SMART Program

Researchers define stress as the body’s response to any demand. It is our human physiologic response to environmental triggers whether they are physical or psychological in nature. The demands could be major negative life events like the death of a loved one or loss of a job, but they can also be positive events like getting married or receiving a new job or retiring. Demands can also be small daily requirements of just living, getting the kids ready for school, driving to work in traffic, waiting in line for a coffee, or interacting with colleagues on a work project. Although it is completely appropriate to experience feeling stressed, stress can become a problem when the demands of stress outweigh our ability to cope. An experience is perceived as stressful when it signifies to you a discrepancy between what “should” be and what is actually occurring. When this disturbance occurs, our body recognizes it as a state of disharmony or threatened stability and engages our bodies innate neurophysiologic alarm system to rectify the perceived stressor. Biochemical (neurotransmitters, peptides, steroids), physiological (heart rate, blood pressure), and behavioral (anxiety, depression, tension). At this point stress begins to wear and tear on the body and, ultimately, leads to physical and/or emotional illness.

Stress is an inflammatory disease! Non-communicable diseases (NCD) like heart disease, chronic lung diseases, cancer, diabetes, and mental illness are overwhelming our medical system every day. The World Health Organization states that NCD constituted more than 36 million deaths (60%) worldwide in 2005, and this is projected to grow significantly by 2030. Stress plays significant roles in the development and exacerbation of these NCD’s.

Today, the scientific community is increasingly interested in understanding the body as a series of complex interactions among thoughts, the body, and the outside world. Our experience of and response to stress is an essential aspect of these interactions. We now know that the majority of all visits to primary care doctors are for stress-related conditions. We also know that mind-body medicine is often the most effective and safest way to reduce stress, promote health and prevent stress related illness and improve our quality of life.

There are three essential components to the SMART program:

• Practicing Relaxation Response (RR) techniques: Each session presents different techniques to elicit the Relaxation Response. This involves creating and keeping mental focus, by repeating a concept, be it a sound, visual image, prayer or phrase, and an open receptive attitude, and a letting go of thoughts. Recent genetic studies show that using the relaxation response turns off genes associated with stress and disease vulnerability.
• Stress Awareness: We come to see the many different ways that stress can affect us, as well as understand our personal responses to stress. Throughout the course, we explore how stress affects our thinking, our emotions, our bodies, our behavior, and relationships. Through a series of exercises, you will come to recognize what core beliefs keep you in the stress response and make it difficult to cope with stress.
• Adaptive Strategies: With a new foundation of stress awareness, we will examine and practice helpful strategies for stressful situations. These strategies are grouped into four categories:
  1. Reappraisal and Coping: Our reappraisal approach is based on a unique blending cognitive therapy, which recognizes the link between thoughts and emotions, and positive psychology, which promotes adaptive thoughts and emotions. Through a series of exercises, you will become more aware of your immediate responses to a stressor, and corresponding negative thoughts, emotions, physical sensations, and behaviours. We will then learn how to reframe our responses towards positive/adaptive thoughts, emotions, physical sensations, and behaviours. Through these exercises, you will learn how to decrease the frequency of your negative responses and to better cope with potential stressors. In addition, you will learn to access adaptive coping skills, such as creativity and humor, to buffer yourself from these stressors.
  2. Positive Perspective: Work in this area draws on the field of positive psychology, which emphasizes the expression of positive emotions and character strengths. Through a series of exercises and discussions, we challenge you to find positive meaning, even in the midst of difficult situations, and see stressors from an adaptive perspective. We also shift our perspectives to focus on small, positive experiences such as smells, tastes, interactions, and surprise; these experiences occur daily yet often go otherwise unnoticed.
  3. Social Connectedness: Being in the stress response often leads to a sense of social isolation or disconnectedness and disconnectedness can also lead to stress, creating a vicious cycle. Has anyone ever felt sad or upset and noticed that our natural inclination is to pull back from friends and family when stressed? Does this help? Isolation actually feeds depression and negative emotions. We encourage and support three main aspects of social connectedness: social support, empathy (for oneself and others), and helping others. Through various exercises, we explore the different types of social support. We also explore effective listening skills, and how to elicit empathic thoughts, feelings, and behaviours. Prosocial behaviours that help others, such as volunteerism, is another form of connectedness that can help improve our quality of life. When we do things for others, we not only help others, but we also benefit from enhanced feelings of self pride and connectedness to others.
  4. Healthy Lifestyle Behaviors: In discussing healthy lifestyle behaviours, we will support you in setting goals of physical activity, nutrition and mindful eating, and recuperative sleep. Progress towards individualized goals are documented on a weekly Practice Note and reviewed.

Participation is the Key to Positive Outcomes

To gain the most benefit from this program, attendance and participation are key. Please be sure to be present for each of the eight sessions and to complete any outside assignments. The goal is not to give you more work to add to your daily routines, but to lessen your daily stress by practicing a variety of techniques to help you build resiliency and build prosocial skills.