Here Comes Trouble

June 1, 2000
Are these three words what everyone mutters when they see you coming? The problem may be more than just a `bad hair day.` Stress management enables you to channel your emotions effectively. Who knows? People may actually be glad to see you again!

Are these three words what everyone mutters when they see you coming? The problem may be more than just a `bad hair day.` Stress management enables you to channel your emotions effectively. Who knows? People may actually be glad to see you again!

Tammy Carullo, RDH

What is stress? My belief of what stress means is, "The inability to effectively cope with life`s situations and place each into proper perspective." However, if you ask 50 other people for their definitions, the odds are good that you would receive 50 different answers, or at least variations on answers. The compelling question is: What causes our stress?

Many of us place blame for stress on our surroundings, other people, situations, or events. Rarely do we take a close enough look at our responses to these factors to really get a handle on the origin of our stress.

The cause of most stress is our response mechanism to the external factors in our lives. In layman`s terms, we create our own stress. The logical solution then must be that, if we create the problem, we should be able to resolve our own stress. Right? Wrong!

Health care ranks at the top of the list of stressful careers. And in dentistry, well, let`s just say that dentists are noted for being extremely high on the list for suicidal tendencies. We know the statistics, but we don`t know the reasons behind "why" they exist. While it may be true that we create the stress in our lives, we sometimes are too close to the situation to remain objective enough to solve our own problems. Real solutions are desperately needed. This is where stress management comes in to play.

There are many reasons why dentistry is one of the most stressful career choices. Let`s face it, dealing with the public and providing top-notch care to patients is extremely stressful. Increased stress levels can occur any time you are dealing with other people. Daily interactions among employers, employees, co-workers, patients, friends, and family are bound to produce situations that are stressful, to say the very least.

Stress has an amazingly negative affect on us, even under the very best of circumstances. The negative emotions stress produces can cause relationship conflicts, anger, frustration, worry, and even health complications.

Relationship conflicts and lack of effective communication skills can be anyone`s downfall. Couple that with the heavy responsibilities of treating patients, exposing ourselves to a wide variety of infectious diseases, worrying about potential malpractice lawsuits, licensing requirements, continuing education, bills, overhead, co-workers, kids, and spouses are enough to give anyone a migraine.

So how do we get rid of our stress? We don`t. Stress is a part of life and, unfortunately, it is not something that will just go away. So what is the answer? Stress management is a powerful tool that can be applied to all areas of your life by:

- Helping you make a positive change in your ability to perceive situations.

- Making a difference in your health and emotional well-being.

- Creating a happier, healthier environment at home and work.

In each of these areas, the ability to deal with stress allows you to create collaborative relationships which support growth and a positive response mechanism. Sound too good to be true? Well, in many cases it very well may be, but the alternative is a heart attack at the ripe old age of 42.

Learning to cope with life`s stressful situations is the only solution. The old saying, "You can count on two things, death and taxes," should have most certainly included stress. Although no one knows what the future of the 21st century holds, we can expect the situations and times to become more stressful, not less.

Stress management is both an art and a craft. It requires an approach and perspective that goes beyond traditional techniques and strategies. It also involves a set of learned skills which can be practiced, developed, and mastered to achieve ultimate success. Through coping strategies, we can learn to work through the stressful situations life throws our way. Stress management programs provide real solutions for real people. Books, such as the series Don?t Sweat the Small Stuff by Dr. Richard Carlson, are also a tremendous source of inspiration, putting stress into proper perspective.

How can you start decreasing your stress level right now? Learning how to be less reactive and more responsive is a great first step, along with taking responsibility for our reactions to situations.

A Oreactive mechanismO is one that breeds negativity. This response creates critical thinking, negative emotions, irrational behavior, and loss of perspective. It also lends itself to taking things too personally, never being willing to admit wrong-doing, and irrational thinking and behavior.

A Oresponsive mechanism,O on the other hand, exudes the positive. It creates relaxed, calm, optimistic attitudes; the ability to give others the benefit of the doubt; and the ability to treat people fairly and impartially. While being less reactive and more responsive will go a long way in getting you started on the road to a less stressful existence, it is only the tip of the iceberg.

Learning to OwinO against stress can be one of the most challenging tasks you will ever undertake, but it will also be the most rewarding. Stressful situations will always exist ? always. To think otherwise is ludicrous. But we can learn how to create situations that promote positive change, prevent conflicts, and expand our knowledge and ability to deal with unexpected stressful situations. There is life after stress!

Tammy Carullo, RDH, PC, PS, is CEO of Practice by Design, Inc., located in Lebanon, Pa. Carullo is also a continuing education lecturer. For more information, contact Carullo at (717) 867-5325, by fax at (717) 867-1473, or visit

Quick to anger?

The epitome of stressful emotions are anger and frustration. How do you rate your own hostility? Determining your anger response to given situations is one of the most concise methods of determining your true source of stress. Take a few moments to complete the following Anger IQ Test.

1 - As you prepare to leave for work, already running late, you accidentally spill coffee over your clothing. You hurry and change - out the door you go. You then find yourself behind a very slow-moving vehicle. How would you rate your level of anger or frustration?

(5) Boiling, almost at road-rage level.

(4) Angry, though able to maintain composure; but definitely in a bad mood.

(3) Irritated, but able to move past the negativity.

(2) Only slightly affected.

(1) Completely unaffected and calm.

2 - A situation arises at work where your behavior or abilities are called into question. How do you respond?

(5) Lose control and storm out.

(4) Become angry and defensive.

(3) Seethe internally, but maintain composure.

(2) Accept the criticism as a "part of life," and try to learn from it.

(1) Unaffected, apologize, and try to do better.

3 - You and a co-worker disagree and have words. How do you get past this?

(5) You don`t.

(4) Harbor resentment and talk badly about that per-

son to anyone who will listen.

(3) Initially upset, but apologies are exchanged in a few days - all ends well.

(2) Simply agree to disagree.

(1) You avoid voicing disagreements; you would rather avoid them altogether.

4 - A co-worker who has less seniority gets a pay raise and you haven`t seen one in more than a year. You respond how?

(5) March into the boss` office and demand a raise, issuing an ultimatum.

(4) Complain about the unfairness to everyone.

(3) You are annoyed, but you ask your employer why you were overlooked.

(2) Figure you`ll get one, too, without saying anything.

(1) Congratulate your co-worker without any thought about why you did not receive one.

5 - A personality clash exists at work. What do you do?

(5) Single the person in question out to the point of making him or her feel like an outsider.

(4) Make more of it than there is and talk about it to everyone.

(3) Accept that people are different and try to work past it.

(2) Try to make an extra effort to make the situation better.

(1) Figure things are better left alone.

6 - There is turmoil at home. You and your spouse fight constantly about bills, the kids, and anything else you can think of. During a particularly heated argument about who does more, you respond by...

(5) Shouting at the top of your lungs, so that the entire neighborhood can get a full grasp of what your argument is all about.

(4) Cast blame, because you don`t feel anyone could possibly do more than you. After all, the other person`s contributions are insignificant.

(3) Stop arguing, remain quiet, and do not outwardly react.

(2) Try to calmly discuss the matter, taking into consideration that all parties involved make an important contribution to the household.

(1) Apologize and admit you responded negatively to the household pressures ... then you kiss and make up.

7 - Someone you have been trying to talk to is trying your patience by ignoring you, causing you to repeat your request 15 times. How do you respond?

(5) You lose your temper, yelling, or becoming angry or frustrated at the other person for not listening to you.

(4) You hold a grudge and are unable to immediately move on.

(3) You retaliate at the next opportunity that arises.

(2) You are annoyed, but also understand that this behavior is a normal human characteristic.

(1) You accept that you cannot change others and try to be mindful in the future so as not to be discourteous to others.

8 - You have a fight with your spouse or significant other the night before, and you are in less than a good mood at work. But your co-workers are concerned and urge you to talk about it. What is your response?

(5) Blow like a volcano, telling them it`s none of their business.

(4) Begin to cry and take up the rest of the day talk ing about it.

(3) Refuse to discuss it, but you take your bad mood out on the rest of the world.

(2) Compose yourself, act professionally, and deal with the issue at home.

(1) Deny there is any shift in emotion.

9 - A situation arises at work where a co-worker`s integrity and honesty is questioned. How do you react?

(5) Jump on the office gossip bandwagon even if nobody really knows the truth.

(4) Draw battle lines and form sides.

(3) Oust the person in your mind, refusing to even speak to him or her.

(2) Try giving the benefit of the doubt, sometimes things are not always as they seem.

(1) Simply don`t get involved.

10 - You begin experiencing physical signs of being under stress. Upon further examination, you realize that your blood pressure is high, you have tension headaches daily, you begin having chest pains and shortness of breath. You would react how?

(5) Get angry and take it out on all of the things and people in your life who are creating your stress.

(4) Blame your job, spouse, bills for these ailments, yet do nothing to change.

(3) Ignore the symptoms; they`ll go away.

(2) Call your physician, realizing that they may be warning signs for something far more serious than stress. But you still put the appointment off for three weeks.

(1) Get the necessary medical attention immediately and follow up with making changes that promote a positive, happy, and healthy stress-free life.


Hot Fives = If most of your responses have the number five beside them, you, my friend, are a walking time bomb - ready and waiting to explode on the next unsuspecting victim. You are stressed to the max and need to seriously consider a healthier approach to channeling your anger. Think about possibly getting some professional help.

Simmering Fours = You are among the average. However, that does not mean that your anger and stress over situations in your life is not having a negative toll on you. Take heart now; recognize your warning signs that stress is getting out of hand. Get help if need be.

Sulking Threes = This is the middle ground, but it`s still shaky. If you responded primarily with the third option as your answer, you still have a great deal of unresolved tension, anger, and frustration - stress, in other words! You may be in need of some stress intervention.

Calm Twos = You are calm, cool, and collected. Truly the epitome of "don`t stress." You have learned the art of not stressing over the insignificant events of life. Keep doing what you are doing.

Placid Ones = Usually answers progress from worst-case scenario to best. But if you chose the "ones" as your primary responses, you may have a problem with being too detached from emotion, possibly reaching doormat status. Consider examining your response mechanism closer to see if you really have one.