Show Notes for Podcast Five of Sex & Why
Host: Jeannette Wolfe
Guest Host: Justin Morgenstern
Topic: Stress Response – Part 3
Tricks for optimizing performance under stress
Preloading
- Over train and begin to focus on how to recover from mistakes
- Invest in mindfulness
- Meditate
- Increases your awareness of your own physiological stress response
- Can help you train to go back and forth from narrow to broad focus
- Be Awed
- Have gratitude for what is going right
- Use a transition mantra as you walk into work and move from your personal to your professional life
- Appreciate the power of emotional contagion
- Your mood influences your team’s performance
- Acknowledge and celebrate team’s saves and successes
- Create safe communities in which you can talk and walk through difficult cases without shame or judgement
- Meditate
- Maximize environmental advantages
- Have the right equipment and know where it is
In the moment
- When you are becoming aware of stress- acknowledge its presence and recognize that you can face it as a threat or a challenge and then deliberately and emphatically choose challenge
- Chunk down overwhelming situations into immediate next actions, when in doubt go to the head of the bed and check oxygen connections and monitor leads
- Access mental crutches- simple pneumonics, resource cards, or a favorite app to jumpstart your thinking until your frontal lobe comes back on line
- Consider cognitive reframing and brief emotional detachment
- Keep a talisman in your pocket- use for either spiritual strength or physical distraction
- Use Mike Lauria’s pneumonic BTSF (Beat The Stress Fool)
- Breath
- Tactical breathing and controlling the breath
- Talk
- Positive self-talk
- See
- Visualize successful completion of the task
- Focus
- Use a trigger word
- Tips for breathing
- Consciously slow your exhalation
- Belly breath in which your abdomen expands with inhalation
- Armor for negative thoughts
- Thank your brain for trying to keep you safe
- “Thank you brain for trying to watch my back, but I’ve got this”
- Recognize your thoughts as being “just thoughts”
- Change “I can’t do this” to “I’m having a thought that I can’t do this and fortunately most of my thoughts don’t equate actual reality”
- Identify and label your patterns
- “oh yay, I do this sometimes when I get stuck, but I can choose to do X, Y or Z instead” (repeating if needed.)
- Internally shout at yourself (to snap out of an internal loop) and then remind yourself that you are trained and capable
- Repeat a repetitive negative thought in a strange accent
- Sing a repetitive negative thought
- Refer to yourself as a third person
- Touch something in front of you and describe its shape/temperature and texture
- Acknowledge that you are stressed but decide to just do it anyways
- Thank your brain for trying to keep you safe
- Tricks for focus words
- Consider single word describing next critical action (“drape”, “needle”)
- After the stressful event
- Anticipate parasympathetic backlash
- Consider cognitive offloading
- Have a check list
- Use time outs
- Creates a shared mental model of critical actions
- Allows for information exchange
- Reinforces value of team
- Appreciate that cortisol spiking may subtly shift your tolerance for risk and could potentially impact clinical decision making
- Take a break
- Eat and drink something (preferably without caffeine)
- Emotionally recharge
- After the shift
- Work Out
- Play Tetras- (this was a new one for me and I’ve attached a reference below)
- Breath
Selected Resources
Meditation App- Insight Timer
Justin Morgenstern’s Performance Under Pressure blog: https://first10em.com/2017/03/13/performance-under-pressure/
Adrian Plunkett’s SMACC talk https://www.smacc.net.au/2017/02/learning-from-excellence/
Recent Tetra study: Horsch A, et al: Reducing intrusive traumatic memories after emergency caesarean section: A proof-of-principle randomized controlled study. Behaviour Research and Therapy, 2017 https://doi.org/10.1016/j.brat.2017.03.018
Lauria, M. J., Gallo, I. A., Rush, S., Brooks, J., Spiegel, R., & Weingart, S. D. (2017). Psychological Skills to Improve Emergency Care Providers’ Performance Under Stress. Annals of Emergency Medicine. https://doi.org/10.1016/j.annemergmed.2017.03.018
Parkin, B. L., Warriner, K., & Walsh, V. (2017). Gunslingers, poker players, and chickens1 :Decision making under physical performance pressure in elite athletes. Progress in Brain Research (1st ed., Vol. 234). Elsevier B.V. https://doi.org/10.1016/bs.pbr.2017.08.001
Markway B, Stop Fighting your Negative Thoughts, Psychology Today May 7 2013 https://www.psychologytoday.com/blog/shyness-is-nice/201305/stop-fighting-your-negative-thoughts