1. Resilient Families Managing Stress and Crisis

3. What is Stress? Stress – the unconscious preparation to fight or flee that a person experiences when faced with any demand. Stressor – the person or event that triggers the stress response. Distress (Negative)– the adverse psychological, physical, behavioral, and organizational consequences that may arise as a result of stressful events. Eustress-(Positive) Extreme psychological pressure resulting from enjoyable/or beneficial challenges. Stress Management – a set of skills that enable one to anticipate, prevent, manage, and recover from the wear and tear by perceived threats and coping deficiencies.

4. Duvall’s(1970) family development theory Described 8 stages of family’s development: Marriage and independent home Families with infants-integrate infant in family Families with pre schoolers-adjust to child away Families with schoolchildren Families with teenagers- youngsters develop autonomy Families as launching centers- separate identities of parents and children Middle aged families-dealing with in laws and grands. Aging families- shift from work to retirement

5. Family Stress Family stress can be defined as a real or imagined imbalance between the demands on the family and the family's ability to meet those demands. Benjamin Franklin said the only things a person can be sure of in this world are : Death and Taxes. Third reality is family stress and it involves change.

6. Will Crisis Occur? What is crisis? A crisis is a situation in which the usual behavior patterns are ineffective and new ones are called for immediately. A crisis provides families with both dangers and opportunities 3 factors determine how vulnerable a family is to crisis: The stressor event, The family's perception of the event, and The family's resources

9. 1-Family Stressors Children change- Teenagers, grown ups, married. Parents change- Aged, disabled, sick, divorced. Death and disability Illness in the family and healthcare costs Marital conflict, Sibling conflict Parent-child conflict Family income Family expenses and debts Family relocation or migration

10. 2-Perception Perception of the stressor will have a great effect on the seriousness of the family stress. Family's values and Its previous experience in dealing with change and meeting crisis. Stressor as challenges to be met Stressor as uncontrollable and the beginning of ruin for the family.

11. 3-Role of Resources Family communication patterns, The family's ability to solve problems, The goals of the family, Money, Relatives and friends, and Services in the community.

12. Family Strengths Learning to communicate with family members helps in times of stress. Encourage talking and listening. Accept each other's feelings, concerns, and ideas. Develop problem-solving skills. Let each family member know he or she is appreciated and loved. Being able to accept the support of friends and neighbors can also help strengthen your family.

13. Resiliency model of stress( adjustment and adaptation) McCubbin & McCubbin Emphasizes- Stressful situation is not necessarily pathological/detrimental to the family. Demonstrates – Need of family to make fundamental /structural/ systemic changes to adapt. Model is comprised of 2 distinct parts: Adjustment Phase 2- Adaptation Phase This process ranges from optimal bonadaptation to maladaptation.

15. Coping Skills for Families Hamilton McCubbin, family stress researcher at the University of Wisconsin, states that families who do a good job of managing stress have the following characteristics: They do things as a family. They build esteem in each other and themselves. They develop social support within the community

16. Coping skills for the family 4- They enjoy the lifestyle they have chosen and can endure the hardships of that lifestyle better than those who are not satisfied with their current way of life 5- They develop and use a range of tension-reducing devices. Examples are exercise, relaxation, a positive outlook, and keeping involved in activities.

17. Unhealthy ways of coping with stress These coping strategies may temporarily reduce stress, but they cause more damage in the long run: Smoking Drinking Overeating or under eating Zoning out for hours in front of the TV or computer Withdrawing from friends, family, and activities

18. Unhealthy ways of dealing with stress Using pills or drugs to relax Sleeping too much Procrastinating Filling up every minute of the day to avoid facing problems Taking out your stress on others (lashing out, angry outbursts, physical violence)

19. Dealing with Stressful Situations: The Four A’s Change the situation: Avoid the stressor. Alter the stressor. Change your reaction: Adapt to the stressor. Accept the stressor.

20. Stress management strategy #1: Avoid unnecessary stress Learn how to say “no” – Know your limits and stick to them. Whether in your personal or professional life, refuse to accept added responsibilities. Avoid people who stress you out– If someone consistently causes stress in your life and you can’t turn the relationship around, limit the amount of time you spend with that person or end the relationship entirely. Take control of your environment– If the evening news makes you anxious, turn the TV off. If traffic’s got you tense, take a longer but less-traveled route. If going to the market is an unpleasant chore, do your grocery shopping online. Avoid hot-button topics – If you get upset over religion or politics, cross them off your conversation list Pare down your to-do list – Analyze your schedule, responsibilities, and daily tasks. If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.

21. Stress management strategy #2: Alter the situation Express your feelings instead of bottling them up. Communicate your concerns in an open and respectful way. If you don’t voice your feelings, resentment will build. Be willing to compromise.When you ask someone to change their behavior, be willing to do the same. If you both are willing to bend at least a little, you’ll have a good chance of finding a happy middle ground. Be more assertive. Don’t take a backseat in your own life. Deal with problems head on, doing your best to anticipate and prevent them. If you’ve got an exam to study for and your chatty roommate just got home, say up front that you only have five minutes to talk. Manage your time better. Poor time management can cause a lot of stress. When you’re stretched too thin and running behind, it’s hard to stay calm and focused. But if you plan ahead and make sure you don’t overextend yourself, you can alter the amount of stress you’re under.

22. Stress management strategy #3: Adapt to the stressor Reframe problems.Try to view stressful situations from a more positive perspective. Rather than fuming about a traffic jam, look at it as an opportunity to pause. Look at the big picture. Take perspective of the stressful situation. Ask yourself how important it will be in the long run. If the answer is no, focus your time and energy elsewhere. Adjust your standards. Perfectionism is a major source of avoidable stress. Stop setting yourself up for failure by demanding perfection. Learn to be okay with “good enough.” Focus on the positive. Take a moment to reflect on all the things you appreciate in your life, including your own positive qualities and gifts.

23. Stress management strategy #4: Accept the things you can’t change Don’t try to control the uncontrollable.Many things in life are beyond our control— particularly the behavior of other people. Look for the upside. As the saying goes, “What doesn’t kill us makes us stronger.” When facing major challenges, try to look at them as opportunities for personal growth. Share your feelings. Talk to a trusted friend or make an appointment with a therapist, even if there’s nothing you can do to alter the stressful situation. Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes. Let go of anger and resentments.Free yourself from negative energy by forgiving and moving on.

24. Stress management strategy #5: Make time for fun and relaxation Set aside relaxation time.Include rest and relaxation in your daily schedule. Connect with others. Spend time with positive people who enhance your life. A strong support system will buffer you from the negative effects of stress. Do something you enjoy every day. Make time for leisure activities that bring you joy, whether it be stargazing, or working on your bike. Keep your sense of humor.This includes the ability to laugh at yourself..

25. Stress management strategy #6: Adopt a healthy lifestyle Exercise regularly. Physical activity plays a key role in reducing and preventing the effects of stress. Make time for at least 30 minutes of exercise, three times per week. Eat a healthy diet. Well-nourished bodies are better prepared to cope with stress, so be mindful of what you eat. Reduce caffeine and sugar.The temporary "highs" caffeine and sugar provide often end in with a crash in mood and energy Avoid cigarettes, and drugs. Self-medicating with alcohol or drugs may provide an easy escape from stress, but the relief is only temporary. Get enough sleep. Adequate sleep fuels your mind, as well as your body

26. Islamic Coping Mechanisms Most of these techniques are rooted in 1-Islamic spirituality and 2-Ibadatat-different Islamic forms of worship, If performed in the correct manner – considered as best tools for coping with life’s stresses.

27. Testing is to be expected from Allah Be sure We shall test you with something of fear and hunger some loss in goods or lives or the fruits (of your toil) but give glad tidings to those who patiently persevere. Al Baqarah, 2:155

28. You can handle Allah’s tests On no soul doth Allah place a burden greater than it can bear.

29. Positive Stress The stress response itself is neutral. • Some stressful activities (aerobic exercise, etc.) can enhance a person’s ability to manage stressful demands or situations. • Stress can provide a needed energy boost. Examples: First day on a job.

30. Negative Stress (Distress) Negative stress (distress) results from: a prolonged activation of the stress response. mismanagement of the energy induced by the response. unique personal vulnerabilities. Examples: Flat tire, argument with spouse.

31. Individual Distress Work-related psychological disorders (depression, burnout, psychosomatic disorders) . Behavior problem ( substance abuse, violence, accidents) . Medical Illness ( Heart disease, stroke, back ache).

32. Islamic Coping Mechanism #1:The Faith Truly no one despairs of Allah’s Soothing Mercy except those who have no faith. ” (Qur’an, Yusuf,12: 87)

33. Islamic Coping Mechanism #1:The Faith 1 The stress response is not created by any particular type of event or situation. 2. Stress response is a matter of perception, or awareness. 3. The stress reaction is activated by neural perceptions or by what amounts to one’s worldview.

34. Islamic Coping Mechanism #1:Iman,The Faith 1. Control has been found to be a key factor in the psychology of stress. 2. Muslims believe that Allah, Who controls the whole world and all the creatures in it, supports them. 3. It was reported by Umar (ra) that the Prophet (s) has said: “If you people depended on Allah as you should, He would provide for you as he provides for the birds leaving their nests hungry and coming back satisfied.”

35. Islamic Coping Mechanism #1:Iman , The Faith It is reported that Talq b. Habib said, “A man came to Abu Darda and said to him, ‘O Abu Darda, your house has burned.’ He said: ‘No, it cannot be burned. Allah will never allow this to happen because of the words that I heard from the Prophet (s). Whoever says these words in the beginning of a day, the Prophet (s) told us, will not be afflicted by a misfortune until the end of the day, and whoever says these words in the evening will not be afflicted until morning.

36. Islamic Coping Mechanism #1:Iman,The Faith These words are, “O Allah, You are my Lord, there is no god but You, I put my trust in You, You are the Lord of the Mighty Throne. Whatever Allah wills will happen and what He does not will, cannot happen. There is no power or strength except with Al Allah, the Exalted, the Mighty. I know that Allah has power over all things, and Allah comprehends all things in knowledge. O Allah, I seek refuge with You from the evil of myself and from the evil of all creatures under Your control. Surely the straight way is my Sustainer’s way“.” (Source: Fiqh-Us-Sunnah, volume 4, #115)

37. Islamic Coping Mechanism #2:The Meditation and Relaxation(FIKR) 1. Meditation elicits the relaxation response. 2. Reductions in total and low-density lipoprotein (LDL) cholesterol, decreased anginal symptoms, and regression of coronary artery disease. 3. Meditation seems to produce these changes to a greater extent and more efficiently than sleep.

38. Islamic Coping Mechanism #2:The Meditation and Relaxation Men who celebrate the praises of Allah standing sitting and lying down on their sides and contemplate the (wonders of) creation in the heavens and the earth (with the thought): "Our Lord! not for naught hast thou created (all) this! Glory to thee! give us salvation from the penalty of the fire. Ale Imran, 3:191

39. Islamic Coping Mechanism #3:The Remembrance (Zikr) 1. Meditation can also be performed by concentrating on one word or a few words that give the person a sense of internal peace and calm; for example by repeating the words subhan Allah (glory be to Allah) or al-hamdulillah (all praise be to Allah). 2. Deep and silent repetition of such words produces the same physiological effects of meditation.

40. #3 The Remembrance (Zikr) "Those who believe and whose hearts find satisfaction in the remembrance of Allah: for without doubt in the remembrance of Allah do hearts find satisfaction.

41. Islamic Coping Mechanism #4:The Imagination (Mushahida) 1. The Imagination is considered one of the most powerful methods of stress reduction. During this practice, the person imagines that he or she is in a place, which gives him internal peace, calmness and rest. Muslims can find their safe place through imagining what will be present in the Paradise.

42. Islamic Coping Mechanism #4:The Imagination 2. Abu Hurairah, may Allah be pleased with him, reported: Allah’s Messenger (s) said:Allah, the Exalted and Glorious, said: I have prepared for My pious servants’ bounties which no eye (has ever) seen, no ear has (ever) heard and no human heart has ever perceived.”

43. Islamic Coping Mechanism #5:The Prayer (salaat) O ye who believe! seek help with patient perseverance and prayer: for Allah is with those who patiently persevere. (Al Baqarah, 2: 153)

44. Islamic Coping Mechanism #5:The Prayer (salaat) 2. It was reported by Jaber may Allah be pleased with him that the Prophet has said: “[Y]our prayers are like a flowing river at your doorstep you wash yourself in it five times a day.” 3. Results of recent scientific investigations confirm the benefits of prayer.

45. Islamic coping mechanism #6 Sabar and its rewards “Not so do those who show patience and constancy, and work righteousness; for them is forgiveness (of sins) and a great reward.” Hood, 11:11 1. Forgiveness of sins. 2. Great reward.

46. An Amazing Example of Sabr ‘Ata ibnRabah related that he heard Ibn ‘Abbas say: “Shall I show you a woman of Paradise?”I said: “Yes, indeed.” He said: “A black woman came to the Prophet, peace be upon him, and said: ‘I suffer from epileptic fits, and because of these, (at times) my body becomes uncovered. Would you invoke Allah, the Exalted One, to cure me of this disease? ‘

47. An amazing example of Sabr The Prophet, peace be upon him, said: ‘If you wish, you can be patient and you will attain Paradise (for this suffering). But if you prefer, I will pray to Allah, the Exalted, to cure you of it?’ The woman said: ‘I will be patient,’ then added: ‘I become uncovered (when I have fits), so invoke Allah for me that I do not become uncovered. ‘ So the Prophet, peace be upon him, prayed for her.”

48. When under stress, do not ask fordeath in your du’a 1. It is makruh or “disliked” to wish for one’s death, or pray to Allah for it, due to poverty, distress, illness, or the like. 2. Anas (r) reported that the Prophet (s) said: “Let no one among you wish for death due to any hardship that may befall him. But if one has no other choice, but to do so, one should say: “O Allah! Grant me life as long as life is good for me, and cause me to die when death is better for me.”

49. Islamic Coping Mechanisms Abu Hurairah (r) said: “The Prophet (s) remarked: ‘The example of a believer is like a fresh tender plant; from whichever direction the wind blows, it bends the plant. But when the wind dies down, it straightens up again. (Similarly a believer is tested by afflictions to strengthen his faith and heart, and he remains patient and firm). And an evil person is like a pine tree which remains hard and stiff until Allah breaks it whenever He wills.” Source: Fiqh-us-Sunnah, volume 4, #1

50. Islamic coping mechanism #7 Shukar Allah Loves Those Who do shukar Verily Allah will defend (from ill) those who believe: verily Allah does not love any that is a traitor to faith or shows ingratitude. Al Hajj, 22:38

51. Gratitude (Shukar) is sign of wisdom & Allah’s command We bestowed (in the past) wisdom on Luqman: "Show (thy) gratitude to Allah." Any who is (so) grateful does so to the profit of his own soul: but if any is ungrateful verily Allah is free of all wants worthy of all praise. Luqman, 31:12

52. Avoid Stress Through Gratitude Narrated AbuBakrah in Sunan Abu Dawood, #1190: When anything came to the Prophet (s) which caused pleasure (or, by which he was made glad), he prostrated himself in gratitude to Allah.

53. Avoid Stress Through Gratitude Study (Emmons & McCullough, 2003): People who were consciously more grateful: 1. Felt better about their lives. 2. Were more optimistic. 3. Were more enthusiastic. 4. Were more likely to have helped someone else. 5. Had fewer illnesses.

54. Summary of PreventativeStress Management Primary Prevention – designed to reduce, modify, or eliminate the demand or stressor causing stress. Secondary Prevention – designed to alter or modify the individual’s or the organization’s response to a demand or stressor. Tertiary Prevention – designed to heal individual or organizational symptoms of distress and strain.

55. Individual Preventive Stress Management A- Primary prevention Learned optimism: Alters the person’s internal self-talk and reduces depression. Islamic worldview. Time management: Improves planning and prioritizes activities Leisure time activities: Balance work and non-work activities

56. B- Secondary Prevention Exercise: Improves cardiovascular function and muscular flexibility Meditate (Zikr) & relax: Lowers all indicators of the stress response Diet: Small portions, low fat and low sweets lowers the risk of cardiovascular disease and improves overall physical health.

57. C-Tertiary Prevention Salat & Nasiha: Releases internalized traumas and emotional tensions Professional help: Provides information, emotional support, and therapeutic guidance

58. Make time to relax and do zikr and dua. Relaxation Exercises: • Twice a day • 20 minutes • Progressive muscle relaxation Zikr: After each prayer, tasbih. After Fajr and Maghrib or Esha While driving At stop lights: How many trees do you want to have planted on your behalf in Jannah? Dua: Remember nothing changes destiny except dua.

59. Additional Reading The Joy of Success: How To Make Stress Work for Youby P. Hanson, M.D., Kansas City, Missouri: Andrews and McMeel, 1988. Love, Medicine and Miraclesby B. Seigel, M.D., New York, N.Y.: Harper & Row, Publishers, 1986. Stress and the Healthy Familyby D. Curran, Minneapolis, Minn.: Winston Press, 1985. Reference Family Stress, Resources and Coping by H. McCubbin and J. Patterson, St. Paul, Minn.: Department of Family Social Science, 1981.

60. These slides and more available at: WWW.Slideshare.net/DrYunus

61. Thank you . Any questions?