After you have a better understanding about the ways in which your thinking can produce your stress, you’re in a good position to do something about your stress-producing thoughts. Systematic stress analysis is a structured technique that shows you, step-by-step, how to take any stressful situation and determine exactly how much of a role your thinking is contributing to your stress level. More importantly, it shows you how you can correct your stress-producing thinking and replace it with stress-resistant thinking.

To start, you might copy the Stress-Analysis Worksheet below into your Stress Reduction Notebook.

Your Stress Analysis Worksheet

1. My stress trigger (stress-producing event or circumstance):

2. The importance of this stress trigger (0- 10 scale):

3. My stress response (how I reacted to the stress trigger):

4. My overall stress response level (0-10 scale):

5. My Self-Talk:

6. My Thinking Error:

7. My Coping Self-Talk:

Write down what’s stressing you
At the top of the page, where it states My Stress Trigger, write down what is triggering your stress. This may or may not be related to Culture Change in your facility. Be brief, such as the following description: “I was so upset when Wendy the CNA did not give Hazel the yarn winding I left in an Activity Bag in Hazel's room. She attended my inservice, and we discussed this specifically related to Hazel.”

When shortened, becomes: Wendy not give room project to Hazel.

1. My stress trigger

2. The importance of this stress trigger (1-10) Scale

Then, regarding “My Stress Response,” write your feelings - your reaction to your stress-trigger. It might be: irritation, anger, upset, anxiety, worry, a headache, muscle tension, rapid breathing — or any of the many other stress-induced signs and symptoms. In my example regarding Wendy, your stress-response may be: upset and angry.

3. My stress response (how I reacted to the stress trigger):

Assess your stress balance
Next rate your Level of stress about that situation or event (on a 10-point scale, where 10 indicates major stress). Then, rate the Importance of the stressful situation on a 10-point scale (where 10 is a biggie). Enter your ratings in the appropriate places on the Worksheet above or the box below.

4. My overall stress response level (0-10 scale):

Identify your stress producing self-talk
Write down what you may be saying to yourself to create much of this stress. Remember that much of this self-talk is pretty automatic. You’re probably not even aware of saying anything to yourself. But you are. To help you get in touch with this automatic self-talk, ask yourself: What might I have been saying to myself about this stress-trigger? In this situation, you may have said something like this: Oh my gosh! This is awful! It couldn’t have happened at a worst time. I could have been a contender. Everything will be ruined! I just hate it when things like this happen! I’ll never be happy again!

5. My Self-Talk:

Find your Thinking Errors
From your self-talk, try to identify the Thinking Errors that seem to be relevant. In the examples in the preceding section, you can see that there is more than a little awfulizing going on, with a healthy dose of can’t-stand-it thrown in. So review the previous section and write a Thinking Error below.

6. My Thinking Error:

Use your coping self-talk
You are now ready to respond to your stress-producing self-talk, correct any Thinking Errors, and come up with a more stress-resistant way of looking at your stress-triggers. In my example with Wendy in #6 you realize you were involved in awfulizing. You coping self-talk might be “What a hassle. There’s nothing I can do right now about Wendy. Let’s see if she remembers tomorrow to give Hazel her Yarn Winding. If not I need to decide whether talking to her directly or to the DON or the Charge Nurse or giving another inservice is best.” In short you don’t go ballistic because Wendy has never give activity projects to any residents. Our course on Gaining Staff Support and Cooperation provides some detailed actions you might consider.

Talk like an air-traffic controller
One way to help yourself is to use your coping self-talk to think like an air-traffic controller. Consider this B-grade movie scenario: The weather at the airport is foggy. Very foggy. You are the air-traffic controller in charge. You learn that a novice pilot is having trouble landing and is panicking. He badly needs your help. You begin to talk him down. You say: “You’re doing just fine. Hang in there... Take a deep, slow breath... Great! Now, remember what you learned in pilot school. Pull the throttle toward you. That’s it. You can do this. . . Let her steady out… Begin your descent… Good. Take another deep breath. Don’t panic. Hold her steady. . . you’re almost down... You’re doin‘ great... You’re on the ground. You made it!” You get the idea? Talk to yourself in a way that helps you cope better with the stressful or potentially stressful situations.

What to say to yourself
If you are at a loss for words, and can’t seem to come up with what to say to yourself as you are experiencing your stress trigger, use the following list as a reference. It includes most of the essential self-talk elements you need.

Here’s what your coping self-talk might look (and sound) like in your Worksheet: “This isn’t really a major tragedy. Yes, I am disappointed. I need to decide who in the facility to approach to get follow through from Wendy. It’s not anything I can’t deal with. Don’t blow it up. Calm down and see what you can do to fix this situation. Start breathing... You’re doing fine. What to do? Should I wait? Or have I waited enough? Should I schedule a meeting with the DON now?” You can use the same approach whenever you find yourself in any stressful situation. Yes, you can talk yourself out of being stressed.

- Adapted from Elkin PhD, Allen; “Stress Management for Dummies”; Wiley Publishing, Inc: Indiana; 1999

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