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Healthcare Training Institute - Quality Education since 1979

Section 15
Using the Tool of Self-Talk Four Phases

Table of Contents | NCCAP/NCTRC CE Booklet

The more concrete you can be about focusing on these three situations you are defining as "the most stressful," the more beneficial the twelve Sections of this Manual will be to you.

Think of that one most-stressful situation in your facility now.  Reenact it in your mind.  What were you thinking at the time your Administrator reprimanded you; the Surveyor discovered your Progress Notes were out of date; Ernie your exploding resident exploded at you; you scheduled the Birthday Group for the wrong day and they showed up last night, leaving the facility very disgruntled; or think about whatever is your "favorite" stressful situation at work. 

Often times your thoughts are best understood as self-talk. In other words, your thoughts are your way of talking to yourself.  Self-talk is what you silently say to yourself about the events you ex­perience.  What you say to yourself influences you in many profound ways, as you are probably aware. What you say to yourself changes what you see and hear, what you feel, and what you remember when you look back on your experiences. Agree?  In this Section, we will concentrate on the ways in which the things you say to yourself can help you to prepare for and overcome stress in the facility whether it is related to Culture Change or not.  First, let’s examine how you can create stress and anxiety by what you say to yourself about a situation.

When talk to your DON about med and shower schedule changes, if you are saying to yourself, "I know she never liked me anyway.  She's always on my case," how receptive will you be to providing empathic support?  When we start to think this way, we are likely to feel inadequate and anxious. If upon re­turning to your office from such an encounter, you say to yourself that you will never get along with the Administrator, you are likely to remember only the negative parts of the meeting and not the positive ones from which you might learn, and change your behavior.  When Ernie the exploding resident yells at you, are you saying to yourself, "Boy, did I mess up!  What did I do to deserve this?  I am so embarrassed!  Other staff and residents are looking at me!"  Negative thinking and negative self-talking is stress-provoking and interferes with any possibility for an objective evaluation of the situation.  Agree?

The Power of Positive Talking
In this Section, you will be provided with phrases to tell yourself that have been shown to improve performance and decrease stress.
 

To manage a stressful situation, we need to take steps during four major time periods. These phases can overlap, but usually they follow one another. You need to
(1) Prepare for the stressful situation, if you can anticipate it
(2) Handle feelings as they start to build
(3) Handle feelings as they start to overwhelm you, and finally
(4) Handle the feelings after they have passed.

By breaking a potentially stressful experience into these four parts and learning ways of handling each, you can make the ex­perience interesting and challenging, rather than overwhelming and unbearable.

The following four tables take the above four phases of a stressful situation and give you examples of “Effective Positive Self-Talk Affirmations” on the left and “Less Effective Negative Self-Talk Affirmations” on the right. Either circle the affirmations that seem the most appealing to you, write them in a notebook, or type them into Excel, Word, etc in your computer.  In short, choose your favorite Positive Self-Talk Affirmations for each phase of a situation you anticipate as being stressful. 

Common Problems and Helpful Hints
Have you ever been so stressed that you cannot think clearly?  Sure, we all have.  This is why it is important to memorize a few of the above Positive Self-Talk Affirmations for each phase of your anticipated stressful event. For example, you have a follow-up meeting with your DON about med and shower changes to accommodate attendance at activities, or you need to invite Ernie, your exploding resident out to the Sing-a-Long.  Of course, because you are anxious, it will be more difficult to remem­ber your favorite Positive Self-Talk Affirmations. That is why, if you can, memorize your favorite affirmations so that they will be available to you quickly when you are stressed.   

For example, as you walk down the hall towards the DON’s office you might say to yourself, “I have succeeded in situations like this one before. I am confident.”  If your anxiety continues to build-up state to yourself, “I’m in control. Relax and take a deep breath.”  If you are feeling overwhelmed with anxiety you might state to yourself, “It’s okay to feel some anxiety. It motivates me to do my best.”  When the meeting with your DON is over you might state, “That wasn’t as hard as I thought. Next time it will be even easier.

You may ask yourself, when do I have time to memorize these Positive Self-Talk Affirmations?  Try to use your periods of downtime during the day.  You feel you have no downtime?  Sure you do.  How about memorizing these when you are waiting at a traffic light, or checking out in a grocery store, or, if you are really motivated, during commercial breaks for your favorite TV show.  Consider keeping your Stress Reduction Notebook in your car, purse, or on the couch in front of the TV.  These are good times to relax and review your new self-talk.  Or keep these phrases on a slip of paper in your wallet or daily planner for review during the time when you are on hold placing an online order.  

Also, a good time to learn these statements is just before you go to sleep, and for this reason, I suggest that you leave the list on your nightstand. When you practice, remember to avoid negative thinking. Nega­tive thinking will only lead to avoidance or additional stress. Stay on guard against statements like “I always lose control” or "I just can’t cope.”

Practice with a Mental Movie
If you find that you are unable to remember the words in a real life stressful situation, decide what Affirmations above you truly want to remember.
1. Then reread the statements again several times.
2. Create the upcoming anticipated stressful situation in your mind.  So that when you want to recall your Positive Self-Talk Affirmations, you will recall the statements and be able to cope more successfully.
3. Make the visualization or Mental Movie of the upcoming stressful situation as clear and detailed as you can.  What are you wearing what is your DON wearing?  Are you standing or sitting?
4. It is helpful to exaggerate the anxiety-provoking events to test your skill.  For example, envision the DON breathing fire out of her nostril, her office going up in flames, and you calmly restate you case regarding shower and med schedule changes to accommodate activity attendance.  Continue doing this in your Mental Movie and you will find yourself better and better able to cope with your feelings in stressful situa­tions.

However, do not try to learn all the statements or visualize all the scenes at one time. It may be useful to review all of them in the begin­ning, but choose a few to memorize or work on each day. This is similar to taking a series of injections for inoculation against a disease. In fact, these techniques are sometimes called stress inoc­ulation.

Summary:  To manage a stressful situation, you probably need to take steps during four major time periods. These phases can overlap, but usually they follow one another. We need to
(1) Prepare for the stressful situation
(2) Handle feelings as they start to build
(3) Handle feelings as they start to overwhelm you, and finally
(4) Handle the feelings after they have passed.
By breaking a potentially stressful experience into four parts and learning ways of handling each part, you can make the ex­perience interesting and challenging, rather than overwhelming and unbearable.

Be sure to include some phrases that will prepare you for the event, some to remind you to relax as the feelings begin to build, some to help you cope when the feelings become stronger, and some to keep perspective after the event and encourage yourself in the future.  Complete the following table with Effective and Less Effective Self-Talk for each of the four phases of stress.
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