture when facing acute stress and pressure. This is the benefit of increasing self-awareness. As you recognize the symptoms associated with your stress response, both mental and physical, use it as a trigger to catch yourself. It can be a specific recurring thought that you have, or something in your body such as your neck getting stiff, clenching your jaw, or a stomach ache. In addition, you can set yourself up with reminders to recognize your state of mind and thought pattern. Ways of implementing this would be to wear a bracelet with words to remind you. Another would be to have your phone alarm go off every hour or two to remind you of what mental state you are in.
The third and final step is called cognitive shifting. This is when, after you catch yourself, to actively switch your thought and mental powers back to the task at hand. Start with slowing down your perception of time. Slow, deep breaths will counter the effect of the short, shallow breathing caused by the sympathetic nervous system response. Then, you direct your focus with laser-like intensity. Put all of your mental focus into doing what needs to get done. Don’t get overwhelmed by the quantity or complexity of your task. Rather, simplify it and then tackle only one task at a time. Do not even consider multitasking. Multitasking is actually a misnomer, because the human brain cannot perform two complex tasks simultaneously, so actually you shift your focus back and forth, and this vacillation causes decreased effectiveness and efficiency. For example, often times after a car accident or other unfortunate incident, the driver or passenger comes to the emergency room with multiple life-threatening injuries. I then take him or her immediately to the operating room. While I am repairing the injuries, I can only operate and treat one injury at a time. I must give my full attention to the injury that I am fixing. If I think about all of the other injuries I have to repair, this will distract me from giving my full mental capacity to the task at hand, and that would reduce the quality of my work. There is no room for error. This concept can be applied to any task at hand, surgical or not.
The physiologic stress response is an effective way to improve our performance. However, left uncontrolled and unhampered, it can significantly reduce our effectiveness and cause serious illness. Becoming more consciously aware of the effects of stress is the key to controlling it. As you gain more insight and awareness, it will become increasingly easier to catch yourself. Once you catch yourself and put yourself in the zone, you will become unstoppable!
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