Government Training Programme

1. ”Learn how to combine ancient wisdom with a scientific,
practical, individualized approach to be healthy and happy – and
achieve true wellness.”

2. Stress Management & Relaxation Training
(SMART) Program
with
Health Preservation, Personality Development & Anti-aging
By,
Dr. Shahzad Anwar Tirmzi
INSTITUTE OF STRESS MANAGEMENT &
PERSONALITY DEVELOPMENT
16 AWAISIA SOCIETY COLLEGE ROAD TOWNSHIP, LAHORE
Ph: 0345 8477000 0423 5184139
E-mail: ismpd.pk@gmail.com
www.ismpd.com

3. Presentation Outline
Part 1 - General Awareness
Part 2 - Stress at Work
Part 3 – Coping Strategies

4. Part 4 – Relaxation Techniques
Part 5 – Health Preservation & Anti- aging
Part 6 – Acupressure, Reflexology, Yoga

5. Objectives of the Program
• Understanding Stress
• Coping Strategies
• Relaxation Techniques
• Self awareness – Confidence
• Behavior – Choice and Decision
• Positive thinking - Values
• Spirituality – Beyond Human

6. Part 1
General Awareness

7. A
Challenge
Please write one sentence
Definition of
S T R E S S.

8. WHAT IS STRESS ?
• Stress is anything that causes mental,
physical, emotional, or spiritual tension.
• Stress is the “wear and tear” our minds and
bodies experience as we attempt to cope
with our continually changing environment.
I HATE YOU

9. WHAT IS STRESS ?
• Simply put, stress is any outside force or event
that has an effect on our body or mind.
Stress is life.
It arises when we worry that we can’t cope.
HELP ME!

10. S = P > RStress occurs when the pressure is greater than the resource

11. ‘Stress is a socially acceptable
form of mental illness’

12. TYPES OF STRESS

13. NOT ALL THE STRESS,
WE EXPERIENCE IS
NEGATIVE

14. EUSTRESS
Eustress or positive stress occurs when the
level of stress is high enough to motivate you
to move into action to get things accomplished.

15. DISTRESS
Distress or negative stress occurs when the
level of stress is either too high or too low and
your body and/or mind begin to respond
negatively to the stressors.

16. The Stress Response

18. The Stress Response
19301930’’ss
Dr. Hans SelyeDr. Hans Selye Dr. Walter CannonDr. Walter Cannon
‘‘Fight or Flight ResponseFight or Flight Response’’

19. Endocrine System
Stress response is controlled by the Endocrine
System.
Sympathetic
Parasympathetic

20. • Increased or excessive demands on the
physical or mental systems of the body
result in increased sympathetic activity and
hormone secretion (Adrenaline,
Testosterone)

21. SYMPTOMS OF STRESS
• Physical symptoms
• Mental symptoms
• Behavioural symptoms
• Emotional symptoms

22. When you are stressed, it may result in
any or all of the following:
• Decrease in communication.
• Decrease in motivation.
• Decrease in performance.
• Learned helplessness.

23. • According to Wikipedia, “learned
helplessness is a psychological condition in
which a person feels that he/she has no
control over his/her situation and that
whatever he/she does is futile.
• As a result, he/she will stay passive when
the situation is unpleasant or harmful.”

24. STRESS RELATED ILLNESSES
Stress is not the same as ill-health, but has
been related to such illnesses as;
• Cardiovascular diseases
• Immune system diseases
• Asthma
• Diabetes

25. • Modern medical science
proves that more than 95%
of diseases result from
chronic stress.

26. COSTS OF STRESS
• In the UK, 40 million working days per
year are lost directly from stress - related
illness.
Costs in absenteeism to British economy are
estimated at £ 4.5 billion pounds per year.

27. Part 2
Stress at Work

28. WHY DO WE WORK ?
Work provides an income and fulfils a
variety of other needs; - mental and
physical exercise, social contact, a feeling
of self-worth and competence.

29. Stress is an integral and
inevitable feature of
most contemporary
workplaces

30. Workplace stress arises when individuals
perceive an imbalance between the
pressures and demands made on them
and the resources they have to cope with
these demands

31. Job Stress Statistics
Reports & Surveys

32. The NIOSH Report (1992)
• 40% of workers reported their job was very
or extremely stressful;
• 25% view their jobs as the number one
stressor in their lives;
• Three fourths of employees believe that
workers have more on-the-job stress than a
generation ago;
• 29% of workers felt quite a bit or extremely
stressed at work;

33. • 26 percent of workers said they were "often
or very often burned out or stressed by their
work".
• Job stress is more strongly associated with
health complaints than financial or family
problems.

34. "Attitudes In The American
Workplace VIII“ (2013)
• 80% of workers feel stress on the job,
nearly half say they need help in learning
how to manage stress and 42% say their
coworkers need such help;
• 14% of respondents had felt like striking a
coworker in the past year, but didn't;

35. • 25% have felt like screaming or shouting
because of job stress, 10% are concerned
about an individual at work they fear could
become violent;
• 9% are aware of an assault or violent act in
their workplace and 18% had experienced
some sort of threat or verbal intimidation in
the past year.

36. FACTORS INFLUENCING
WORK STRESS

37. FACTORS INFLUENCING
WORK STRESS
• The drive for success
• Changing work
patterns
• Working conditions
• Overwork
• Under-work
• Uncertainty
• Conflict
• Responsibility
• Relationships at work
• Change at work

38. Healthy Work
Managing Stress in the Workplace
“ Creating a healthy and safe workplace
requires employers and employees to
work systematically together to identify
hazards and manage them”

39. Part 3
Coping Strategies

40. RECOGNISE THE PROBLEM
The most important point is to recognise the
source of the negative stress.
This is not an admission of weakness or
inability to cope!
It is a way to identify the problem and plan
measures to overcome it.

41. STRESS CONTROL
A B C STRATEGY

42. ABC STRATEGY
A = AWARENESS
What causes you stress?
How do you react?

43. ABC STRATEGY
B = BALANCE
• There is a fine line between
positive & negative stress
• How much can you cope with
before it becomes negative ?

44. ABC STRATEGY
C = CONTROL
What can you do to help yourself combat the
negative effects of stress ?

45. Coping Strategies
• Change your thinking
• Change your behaviour
• Change your lifestyle

46. Change your Thinking
• Re-framing
• Positive thinking

47. Re-framing
• Re-framing is a technique to change the
way you look at things in order to feel
better about them. There are many ways to
interpret the same situation so pick the one
you like.
• Re-framing does not change the external
reality, but helps you view things in a
different light and less stressfully.

48. Positive Thinking
Forget powerlessness, dejection, despair &
failure.
Stress leaves us vulnerable to negative
suggestion so focus on positives;
• Focus on your strengths
• Learn from the stress you are under
• Look for opportunities
• Seek out the positive - make a change.

49. Positive Thinking: Values
• I Can
• Progressive
• Positive
• Optimistic
• Constructive
• Helpful
• Do more than paid for

50. Change your Behaviour
• Be assertive
• Get organised
• Ventilation
• Humour
• Diversion and distraction

51. Be Assertive
Assertiveness helps to manage stressful
situations and will in time, help to reduce
their frequency.
Lack of assertiveness often shows low self -
esteem and low self - confidence.
The key to assertiveness is verbal and non -
verbal communication. Extending our range
of communication skills will improve your
assertiveness.

52. Being Assertive
Being assertive involves standing up for
your personal rights and expressing your
thoughts, feelings and beliefs directly,
honestly and spontaneously in ways that
don’t infringe the rights of others.

53. Assertive Skills
• Establish good eye contact / don’t stare
• Stand or sit comfortably - don’t fidget
• Talk in a firm, steady voice
• Use body language
• ‘I think’ / ‘I feel’
• ‘What do you think?’ ‘How do you feel ?’
• Concise and to the point

54. Get Organised
• Poor organisation is one of the most common
causes of stress.
• Structured approaches offer security against ‘out
of the blue’ problems.
• Prioritising objectives, duties and activities makes
them manageable and achievable.
• Don’t overload your mind.
• Organisation will help avoid personal and
professional chaos.

55. Time Management
• Managing your time well,
makes you successful.

56. Time Management
• Make a list
What MUST be done
What SHOULD be done
What would you LIKE to do
• Cut out time wasting
• Learn to drop unimportant activities
• Say no or delegate

57. Time Management Quadrant
1 Urgent
Important
2 Not Urgent
Important
3 Urgent
Not Important
4 Not Urgent
Not Important

58. • Plan your day
• Set achievable goals
• Don’t waste time making excuses for not
doing something

59. Ventilation
‘A problem shared is a problem halved’
• Develop a support network through friends
or colleagues to talk with. It’s not always
events that are stressful but how we
perceive them.
• Writing a diary or notes may help release
feelings but do not re-read what has been
written immediately.

60. Humour
• Good stress - reducer
• Applies at home and work
• Relieves muscular tension
• Improves breathing
• Pumps endorphins into the bloodstream -
the body’s anti-depressants and natural
painkillers

61. Diversion and Distraction
• Take time out
• Get away from things that bother you
• Reduce stress level
• Calm down
• Think logically

62. Change Your Lifestyle
• Smoking & Alcohol
• Exercise
• Sleep
• Eat healthy foods
• Leisure
• Relaxation

63. Part 4
RELAXATION
TECHNIQUES

64. What is Relaxation?
• Relaxation is the act of
relaxing the mind and body,
and can also be defined as the
state of being relaxed.

65. • Exercise
• Sleep
• Leisure
• Deep Breathing
• Meditation
• Qi Gong
• Progressive Muscle Relaxation
• Stretching
• Detoxification
• Fasting
• Spirituality

66. EXERCISE
• Exercise daily for 30 – 45 min.

67. Benefits of Exercise
• Uses up excess energy released by the
‘Fight or Flight’ reaction.
• Improves blood circulation
• Lowers blood pressure
• Clears the mind of worrying thoughts
• Improves self image
• Makes you feel better about yourself
• Increases social contact

68. Sleep
• Good stress reducer
• Difficult to cope when tired
• Wake refreshed after night’s sleep
• Plenty of daytime energy

69. Leisure
• Interest
• Gives you a ‘break’ from stresses
• Provides outlet for relief
• Provides social contact

70. Deep Breathing
&
Meditation

71. • The essence of meditation is to quiet your
thoughts by focusing completely on just
one thing.
• Unlike hypnosis, which is more of a
passive experience, meditation is an active
process which seeks to exclude outside
thoughts by concentrating all mental
faculties on the subject of meditation.
• Keep your body relaxed. It should be in a
position that you can comfortably sustain
for a period of time (20 - 30 minutes is
ideal).

72. • Focus your attention on your breathing.
• Concentrate on breaths in and out. Count your
breaths using the numbers 0 to 9.
• Visualize images of the numbers changing with
each breath.
• Alternatively, visualize health and relaxation
flowing into your body when you inhale, and stress
or pain flowing out when you exhale.

73. Some people like to focus on
sounds.

74. Create a mental image of a pleasant
and relaxing place in your mind. Involve
all your senses in the imagery: see the
place, hear the sounds, smell the
aromas, feel the temperature and the
movement of the wind. Enjoy the
location in your mind.

75. Qi Gong
• As part of Traditional Chinese Medicine (TCM) being practiced for the last 5000 years for
health preservation.

76. • Breath out deeply and slowly. First feel your
belly contract in towards your spine, then feel
the air move through the chest, up the neck,
and through your mouth.
• Now breath in slowly.
• Focus on the air moving in your nose, down
your neck into your chest and feel your belly
push out. Hold your breath for a few seconds.
• Hold the breath as long as comfortable.
• Visualize stress leaving your body while
breathing out.

77. Progressive Muscle
Relaxation
• While sitting or lying down, tense the muscles
of your feet (curling your toes) as hard as you
can.
• Then relax them.
• Do this once or twice for each part of the body
• Continue this process for each muscle group
all the way up your body until you reach your
head.
• When finished remain relaxed for a few
minutes

78. Stretching
• Several stretches can be done at your desk
• Tilt head to the left and hold
• Tilt head to right and hold
• Reach arms over the head
and interlace fingers

82. Get a Massage from yourself or
from a professional
Self-Massage
• Sit with your shoulders relaxed
• Use your right hand to massage you left
shoulder and neck, working your way up to the
scalp
• Repeat with left hand for right shoulder

83. Benefits of Relaxation
• Lowers blood pressure
• Combats fatigue
• Promotes sleep
• Reduces pain
• Eases muscle tension
• Improves memory
• Improves the quality of life
• Gives a sense of well being

84. • Decreases mental worries
• Increases concentration
• Increases productivity
• Increases clear thinking

85. Part 5
Health Preservation with
Anti-aging Diet &
Techniques

86. Healthy Diet

87. • Eat simple & eat fresh.
• Eat a diet low in fat, high
in complex carbohydrates.
• Reduce caffeine intake.
• Drink green tea.

89. Early morning:
• Juice of half a lemon mixed in a glass of warm water and a teaspoon of
honey.
Breakfast:
• Carbohydrates, whole wheat bread, roti (chapatti), whole grain cereal.
• Butter or Scrambled egg.
• A cup of skimmed milk or Tea.
Lunch:
• Salad of raw vegetables such as carrot, cucumber, cabbage, tomatoes, fruits
and boiled vegetables as starter.
• Wheat chapatti/rice.
• Meat (Chicken, Mutton, Fish, Beef) or Whole grain vegetables like kidney
beans, dal, peas, lightly cooked vegetables, green coriander leaves.
• Skimmed yogurt.

90. Mid afternoon:
• A glass of carrot, orange, pineapple/ mix juice or tea/ milk
made with ayurvedic. preparation to cure any ailment.
• Some fruits.
• Green Tea.
Dinner:
• A vegetable soup as starter.
• Wheat chapatti/rice.
• Meat (Chicken, Mutton, Fish, Beef) or Whole grain
vegetables and lightly cooked green vegetables.
• Fruit salad, cabbage, carrot.
• Light dessert of your choice with minimum sugar.

91. Pre-Breakfast
• 3 – 5 Dates or
• 3 – 5 Figs
(Dipped in water overnight).
• 7 – 9 Almonds.
• 1 - 2 Walnuts.

92. Anti aging Nutritional Supplements
• Most of the cultivation done world wide is inorganic,
size has increased but the natural vitamins and trace
elements have decreased.
• Vitamins are the major source of anti-oxidants.
• Trace elements like Zinc, Selenium, Magnesium &
Calcium.
• Take one tablet of multi vitamins and 2 tablets of
vitamin C.
• Herbs like Ginseng and Ginkobiloba are rich in anti
oxidants.

93. Detoxification

94. Detoxifying Cocktail
• 1 glass of grape fruit juice/ orange juice.
• 2 table spoons full of honey.
• 2 table spoons full of olive oil.
• ¼ cup of lemon juice.
• 2 cloves of garlic (crushed).
• Time: 11:00 pm – 1:00 am (once a month or
every fortnight).

95. Fasting
•Fruit & Juice Fasting
•Water Fasting

96. Part 6
• Acupressure
• Auricular Massage
• Reflexology
• Yoga

97. ACUPRESSURE

98. KI-3
(Kidney 3)
• Location: On the inside of the foot, halfway between
the Achilles-tendon and the side of the ankle-bone.
Use: Press.
Effects: Heals effects on the body of too much fear.
( Also for lower back pain)

99. LIV-3
(LIVER 3)
• Location: On the foot, on the line between the big toe and the second toe.
The point is located about 3 finger widths from the edge, in the depression
the size of a finger tip you can feel there.
Use: move your finger in counterclockwise direction over this point.
Warning: Don't use when weak or low on energy (in that case use SP-6
instead).
Effects: Relaxes and unblocks emotions (especially repressed anger).
Depression, Relaxes body muscles.

100. SP-6
(Spleen 6)
• Location: On the inside of the lower leg, one hand width (four fingers)
above the tip of the ankle bone, on the back of the shin bone.
Use: Press.
Warning: Don't use this point during pregnancy.
Effects: Calms, relaxes and reduces irritability. Heals effects on the body
of too much fear, worrying and thinking. (Also used for gynaecological
conditions.)

101. ST-36
(Stomach 36)
• Location: On the front of the leg, one hand width (four fingers) below the kneecap,
on the outside, in the depression between the shinbone and the leg muscle. It's at the
outside of the bone that's on the front of the lower leg, one finger breadth from the
crest of that bone.
Use: Press. A fingernail or thumbnail is particularly suited for this point, as you will
be able to press more closely to the bone and on a broad range.
Warning: Using this point to go beyond your limits (e.g. overwork) will damage
your health even further.
Effects: Increases stamina and energy. Provides stability and grounding. Heals
effects on the body of too much worrying and thinking.

102. LI-4
(Large Intestine 4)
• Location: On the top side of the hand, on the web between thumb and
index finger. To locate, squeeze the thumb against the base of the index
finger. The point is located on the highest point of the bulge of the muscle,
level with the end of the crease.
Use: Press.
Warning: Don't use this point during pregnancy.
Effects: Letting go of grief. Calms. Headaches.

103. LI-11
(Large Intestine 11)
• Location: On the side of the elbow, on the outer side of the arm. Bend your forearm
with your hand towards your neck, the point is located at the end of the crease at the
elbow. This is halfway up the side of the arm.
Use: move your finger in counterclockwise direction over this point.
Warning: Use this point only when there is Heat, as when you're red in the face or
your skin feels hot to the touch and you're feeling warm from prolonged anger (not
from exertion). Don't use when weak or low on energy.
• Effects: Heals effects on the body of too much anger.

104. PC-7
(Pericardium 7)
• Location: On the middle of the palm-side of the wrist, in the depression
between the two tendons, on or just below the crease of the wrist.
Use: move your finger in counterclockwise direction over this point.
Warning: Don't use when weak or low on energy.
Effects: Heals effects on the body of too much joy or emotion.
Also diminishes nervousness.

105. Sj-5
(Sanjoa 5)
• Location: On the lower arm, on the top side, two thumb
widths below the crease of the wrist. In the middle, in the
depression between the bones and tendons.
Use: Press.
Effects: Increases expressiveness and sensitivity to feelings.

106. GB 20
(Gall Bladder 20)
• Location: just under the base of the skull in two small muscular grooves at
the back of the neck.
• Use: move your finger in counterclockwise direction over this point.
Warning: Don't use when weak or low on energy.
Effects: Heals effects on the body of too much joy or emotion, headaches,
stress and high blood pressure.

107. Auricular Massage

111. REFLOXOLOGY

114. Yoga to Energize Your Body and
Mind

115. YOGA
STRECHES & TWISTS

116. Arm Stretch 1
• 1. Bring your arms behind your back,
clasping your hands. Or, hold a tie,
sweater, or scarf (or something)
between your hands.
• 2. Lift your arms as high as you can.
Lift your sternum.
• 3. Hold for 30 to 45 seconds, relax for
a moment, and then repeat.

117. Arm Stretch 2
• 1. Interlock your fingers and
extend your arms outward, straight
in front of your shoulders. Your
palms should be facing outward.
• 2. Slowly raise your hands
overhead, stretching all the way
from the waist. Work on
straightening your elbows.
• Hold for 30 to 45 seconds, relax,
and try again.

118. Chair Lower Back Stretch
• 1. Sit in your chair and widen your legs so they
are wider than hip-distance apart.
• 2. From the hip crease, bend forward and allow
your entire body to relax. You can round your
back. Drop your head and completely relax
your neck.
• 3. If you are not completely comfortable, try
putting a rolled blanket or towel at the hip
crease and lean over again.
• 4. Hold this pose as long as you like, allowing
each exhalation to relax your body and mind a
little more. Sit up on an inhalation, pause for a
few moments, and try again.

119. Seated Hamstring Stretch
• 1. Sit near the edge of the chair, facing the wall.
• 2. Place your right foot on the floor at the wall,
knee straight, and bend your left leg normally.
• 3. Either place a tie around the ball of your right
foot (as shown) or hold onto the sides of the
chair.
• 4. Lengthen your back, lift your sternum, and
relax your throat, neck, and shoulders.
• 5. Bend slightly forward from the hip crease,
keeping your back elongated (this means do not
round your back). Only bend as far forward as
you can with your back straight.
• 6. Hold for 30 to 45 seconds, then release and
switch sides.

120. Seated Double Hamstring Stretch
• 1. Sit near the edge of the chair
and place your feet on the wall.
Place a tie around the balls of
your feet.
• 2. Lengthen your back and lift
your sternum. From the hip
crease, lean forward.
• 3. Only go as far forward as you
can with your back and knees
straight.

121. Upward Arm Stretch
• Sit in a chair facing the wall. Place your hands
as high on the wall as possible and walk your
fingers higher up the wall, stretching from your
lower back.
• 2. Broaden your shoulders by separating and
lifting your shoulder blades. Keep your throat
and neck soft. Don't tense your shoulders, just
lift them.
• 3. Once you think your fingers are as high as
they can be, rest for a moment in that position
so your body can adjust, and then walk your
fingers higher.
• 4. Rest and repeat several times.

122. Shoulder Shrugs & Circles,
Part 1
• 1. Sit in a comfortable position.
• 2. Bring both shoulders up
tightly toward your ears.
• 3. Release quickly, letting your
shoulders drop. 4. Repeat a few
times.

123. Shoulder Shrugs & Circles,
Part 2
• 1. Bend both elbows and lightly place your
fingers on top of your shoulders.
• 2. Rotate your elbows as though drawing
small circles on the walls.
• 3. Circle 5 times in one direction; reverse and
make 5 circles the other way.
• 4. Drop your arms. Breathe and focus on how
relaxed your neck and shoulders feel.
• Benefits: Improves flexibility in the upper
back, shoulders, and arms, increases strength
in the upper arms, releases tension in the neck
and shoulder area.

124. Cat Stretch
• 1. Kneel in "table position,"
with knees under hips and
arms beneath shoulders.
• 2. Keep your back straight,
your head facing forward.
• 3. Exhale and drop your head
and tailbone. Arch your back,
exhaling further and pulling
your navel up toward your
spine.

125. Dog Stretch
• 1. Inhale and raise your head and
tailbone, letting your abdomen drop
toward the floor. Curve your back in a
swayback position. Look up to the
ceiling.
• 2. Alternative between cat and dog
several times.
• 3. Exaggerate the stretches as you inhale
and exhale deeply.
• Benefits: Increases suppleness along the
spine, improves circulation, stretches
muscles along the back, neck, and arms.

127. Kapalbhati Pranayama
• Sit in a comfortable asana with normal
breathing. Inhale normally and exhale
forcefully. Also keep the body easy and
relax, don’t feel like stress. As a beginner,
the force should be very low as per the
body strength. Continue this practice till
you can perform comfortably. Whenever
feel tired take a break with normal
breathing and then resume. Optimize your
practice to make “one stroke per second”.
The ideal frequency for the kapalbhati is
once per second.

128. Kapalbhati Pranayama
• Abdominal area also makes
inward and outward movements
and considerable force is
applied to the lower 3 Chakras.
• In the beginning the practitioner
may feel little pain in the
abdomen and back because of
new strain to the body, which
disappears after some days.

129. Anulom-Vilom
• In this Pranayama the breath is
regulated with the help of the
nostril. It helps encourages mind
to higher levels of
discrimination, concentration and
thoughts. Gives more energy and
oxygen to the physical body and
helps calm your nerves and
improve circulation.

130. Technique
• Hold your right nasal with thumb,
breathe in from left.
• Now open right nasal and close left
nasal with middle and ring finger
and breathe out from right nasal.
• Now breathe in from right nasal.
• Now close right nasal and open left
and breathe out and in from left
nasal and so on.

131. Corpse Pose
• No yoga session is complete
without the final pose –
Savasana. The body needs this
time to understand the new
information it has received
through practicing yoga. Even
though Savasana is a resting
pose, it’s not the same a
sleeping! You should stay
present and aware during the five
to ten minute duration of final
relaxation.

132. Instructions
• 1. Come to lie down on the back.
• 2. Let the feet fall out to either side.
• 3. Bring the arms alongside the body, but slightly separated from the
body, and turn the palms to face upwards.
• 4. Relax the whole body, including the face. Let the body feel heavy.
• 5. Let the breath occur naturally.
• 6. To come out, first begin to the deepen the breath. Then move the
fingers and toes, awakening the body.
• 7. Bring the knees into the chest and roll over to one side, keep the
eyes closed.
• 8. Slowly bring yourself back up into a sitting position.

133. Spirituality
• Stress is one way of nature
telling us to attend our spiritual
needs.

134. Stress and Spirituality are NOT
polar opposites.
• Stress provides the opportunity for
spiritual growth... when we learn from the
experience!

135. PREVENT
P - Prayer/Spiritual Centering
R – Relaxation
E – Exercise
V – Viewpoint
E - Eating Healthfully
N - Neighborly Love
T - Time Management

136. Thank you very much for your
patience.