Stress-busters for the conscientious hygienist working and living in a crazy world

Oct. 1, 1998
Not surprisingly, everyone doesn`t react to stress in the same way. While stress drives some of us nuts, other people seem to thrive on it. Performing jobs that would literally destroy some of us - air traffic controller, for example - actually exhilarate others.

Frances Dean Wolfe

Not surprisingly, everyone doesn`t react to stress in the same way. While stress drives some of us nuts, other people seem to thrive on it. Performing jobs that would literally destroy some of us - air traffic controller, for example - actually exhilarate others.

Suzanne Ouellette, a psychologist with New York City University says, "Some people have a feeling of being challenged and committed. They like the sense of being in control." She labels this "hardiness of attitude."

According to Hewitt Associates, a Lincolnshire, Ill., consulting firm, very few companies provided stress training for employees even as recently as a decade ago. Today, most Fortune 500 companies provide some form of stress management.

"Companies are now realizing that teaching employees how to deal with stress is just as important as teaching them technical skills," says Paul Sugar, president of the Scottsdale Institute for Health & Medicine. "It`s important," he continues, "for productivity and for the health of workers."

According to the American Medical Association, up to 70 percent of all patients treated by general-practice physicians present with symptoms directly related to unrelieved stress. Stress also is among the top 10 reasons Americans miss work, according to the Occupational Safety and Health Administration.

The American Institute of Stress, based in Yonkers, N.Y., estimates that companies lose $300 billion annually to stress, including medical expenses, health insurance premiums, absenteeism, lower productivity, and rising litigation.

What causes stress?

The classic definition of stress is a force acting on a system that changes the form of that system. Our bodies constantly strive to maintain a state of equilibrium. Social and psychological forces can be considered "stressors" when they affect a person`s natural equilibrium. When we sense an impending crisis, we automatically accelerate our thinking and actions to conquer the situation - a true survival strategy for many hygienists! For example, your 9 a.m. patient (a friend of the doctor`s wife and member of the same country club) breezes in 20 minutes late, which puts you behind in your already tightly booked morning-appointment schedule. You have to work through most of your lunch hour to catch up.

When we feel stressed, the body revs up for the "flight or fight" response. The autonomic nervous system signals the adrenal glands to dump an extra dose of stress hormones (primarily adrenaline and cortisol) into the bloodstream. The heart races and the blood pressure rises. The strain of blood flowing through constricted blood vessels injures the arterial walls, making them more susceptible to blood clots and arterial-plaque buildup.

Under stress, the body actually borrows energy from its reserves. The muscles of the intestine constrict, interfering with normal digestion, which can lead to stomach problems. Excess hormones (especially cortisol) slow metabolism, increasing fat and cholesterol levels in the blood. Cortisol diverts energy from the immune system, leaving the body susceptible to many diseases, including cancer.

This is a natural built-in feature of human beings. What is unnatural, however, is staying in this state for hours, days, and weeks on end! It leads to many physical ills, such as chronic exhaustion, immune-system weakness, gastrointestinal distress, heart attack, hypertension, poor eating habits, and migraine headaches. It also leads to psychological ills, such as depression, career burnout, and the feeling of loss of control over one`s life.

As strange as it may seem, some people actually are addicted to stress. Call it a constant need for a rush. For stress addicts, living from one crisis to the next can all too often feel "natural." You probably know someone who`s a stress-a-holic. In the office, this may be the dentist, the front-office manager, or a chairside assistant. This person constantly puts out the proverbial fires; there`s never enough time to do something right, but always time to do things over. The stress-a-holic always takes on more than is manageable. Classic high achievers with Type A harried personalities or martyr complexes are prime candidates for stress addiction, as well as perfectionists and chronic worriers.

One hygienist`s insight

A veteran hygienist named Janice shared the following with me: "When the stress of working in the inner city became too much - and after I saw what it was doing to my health and my family life - I stopped working. My husband was an overworked pastor, and we had a growing family. All of us were stressed and dysfunctional, and family communication was shutting down.

"I took inventory of my life and saw the great toll my work was taking. I brought a lot of my work baggage and pressures of the office home with me.

"Now, when the going gets tough and I feel stress coming on, I close my eyes, concentrate on an imagined object, and take lots of deep breaths, listening to the air as I inhale and exhale. I also play the piano, take walks in the woods, and let nature surround me. Listening to classical CDs and leafing through art books also helps me relax.

"Now that I`m a widow and my children have left home, I view every day as a very precious gift. I`m enrolled in graduate school and actually have gone back to hygiene, temping occasionally to pay the bills and keep my hand in the profession. I`m glad I`ve gone back to something I originally had undertaken more than 30 years ago, because I enjoy helping people and I love making their smiles even brighter."

Start your stress-reduction plan

The first step in reducing stress is to realize that we can control some causes of stress but not others. It helps to start by visualizing the anticipated outcome. For example, the desired end result may be: "To feel more relaxed and have more time for my family or myself."

Next, determine what new activities or changes in behavior you are committed to taking on to achieve the desired result. Review your calendar and determine a starting date. Then list the lasting benefit(s).

One hygienist named Margaret had a class reunion coming up. She was excited about the prospect of seeing old friends and getting caught up on their lives. At the same time, she began to feel stressed and her energy was depleted. She knew that part of this stress was related to her job. Another cause was the lack of help with chores around the house. A third cause was that she had gained weight during her last pregnancy and had not lost it.

One of the things Margaret realized was that, realistically, she could not make changes overnight. She also realized that she needed to enlist the help of her family and that she needed a "buddy" committed to helping her exercise more regularly. She called a family meeting. Together, she and the children developed a family contract of specific chores that had to be done and the expected rewards for finishing the chores. Jobs none of the children wanted to do (for example, taking out the garbage) were assigned on a rotating basis, so everyone had to do them occasionally.

Margaret called her best friend, Janet, and asked if she would agree to start an exercise program with her. Janet was delighted, saying she had been looking for someone to motivate her, too. Margaret and Janet agreed to walk two miles together three evenings a week and to be a source of support for each other.

Margaret reached her desired outcome. While her house is not exactly in Better Homes and Gardens order, she has gained the help of her family in performing routine chores. She has also lost 18 pounds and elevated her sense of confidence and self-esteem. She eagerly is awaiting her class reunion.

Remarkably, while stress factors into her working day, Margaret claims she has learned how to better manage it. She has also learned to not worry about things that she cannot control.

A worksheet titled, "My personal stress-reduction action plan" appears with this article. You can use it to record your game plan for reducing your daily stress levels. If you have unique stress-busters you`d like to share with RDH readers, please submit them in care of the editor.

Frances Dean Wolfe is the pen name of a dental editor.


- Dr. Charles Daschback, Director of Medical Education, St. Joseph`s Hospital and Medical Center, Phoenix, AZ.

- SOMATICS, Spring 1998.

- Stress: An Overview; the Internet.

- "Stressed workers filling doctors` waiting rooms." The Arizona Republic, August 4, 1996.

- The HOPE Heart Institute.

How hygienists relieve stress

T`ai Chi aside, we polled a number of hygienists for their stress-busting remedies. Here are the results of this unscientific survey. Perhaps you can add to the list.

- Line dancing

- Reading romance novels

- Renting a video

- Going for long walks

- Singing as loudly as you can - in the shower, around the house, or in your car

- Cooking and trying out new gourmet recipes

- Doing creative things, such as painting and sculpting

- Practicing meditation/yoga

- Writing in a journal

- Shopping for yourself

- Dinner, wine, and a movie with your sweetie

- Horseback-riding

- Having a professional massage twice a month

More tips to combat stress

The following tips on ways that you can reduce stress in your life are adapted from the HOPW Institute:

- Get organized! Put things back where they belong to save time looking for misplaced items. Give yourself extra time to complete a task before rushing on to the next priority. Do one thing at a time.

- Live in the present. Stress often occurs when we become too wrapped up in ourselves. Small, everyday occurrences have a way of getting blown up into earth-shattering events. Hint: Next time you find yourself feeling stressed, look outside of yourself and help out someone else. Getting involved in helping the other person helps many problems and stressors disappear.

- Laugh! You can resolve a problem when you find humor in it!

- Give others the freedom to do "their own thing(s)." Remember, especially as a "Super Mom," that you are not the general manager of the universe. Relax! Things don`t always have to be done your way. Take a moment to celebrate different people and their unique styles.

- Monitor your self-talk. The negative messages you tell yourself create stress. The next time your mind starts running away with negative messages, stop! Start thinking positively!

- Take care of yourself. To help cope with the everyday crazies, remember the advice your mother may have given you: Eat right, exercise, and get sufficient sleep.

T`ai Chi helps relieve stress

The ancient Chinese exercise system of T`ai Chi - actually called T`ai Chi Ch`uan - is becoming an increasingly popular method of stress reduction for many professional women. Those who practice it feel that T`ai Chi maintains and enhances health by giving full expression to the life force (or chi) of the universe that is embodied in everyone. This 20- to 30-minute daily routine involves a series of choreographed, slow-motion movements, performed in a relaxed, flowing manner. The exercises are done to deepen breathing and stimulate circulation. T`ai Chi encompasses silent meditation, energizing exercise, a joyful dance, and a precise system of self-defense (also especially great for women)!

Three features characterize the movement of T`ai Chi form:

- breathing deeply

- sinking the weight, and

- moving in a circular fashion.

The roots of T`ai Chi go back to the Taoist monks of ancient China (fifth century, BC). During that time, physicians were compensated for keeping their patients well; when patients become ill, compensation ceased. The Taoist model of health envisions the human being as a vessel and a power station that conducts universal energy.

Breathing deeply is neither a forceful nor a conscious effort. With a relaxed diaphragm, the internal organs receive a soft massage, rather than the strain that heavy breathing or panting provokes. T`ai Chi followers believe a relaxed body is better able to circulate blood.

The practice of sinking the weight improves the body`s balance and stability. By loosening tension and relaxing the muscles toward the extremities, the muscles of the chest, shoulders, and arms feel lightened. When the weight is sunk, the upper body feels buoyant; the lower body is grounded.

Moving in a circular fashion keeps a reserve of energy to maintain balance. The circular motion is apparent in the follower`s posture. The spine acts as the axis - always straight, turning with the rotation of the waist. The head is held as if it is suspended from above to maintain uprightness and prevent collapse of the spine. The image is one of holding a large soap bubble so carefully that it neither escapes nor breaks.

To learn more about T`ai Chi or to locate a class, consult the Yellow Pages of your phone book under "Exercise classes" or call your local YWCA.