Defense mechanisms

Defense Mechanisms

Defense mechanisms are unconscious psychological and behavior strategies that help protect a person from anxiety. When an individual is faced with problems, difficulties or failures, he employs certain ways or devices to achieve health happiness or success. These are called defense mechanisms.

Some Good Coping Skills Include:

• Keep a Positive Attitude: Sometimes the way of think about things can make all of the difference. Own attitude can help offset difficult situations.
• Avoiding Unnecessary Stress: Learning to say no, knowing owns limits in personal and professional life will help to avoid stress and remember that you can learn to control stress because stress comes from how you respond to stressful events.
• Meditation and Relaxation Techniques: Practicing deep breathing techniques, the relaxation response, or progressive muscle relaxation are ways to help reduce stress and induce relaxation.
• Physical Activity: Moving around and getting the heart rate up causes the body to release endorphins (the body's feel good hormones). Exercising provides some stress relief.
• Reading: Escape from reality completely by reading.
• Friendship: Having friends who are willing to listen and support one through good and bad times is essential.
• Humor: Adding humor to a stressful situation can help to lighten the mood. Hobbies: Having creative outlets such as listening to music, drawing or gardening are great ways to relax and relieve everyday stress.
• Spirituality: Actively believing in a higher power or divine being can have many health benefits. In recent studies, it has been found that people who pray have better mental health than those who do not.
• Pets: Taking care of a pet helps distract the mind from stressful thoughts. Studies show that pets are a calming influence in people's lives.
• Sleeping: The human body needs a chance to rest and repair itself after a long and stressful day. Sleeping gives the body this chance so that it is ready to perform another day.
• Nutrition: Eating foods that are good not only improves physical health, but also plays a major role in mental health. When the body gets the proper nutrients, it is better able to function in every capacity.

Some Important Techniques of Coping with Stress

There are many methods of stress control but the relaxation technique is widely used. It brings about physiologic changes, reduces the psycho-physiological effects of stress and promotes a sense of physical and mental well-being. Some of the techniques of coping with stress are:

• Relaxation techniques,
• Biofeedback training,
• Stress reduction program,
• Development of rational philosophy of life,
• Time management.

Relaxation Techniques

Relaxation is the state of generalized decreased cognitive physiological and/or behavioral arousal. It helps individuals to develop cognitive skills reducing the negative ways in which they respond to situations within their environment. Some of relaxation techniques are as below:

Progressive Relaxation

Relaxation techniques have been used extensively to reduce high levels of stress and chronic pain. Using relaxation techniques enables to client to exert control over the body's responses to tension and anxiety. In progressive technique the individual concentrates on various gross muscle groups in the body. First, tensing and then relaxing each group. About 20-30 minutes should be spent in this exercise.

Steps:

• First find a comfortable place to relax where there are no distractions. During the day darken the room, at night go to sleep after the exercise.
• Sit comfortably in a chair, with your feet flat on the ground.
• During the tension part of the cycle, the patient is taught first to tense and then to relax We groups of voluntary muscles in a systematic manner. First the feet, then the lower legs, the thigh and so on up to the trunk and arms to the face.
• During the relaxation part, relax the muscles completely and quickly, let your mind relax and see how relaxed muscles are feeling.
• Tense and relax each muscle group twice after you have completed the entire sequence, go back and tense and relax specific muscles which you still feel tense.

Note: This process helps the person learn to control tension in the muscles, thus leading to reduction in heart rate and blood pressure and creating mental and emotional calmness.

Meditation

It is general term for a wide range of practices that involve relaxing the body and stilling the mind. It is a technique used to quiet the mind and focus in the present and to release fears, worries; anxiety and doubts concerning the past and the future and that reduce daily stress.

It produces a state of deep peace and rest combined with mental alertness. Originally, meditation was viewed as a religious practice and is still practised by many as a form of prayer.

Meditation exercises can give clients relief from chronic pain, insomnia, anxiety, and depression and can help in coping with the side effects of uncomfortable therapy, twice a day for 10 to 20 minutes. Sit quietly in a comfortable position with their eyes closed and repeat a sound; phrase or sacred word in rhythm with breathing, gently disregarding intrusive thoughts as they do so, experience decreased metabolism and heart rate, easier breathing and slower brain waves. 

Guidelines for Meditation

• Create special time and place for meditation. Ideally, choose the early morning or evening and wait at least 2 hours after eating so that complete energy is devoted to meditation rather than to digestive demands. A quiet, comfortable place, avoid of distraction, is essential.adioagyd sdr olde 21
• Sit either cross-legged on the floor or upright in a straight backed chair, keeping the spine straight and the body relaxed.
• Support the palms on the thighs and close the eyes.
• Follow deep breathing and/or progressive relaxation exercises.
• Focus attention completely on either breathing or a chosen mental image. If using a mantra, repeat word or phrase either aloud or silently while exhaling. When distracting thoughts appear, allow them to drift into and out of your mind without giving them undue attention; then refocus on your breathing or your mantra.
• Practice the process for 10 to 15 minutes.

Prayer

It is similar to meditation but is intended to be communication with God; a saint or some other being who answers the prayers. The act of prayer gives an individual the opportunity to renew personal faith and belief in a higher being in a specific focused way that may be highly ritualized and formal or quiet spontaneous and informal. Prayer may be conducted individually or in groups and may even be conducted at a distance by individuals unknown to the person for whom the prayers of healing are made.

Imaginary 

It is the internal experience of memories, dreams, fantasies and visions that serves as bridge connecting body, mind and spirit. A visualization technique uses the conscious mind to create mental image to stimulate physical changes in the body, improve perceived wellbeing and or enhance self-awareness. Imagery enables people to open their minds to mental ideas of positive creative images that foster self-healing and bring about desired achievements. Imaginary can be self-directed or guided.

Guidelines for Guided Imaginary

• Begin the session with the person lying in bed or seated in a chair.
• Ask the person to assume a position as comfortable as possible, one in which the person might even fall asleep.
• Sit near the person and speak slowly and soothingly as you provide guidance in the person's through processes.
• Try to elicit images that are pleasant, relaxing and associated with positive physical sensations.

Autogenic Training

It is a systematic technique teaching the body and mind to respond to verbal commands, allowing the person to achieve a deep state of relaxation through self-suggestion. Autogenic training requires the patient to sit in a comfortable position and then follow the following methods.

• Induce the sensation of heaviness of limbs, to do this think, "My arm is heavy".
• Induce the sensation of warmth in the limbs. Think, "My arm is warm".
• For cardiac regulation, think, "My heart beat is calm and regular".
• For respiratory regulation, think, "I breathe normally".
• Induce the sense of upper abdominal warmth. Think "My solar plexus is warm".
• Induce the sense of coolness in the forehead. Think "My forehead is cool".
• The autogenic regulations require 4-10 months to develop a sense of passive concentration.

Hypnosis

It is an altered state of consciousness in which an individual's concentration is focused and distraction is minimized. It can be used to control pain, alter body functions and change lifestyle habits, for example, once the subject is comfortable, the hypnotherapist may say "Imagine descending in an elevator, as you pass each floor on the way down you feel a little more relaxed". Autohypnosis is also possible.

Yoga

It is a discipline that focuses on muscles, posture, breathing and consciousness. In other words, it focuses on the body's musculature, posture, breathing mechanism and consciousness.

Goal of yoga is attainment of physical and mental well-being through mastery of body achieved through exercise, holding of postures, proper breathing and mediation.

Yoga involves the practice of physical exercise and meditation. The correct performance of yoga results in deep relaxation without sleep.

Journal Writing

For many people keeping a private personal journal provides a therapeutic outlet for stress, and it is well within the realm of nursing to suggest journal keeping to clients experiencing difficult situations. In a private journal, clients can express a full range of emotion and their honest feelings without hurting any one's feelings and without concern for how they might appear to others.

Music Therapy

The human body has a fundamental vibrating pattern, according to music therapists, thus musical vibrations that closely relate to the body's fundamental frequency or vibrating pattern can have a profound healing effect on the entire human body, mind and spirit bringing about changes in emotions, organs, hormones, enzymes, cells and atoms. Theoretically, carefully selected music helps to restore regulatory functions that are out of tune during times of stress and illness. Music aligns the body, mind, and spirit with its own fundamental frequency.

Music therapy consists of listening, rhythm body movement and singing.

Humor and Laughter

Health care professionals recently have focused on the positive effects of humor and laughter on health and disease. It involves the ability to discover, express or appreciate the comical or absurdly in congruous. Humor in nursing is defined as helping the client "to perceive, appreciate and express what is funny, amusing, or ludicrous in order to establish relationship, relieve tension, release anger, facilitate learning or cope with painful feeling. Humor also has physiologic benefits that involve alternating states of stimulation and relaxation. Laughter States ope wi stimulates increases in respiratory rate, heart rate, muscular tension, and oxygen exchange. A state of relaxation follows laughter, during which heart rate, blood pressure, respiration and muscle tension decrease. Humor stimulates the production of catecholamine and hormones. It also releases endorphins, thereby increasing pain tolerance.

Support Systems

A support system of family, friends and colleagues who will listen, offer advice and provide emotional support benefits a client experiencing stress.

Therapeutic Touch

Therapeutic touch is a training specific therapy that was developed by a nurse. It is similar in that it involves trained health care professionals who attempt to direct their own balanced energies in an intentional and motivated manner toward those of the client.

It is a method used to diagnose and relieve symptoms in ill persons by using the hands. It is the use of touch to reduce anxiety and stress, relief pain and provide comfort.

Biofeedback Training

It is a group of therapeutic procedures that use electronic or electromechanical instruments to measure, process and provide information to persons about their neuromuscular and autonomic nervous system activity. 

It is a technique of feedback to help individual's monitor and control automatic physiologic functions e.g. blood pressure, heart rate. It is a scientifically planned program that trains selected subjects to control one or more "involuntary" functions. While in the program, the person may learn to regulate blood pressure, heart rate, brain waves, skin temperature and muscle tension. It requires monitoring devices e.g. ECG machine. It can immediately demonstrate to clients their ability to control some physiological responses. Biofeedback training involves:

• Attaching the subject to electronic monitoring equipment.
• Monitoring a particular physiological function e.g. heartbeat.
• "Feeding back" selected information about that function e.g. increase or decreases in heart rate to subject by picture, sounds and so on: and
• Rewarding the person for learning to control that function.

Biofeedback training is used by some clinicians to treat hypertension, lower back pain, tension headache and insomnia, when these symptoms are due to anxiety and muscle tension.

Stress Reduction Programme

Stress reduction programme is needed to reduce stress. This programme involves six steps: toms s

• Identifying the problem.
• Assessing the cause of the problem.
• Becoming aware of personal behavior patterns that contribute to the problem.
• Developing a plan of action.
• Putting into action.
• Evaluating the plan and modifying if necessary self-help mechanisms used for reducing stress must be applied with moderation and help persons who are under stress to assess their lifestyles and coping responses. Help people engage in self-care and make the lifestyle changes to control stress and prevent stress related disorders.

Development of Rational Philosophy of Life

An individual has a plan and balance the activities in his/her life which helps to achieve maximum psychological and physiological well-being. To achieve his goals, the individual must identify and manage the source of stress. This helps to improve the self-esteem of the individual and reinforces positive behaviour patterns.

Time Management

Time management techniques include developing lists of tasks to be performed in order of priority. People who manage their time effectively usually experience less stress because they feel more in control their circumstances. For example, those tasks that require immediate attention, those that are important and can be delayed, those tasks which are routine and can be accomplished when time becomes available. In many cases setting priorities help individual identify tasks that are not necessary or perhaps can even be delegated to someone else.

Nurse's Role in Stressful Situation

• Help to clients to:
  • Determine situations that precipitate anxiety and identify signs of anxiety.
  • Find out his facts rather than imagine the worse.
  • Identify personal strengths.
  • Recognize usual coping patterns and differentiate positive from negative coping mechanisms.
  • Identify and develop support systems with colleagues and friends.
  • Verbalize feelings, perceptions, and fears as appropriate. Some cultures discourage expression of feelings. 
• Tell him the truth as much as possible.
• Do not give false reassurance.
• Encourage him to face the crisis.
• Listen attentively; the most important skill to learn when dealing with anxious patients is to listen. Try to understand the client's perception in the situation.
• Provide an atmosphere of warmth of trust; convey a sense of caring and empathy. 
• Provide factual information as needed to prepare client for tests, treatments and so on.
• Encourage client participation in the plan of care; give them choice about appropriate aspects of care.
• Stay with clients as needed to promote safety and feelings of security and to reduce fear.
• Instruct the client how to increase her resistance to stress.
• Exercising regularly.
• Enhancing self-esteem by using positive self-talk and by becoming successful in a skill for which the person takes pride.
• Developing alternatives to goals that are problematic.
• Building coping, resources such as social support, continuing education, a financial daireserve, and it improve personal appearance.
• Train the client in skills that help reduce the physiological reaction to stress, including bio-feedback, relaxation training and imaginary etc.
• Eliminate or restrict the amount of alcohol, coffee, and other mood altering substances as a means of managing stress.
• Learn to accept failure and turn it into a constructive experience.
• Develop techniques for assertiveness to have more feelings of personal control.
• Have an optimistic view of the world and believe that most people are doing the best they can.
• Discuss with other family members about the needs of the family and the client.
• Nurses must consider the client's cultural socio-economic and ethnic values.
• Provide support by asking of priest to visit the family; the family with strong faith or religion may appreciate the visit of a priest or lama.
• Nurses must inform the family about the prognosis of the disease and treatment at their level of understanding.