Client Stress Series Part 2

In part 1 of our stress series, we discussed what stress is and how it relates to hearing loss and tinnitus. Off the top of your head, I’m sure you could come up with several strategies to reduce some of the stress caused by those. However, the most important thing about these strategies is their ability to regulate stress in a consistent way. This is where self-regulation and stress come in. 

Self-Regulation

Dr. Stuart Shanker has created a framework for life and stress called Self-Regulation (or Self-Reg). Dr. Shanker is not the first to use this term, but his particular perspective on how it can affect our lives is unique. Self-reg is not self-control or stress management; it’s a way of looking at stress and working out the root cause rather than just trying to control or manage the behaviour.

So what is Self-Reg?

Mindful self-reg involves learning to recognize and respond to stress in our environments to bring ourselves back to homeostasis (balance or calm). It’s about…

• exploring and testing out the ways in which relationships, environments, routines and activities can enhance self-regulation
• recognizing stress behaviour (behaviour that is reactive or caused by excessive stress)
• noticing subtle signs of stress behaviour that we never saw or understood before
• finding our own self-reg so we can help those around us learn how to regulate themselves in the same way

We do this by understanding there is positive and negative stress. Stress is on a curve…

We need a moderate amount of stress to be productive.

With too little stress we are unmotivated, falling asleep, and easily distracted.

On the flip side, too much stress causes our bodies to go into fight (frustration, anger, etc.), flight (running away, inability to concentrate on a task), or freeze (which can look like compliance).

So what do we do with too much stress? How do we use self-reg to bring us back to calm?

Self-Reg Perspective

Dr. Shanker’s self-reg walks you through a process using 5 areas that stress can occur. These are the 5 domains:

• Biological – anything affecting your body (including hearing loss)
• Emotional – feelings or situations that evoke feelings
• Cognitive – thoughts, brain processes, attention…
• Social – relationships within your social community (parents, friends, family, co-workers, etc.) and other social interactions
• Prosocial – how we expect social engagement and react to others

 

There are lots of stressors in each domain and they can vary person to person. For a more detailed list of stressors in each domain click here.

Self-Reg wants to look at what are the stressors, how are they affecting the individual, and how to reduce the stress. This is accomplished through 5 steps…

*Note: These steps are not all the time linear. It’s more of a process that can jump back and forth as you continue to discover stressors in your life.

Five Steps

1. Reframe the behaviour – Why is this behaviour happening? More often than not it’s because of stress.
2. Recognize the stressors (across the five domains) – What things are causing too much stress?
3. Reduce the stress – what reduces your stress? What makes you feel calm?
4. Reflect: enhance stress awareness – Figuring out how you feel when those stressors start, what calm feels like, etc.
5. Respond: restore your energy – Develop personalized strategies to promote resilience and restoration

Self-Reg for Hearing Loss

Self-reg is for everyone – regardless of their age, profession, etc. So it can really be applied to anything; it’s a way to look at life. In regards to hearing loss, there are a few ways this perspective can shift our thinking. So let’s walk through an example (these are just a few possibilities; everyone is different):

Stressors (Example)

Biological	Expending a lot of energy trying to listen Tired Headaches Ear aches Balance issues Sweating Heart beats faster Suddenly cold Hearing loss Aging*
Emotional	Feeling alone Feeling left out or unwelcome Depression Embarrassment  Getting frustrated Irritated Agitated Sad Fearful
Cognitive	Not feeling engaged in the conversation  Responding inappropriately in conversation Hard to focus Har to problem solve Guessing what someone is saying Words come out wrong
Social	Being left out Overwhelmed in large groups/crowds Public speaking Trying to have your turn in a conversation Two or more people talking at once People talking too loud thinking it will help People not looking at you when they are talking
Prosocial	Dealing with other’s responses to your hearing or lack of engagement Feeling unprepared Expectations of others (for them and those they put on you) Feeling like people are talking about you Feeling self-conscious reminding people to talk louder Taking it personal-hearing loss your fault somehow

*Age is not the only factor when it comes to hearing loss, but it is something that we expect as we naturally age. Dr. Shanker has a really interesting perspective on the stress of aging…

Self-Reg Steps (Example)

Step	Questions to Ask	Example
Situation		I don’t like socializing in a group
Reframe	Am I feeling isolated?  Am I avoiding social interactions? Do I get frustrated in conversation?	Groups are stressful because it’s hard for me to hear
Recognize	Is my hearing loss causing stress? What other stressors are affecting me right now?	This is where the domains come in! (see above)
Reduce	What or when do I feel calm? What helps reduce my stress in the moment?	Find a quiet place to talk with someone Socialize in smaller groups Asking music to be turned down in a restaurant, coffee shop, etc. Hearing Aids or other devices Having a good communication partner with me to be my advocate Ask my friends ahead of time to make sure to have my attention before speaking Give myself breaks if I need it (okay to step away from the table for a minute) Advocate for myself in the moment “could you please slow down and repeat”
Reflect	Can I feel my stress rising? When? How? Did the strategy help a little bit, a lot? Do I feel calmer physically, emotionally, and cognitively?	[Notice how you feel before and after trying out a strategy]
Respond	When stress happens what can I do in the moment to help? How can I prepare for when that stress comes up in the future? What gives you energy? What can you do to build resilience and support your wellbeing?	Get adequate sleep Give yourself a reward for socializing in a group[ Do an activity you like before and after being in a group

 

Self-Reg for Tinnitus

Since stress is a major trigger for Tinnitus we need to break it down a bit. In order to understand why your stress increases your tinnitus, we have to look at where the stress is coming from and break it down into its individual components or stressors.

Stressors (Example)

Domains	Stressors or Tinnitus Triggers
Biological	Tinnitus Fatigue Low energy Sharp sounds – dishes clanking, motors running Diet – high sugar, salt, caffeine, alcohol etc. For more info on how diet affects Tinnitus check out our blog here.
Emotional	Loneliness Helplessness  Depression Frustration
Cognitive	Extra focus needed to do a task Mental fog
Social	Large groups Lots of noise
Prosocial	Expectations you feel from family and friends Others around you not understanding your situation

 

Now that you’ve got an idea of some of your stressors, let’s look at how to reduce the stress…

Self-reg Steps (Example)

Step	Questions to Ask	Example
Reframe	How does your tinnitus affect you?	I’m having a tinnitus flare up and can’t seem to do very much at the moment
Recognize	What has changed that might be causing me stress/tinnitus flare-up?	This is where the 5 domains come in! (See above)
Reduce	What or when do I feel calm? What helps reduce my stress in the moment? When is my tinnitus low?	On good days I feel rested (slept well) Being in nature is calming Distracting myself can help bring it down (I like playing CandyCrush) Listening to soft music
Reflect	Can I feel my stress rising? When? How? What are the early signs of a flare-up?	This could include tracking your tinnitus over the next few days or weeks  Use a notebook  Try a tracking app like ‘Track Your Tinnitus’
Respond	When stress/flare-up happens what can I do in the moment to help? What can I do to prepare for when that stress/flare-up comes up in the future? What gives you energy?	Have music on my phone when out in public and listen to music at night to help me fall asleep Play CandyCrush when I need to distract myself Plan to go to more quiet events with family and friends Go for a walk in nature Be conscious of my diet during the day and look into alternatives for things that increase my tinnitus (i.e. tomatoes before bed)

For a tinnitus flare-up:

• What is going on around you?
• Environment, emotions, etc. Are there things that make a noticeable difference in your tinnitus?
• When is your tinnitus at its lowest?

Try using resources like the Tinnitus inventory or apps to help track the various aspects of your tinnitus.

Homework

Make a list of your stressors using the domains and work through the steps as best as you can. You can use this Profile tool to help guide you through. This takes time, so don’t rush it, dig deep, and use this time to learn more about yourself. Begin to think about your stress. Break it down and come up with some ideas to bring down that stress. Then, try them out!

Conclusion

We hope this information provides you with a new perspective to look at your hearing loss, tinnitus, and life stress in general. Our lives are filled with so much stress, having effective ways to look at it and bring ourselves back to calm is crucial.

Additional Resources

For more information on how hearing aids can help reduce your stress caused by difficult communication, don’t hesitate to contact us at www.TheEarDepot.com or call 705-749-0707.

If you’re interested in learning more about Dr. Shanker’s Self-Regulation, check out their website www.self-reg.ca

Strategies in the 5 Domains

Lighten the Stress In the Moment

*Note: Taylor is a Self-Reg Champion through The MEHRIT Centre and works on staff in their e-school department.