1Perception InterventionsChapter 7Perception Interventions• Selective Awareness• Humor• Adopting Type B Behavior • Improving Self-Esteem• Developing an Internal Locus-of-Control• Anxiety Management• Establishing HardinessType A vs.Type B Behavior• Type B behavior is the opposite of Type A behavior– Take scale on p. 122• Type A behavior is associated with coronary heart disease• Characteristics of Type A behavior include– Excessive/external competitive drive– aggressiveness– impatient– sense of time urgency– free-floating, well-rationalized hostility– Verbal/non-verbal “hurrying”2Type B Behavior• People are less prone to cardiovascular disease• They– exhibit no free-floating hostility– exhibit no sense of time urgency– are not externally competitive– Assertive but not aggressive– Collaborative, not autocraticBehavior Modification• Behavior modification can help Type A people become more Type B– New behaviors can be learned– P.124• Define Type A behaviors that need changing• Establish weekly, realistic, attainable goals– define rewards for accomplishing Type B behaviors– ignore or establish punishments for unwanted Type A behaviorHardiness• Kobasa’s orginal research– Downsizing in Chicago• Three Characteristics– Commitment– Control– Challenge• Follow-up research- What is most important?3Stress, Hardiness and Illness0200400600800100012001400High Stress Low StressLow HardinessHigh HardinessIllness IndexData from Kobasa et al. (1982)Stress, Coherence, and llness0200400600800100012001400Low Hassles High HasslesLow SOCHigh SOCData from Bishop (1993)Illness ScoreLocus of Control• Do you believe that life is something “that happens to you” or vice versa (p.128 scale)– internal locus of control– external locus of control• With acceptance of control comes responsibility– Understanding successes and failures!4Choosing Positive Control• Seeing the positive (selective awareness)• Finding novel experiences (breaking out of routines of life)• Remembering the positive (gratitude)Selective Awareness• There is good and bad in any situation• Focus on the positive; deemphasize the negative• Take time to stop and smell the roses– enjoy the process of achieving goals– “experience” life - adopt less routine behaviors• Put life situations in proper perspectiveSeeking New Paths• Choosing (or Stumbling) upon new paths– Literally!– Life can be a rich experience if you put yourself in a position that richness is more likely to be found• What prevents us from being aware of life as we live it is often the routine of daily experience.5An Attitude of Gratitude• Learn to be grateful for what you have.– A nightly task for improving appreciation of life• 5 good things (can you think of 10?)Humor and Stress• Humor comes in many different forms• Initial physiologic changes include– increased muscular activity– increased respiratory activity– increased heart rate– increased production of catecholamines and endorphins• A relaxation state follows the initial physiologic changesLaughter and Immune FunctioningBennett MP, Zeller JM, Rosenberg L, McCann J. Altern Ther Health Med. 2003 Mar-Apr;9(2):38-45.6Humor and Stress ExperienceHumor and Stress• Psychological effects include– relief of anxiety, stress, and tension– an outlet for hostility and anger– an escape from reality– a means of tolerating crises, chronic illnesses, and disabilities• Inappropriately used humor can lead to distressBACK7Self-Esteem• Self-esteem can affect our ability to– respond assertively– establish intimate relationships– maintain a social support network– resolve conflicts – find success• Poor self-esteem is associated with– drug abuse– irresponsible sexual behavior– other “unhealthy” activitiesImproving Self-Esteem• Identify parts of yourself about which you want to feel better.• Accept those parts of yourself that cannot be changed.• Focus your efforts on changing what can be changed.– Determine what you can do to improve this part of yourself.– Do it now and stick with it.Anxiety Management• State vs. trait anxiety• Coping techniques for state anxiety– Environmental planning– Relabeling– Self-talk– Thought stopping– Systematic desensitization• fear hierarchy• progressive relaxation– Ellis’ ABCDE technique8Anxiety Management: ABCDE• What is the activating agent (Stressor)• What belief system is affected (rationality)• Consequences of unchecked action?• Dispute irrational beliefs– We must be loved and respected by everyone– We must be competent, adequate and achieving at all times– If things don’t go as I want it’s a catastrophe• Effect of challenged/changed