90:10 The Single Most Important Thing You Can Do For Your Stress

I’m doctor make events welcome to this
visual lecture answering the question what is the single most important thing
we can do to manage your stress a few years ago we moved her family to
France for three months was a time the European Cup football championships and
So we would take our kids to a local bar to watch the game on TV watching the moods of people from
different countries swing from pure joy to total anxiety
to despair and back again was as entertaining as the game itself
and I wondered if there is any scientific analysis so how this can a stress
affects people it turns out there has been a study in
the quarterfinal the 1996 championship between the French and Dutch teams a draw at the end of overtime resulted
in a sudden death penalty shoot out which is won by the French when researchers
look back to see if there were health changes on that day it turned out there was a relative
increase in the risk of death from a heart attack by about 50 percent among the Dutch men on the
day and the match compared with the five days on either side in the match there is no such effect on French men or
woman from either country for that matter so this
story striking because it it’s about one event end and really one negative health
outcomes stress but in reality stress is very
complex multiple factors multiple outcomes
physiologists sees stress increase blood Heart rate or changes in the chemicals
that modulate the immune system pressure the social worker sees vulnerability
with the compromised social networks coping and problem solving skills the doctor sees increase visits
estimated that up to 70 percent a primary care visits are stress-related worse health outcomes bad self treatment
with alcohol and drugs gateways to depression and anxiety and
of course the worst quality of life these perspectives represent the
standard negative picture stress but I believe we also see a positive side
distress athletes were able to find a stress level that is high but but not too high for optimum performance
executives are mothers or aid workers who manage stress like a bicycle
tire they regulate enough pressure to keep
rolling but not too much so that if they hit a bump they explode And to me this is really the most
interesting question when we look at stress and health under some people
undergoing intense stress remain healthy and even thrive in and what makes them
stress resistant well I think the answer it big include factors like how
much control people feel they have in their lives their social network and I mean that the
old sense of the word openness to change attitudes like
optimism self-care skills such as exercising and and humor and so on research on mental
health shows that we are sort of a bento box more
severe mental health issues in trying to figure out what works and
what doesn’t which is great but we’ve done much less research and most common
problem stress and when it is steady its usually in
the context of other diseases so based on a current literature my pick
for the single most effective treatment for managing stress is actually kind of a simple one change your
thinking style most people think stress is something
that happens to us like a piece a steel on a bridge that is constantly being
stressed and then eventually stretched this is a physical model but it’s it’s
actually not a human model that differences is stressed passes
through a two-pound piece a tissue on the top your face called your brain so we see things like my job is
stressful or my friend Sylvia is stressing me out but in fact we create the stress in our
brains your work or Sylvia isn’t stressful
what you’re thinking that brings a stress your brain is is a volume dial that can turn to stress
out but I think you can also track people think
we’re born a certain attitudes and and i think is down but the truth is stress
management is a skill that can be Learned doctor Mat Gulliksson and his
colleagues and hoops Sweden published a trial in 2011 in the
Annals of Internal Medicine falling over 400 people loosely woman
that had significant her heart events such as her attacker or bypass surgery half the group received usual care and
the other half got usual care plus cognitive behavioral therapy or CBT CBT has become an umbrella term where you learn practical techniques
such as problem solving relaxation and and challenging common thinking trapped
so for example a negative filters so if five people say
great job and one says nothing and you think you blew it
fortune-telling I’m not going to that job interview that
just reject me mind reading a friend walks by without noticing any
you assume he dislikes you now polarizing are black and white thinking
I feel might die if I bite into that piece a cake now I might as well eat the whole thing
and so on the thought record is then used to
reframe your automatic thinking and a more healthy thinking as the American psychologist William
James said over 100 years ago the greatest weapon against stress is
our ability to choose one thought over another so the researchers want to
see people could use these techniques to reduce the daily experiences stress time urgency and hostility in this so
could that lead to better outcomes so so not a drug not a diet not a stent just changing the way you think the
participants were followed for over seven years those that got the CBT had a forty-one
percent reduction heart attacks and at 28 percent lower death rate the more CBT session a person attended the
better they did now another way to change your thinking
style in order to reduce stress is through the use of mindfulness
techniques mindful used to be more through it I
will call the king by crowd but the programs have actually become much
more mainstream in fact my patient have Heart attacks and chronic diseases now
often taken mine from this course part their treatment and there’s a growing evidence about its
effectiveness a recent trial following clinically depressed patients by doctor
Zindel Segel College University of Toronto is a good example when the patient experience remission
they were randomized to an antidepressant or placebo or mindfulness-based
cognitive therapy the results show that mindfulness was
as protective against relapses medications my sense is that the success from mindfulness
is probably due to the fact that combines many useful techniques for
stress reduction such as increased self-awareness
involving a physical component like breathing or muscle relaxation meditation and perhaps most important in our busy
world an emphasis on letting go of distractions in being in the moment mindfulness can give us ability to let go
of worry and not get trapped in the anxious leaped perhaps less about changing the thought
and in really more about choosing where to place your attention as a famous Austrian psychiatrist Victor Frankel
pointed out between stimulus and response there’s a space and I think mindfulness
teaches us awareness so that space in and that we have the power choice so
another factor that the research tells us that impacts your thinking
style is your attitude your outlook on life doctors Suzanne Kobasa
and her colleagues from the University Chicago look at this by following a
natural experiment in the nineteen eighties break up of the Ma Bell
Telephone Company the followed who coped well and who didn’t
and identified three key trait of those who coped well the first motion was commitment the
stress resistant executives were committed a different aspects of their
lives so even while facing uncertainty they
stay committed to quality work in engaging with family and friends their
communities there faith hobbies they saw and I think we’re committed to the
bigger picture success and this allowed them to weather the
turbulence in in a specific area of their lives the second motion was control this is
interesting in that because its restructuring these
executives actually had little control in fact you might see their skill
fighting stress is more about being a let go of control they could see that the sands were shifting
and if they were too rigid in their control over territory or department the
main actually lose a bigger opportunity or even their job other psychological
research is focused on locus of control or self efficacy which is really the extent to which
individuals believe they can control events effected and their competence or or ability to
make change the executives may have understood that
a lot what was happening was out of their control but they could adapt in and I think you can choose and feel
confident about what they could control the third notion was change the stress
resistant execs were able to limit their self-importance and and see the change
happening around them as a potential stepping-stone not a stumbling block so as we come to the end of our story about
what reduces stress might be helpful to know that the
research has shown that simply rating 0 distressed story to make a big difference the act of
giving coherence in and I think reading your own personal
narrative too stressful event in a letter can be an effective way of negating the
stresses those events the classic therapeutic letter writing exercise is writing
a letter to somebody who stresses you out and then not posting it finally like to leave you with this
advice to improve your thinking style think basics when I play tennis and
things are going badly which is often the case I forget about
everything else to say move your feet watch the ball that it when things are stressful sometimes you
need to keep it simple save yourself I will keep a regular sleep routine I
will avoiding crap I will walk will mingle and and I think
there’s some early evidence for altruism we’re doing good as Abe Lincoln said when I do good I feel good when I do bad
I feel bad and that is my religion and I’m often
reminded about the power simplicity from a a lesson one of my patients taught me I
did deliver bad news to him and when I did he kind of shrugged his shoulders
and said I’ll be ok I followed the 90/10 rule 10 percent of how
we do in life is based on what happens to us and and ninety percent is how we
respond I think the same may be true stress to
take a deep breath think about your big picture commitment
your sense of control Your openness to change consider doing some
homework on yourself refrain rethinking redirect your attention maybe read a
letter repeatedly the evidence shows that people manage their stress well they’re better health outcomes for
virtually any disease a may suffer from and remember the challenges will always
be out there that’s life but remember too that your thoughts and your
added to our the key holders for the stress you experience not the traffic not your boss not your
job not you neighbour but you something you can improve your
thinking hope this helps thanks for listening just just

About the author


  1. I’ve watched this so many times and it always helps me to reframe things. I’ve shared it with many friends too, thank you

  2. This was great! For those with a neurotypical baseline. I just have to add, 90:10 works if that is really how the system is set up for you, if you have certain existing privileges on this earth and are not being systemically undermined or projected upon by OTHER people's inability to inhabit or deal with their stress. Dissociation and projection, or dispossession and transference of feeling, is known in the psychological community and for those often of marginalized or silenced otherness, in daily life. Additionally, I would advocate that some people are naturally rationally minded and CBT is an effective technique. Others are more somatically or kinesthetically sensitive, traits that are not typical tested for in young children in preference for the types of intelligence that succeed in cognitive culture. So to change our thinking towards coherence, we all can benefit from techniques to guide us towards our other brain — no, not that one 🙂 — in terms of being guided by the heart. Choose coherence! I love it. The HeartMath folks are good at coaching this. Thanks again for this fun and guiding video.

  3. This video was recommended to me by a friend, and I found it very useful. I'll be reviewing it carefully and following the advice. Thanks for sharing your knowledge and providing support regarding a very difficult issue.

  4. Thank you for posting this video. I find that being mindful has really helped me to change my negative thinking into something more positive and that seems to lower my stress and anxiety

  5. I think choices are stressful. We all know a shit job, but we have no choice but to accept it or move on. There is no solution.

  6. what an awesome video! I love the simple illustrations too. It's awesome to find a resource which communicates this in such a straightforward, accessible manner. Thanks 🙂

  7. I didn't think there was a back pain cure until I tried an acupressure mat.. These Chinese kniow what it's all about and how to treat pain..

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