What is stress and why do we need skills to manage it?
“Stress” is part of the human condition. The stress response is our ability to respond to a demand, a threat or even just a challenge. It is part of the way that we can protect ourselves when needed. But when stress goes on for too long it can become chronic, and lead to health problems.
Many medical conditions are exacerbated by chronic stress, and indeed chronic stress may also be one of the root causes of functional medical problems such as headaches and insomnia. Long term chronic stress can seriously undermine physical health and well being. It can express itself in many forms and it can make the symptoms of any medical problem worse. In a way we already know this but we might not think we can do anything about it. We simply were not taught.
A neglected part of medical training
As clinicians, most of us have not acquired skills in recognizing stress and preventing its harmful build-up. This did not happen during our studies, our training, or indeed at any time during our busy careers. And this did not happen despite the fact that medicine is known as a very demanding occupation and that harmful stress is pervasive in our society.
A win-win situation
The good news is that is possible and also not difficult to learn to understand and manage stress better. This learning is by its nature experiential. As doctors this is a win-win, because when we learn stress management we engage in self-care and at the same time gain experience which will help us to care for our patients.
Stress Management and Resiliency Training or S.M.A.R.T., an 8-week course
In this course, we spend a small amount of time on the theoretical understanding of stress physiology, which also helps us understand how and why the methods work. Most of the time is spent in a small group setting, exploring a variety of proven methods that address stress from different angles. There is also some time for sharing and reflecting on our experience. The weekly meetings are supplemented by 20 minutes per day for one’s own individual practice. All of these elements balance each other and provide for a unique and enjoyable learning experience.
What is the Stress Management and Resiliency Training 8 week course?
I am very happy to be able to offer the popular Stress Management and Resiliency Training (S.M.A.R.T.) in the original form as taught at the Harvard-affiliated Benson Henry Institute for Mind-Body Medicine. As one of the few non-US doctors authorized to teach this course,
( Training – SMART – Certified Healthcare Practitioners – Benson-Henry Institute (bensonhenryinstitute.org) )
I have been focusing on offering this skills-based course to small groups of doctors and other health professionals since 2021.
Why is this course special?
This 8-week course is based on the work of Dr Herbert Benson, a Harvard cardiologist who began exploring stress and stress management in the 1970’s. At the heart of his research was the description of the “relaxation response”, a natural and essential function of our physiology which is essentially the opposite of the stress response. Through practices involving the use of attention, it is possible to learn to “elicit the relaxation response” and so increase well-being and reduce the effects of chronic stress on our bodies and minds. It was due to contact with meditators in the early days of his research that Dr Benson learned that eliciting the relaxation response was part of meditation in a number of Eastern traditions such as yoga, whose roots go back thousands of years, and that in fact every culture has some method for achieving this state.
His research focused on finding the common ground for stress reduction and presenting it in a simplified, modern and secular way. Dr Benson was one of the first Western physicians to bring about awareness of the mind-body connection and its influence on health and well-being for better or for worse. He continued to research and teach until his death in 2022. During that time he published many research papers and also authored several books for the lay public, such as The Relaxation Response. ( About Us – Dr. Herbert Benson – Benson-Henry Institute (bensonhenryinstitute.org)
The 8 week Stress Management and Resiliency Training evolved over decades to include methods for stress recognition based on cognitive behavioural therapy. From this follows exploration of adaptive responses in stressful situations. But all is based on the mental and emotional space which appears through the practice of the relaxation response, which remains the core skill developed over the 8-week programme. During the course quite a few methods of eliciting the relaxation response are presented, and this means that ultimately participants can chose the methods which suit them personally, and have a wide variety of tools at hand for future self-care.
Continuing Education Credits for UK Doctors
In the UK, doctors who complete the course can receive 16 hours of continuing professional development from the British Society for Lifestyle Medicine (BSLM).
What is in the course?
Here is an outline of what we learn and practice in the course:
Session 1
Theoretical grounding in the science of mind-body medicine, focusing on the physiology of the stress response and the relaxation response. Eliciting (experiencing) the relaxation response through single-pointed focus, such as body awareness and simple breath awareness. Tips for practising on one’s own.
Session 2
Experiencing the relaxation response through the body scan exercise. Addressing sleep. Recognising one’s own stress warning signs experientially. Moments of practice in everyday life.
Session 3
Experiencing the relaxation response through mindful awareness and mindful eating. Identifying emotions and sensations. The role of social support.
Session 4
Experiencing the relaxation response through movement/yoga. Experientially learning to identify negative automatic thoughts and thought distortions.
Session 5
Using insight imagery. Finding choice and developing adaptive perspectives. Selected aspects of diet and habits around food.
Session 6
Caring for oneself and extending towards others. Identifying relaxation signals. Selected aspects of the role of physical activity.
Session 7
Creative expression and appreciation. Integration.
Session 8
Staying resilient, reviewing the toolbox and what works for the individual.
I also offer a one-on-one session for participants in the weeks leading up to the course. This is optional but recommended and provides an opportunity to define goals or discuss issues that may be private. There is no additional charge for this session.
Here is the flyer for the next 8-week cycle of the
Stress Management and Resiliency Training
About me, Dr. Miriam Maisel
I have been a medical doctor since 1992, and have had a varied career based around general practice, with additional experience in palliative medicine and psychiatry. Due to my keen interest in helping patients take an active role in improving and maintaining their own health, I was drawn to study Lifestyle Medicine and I hold the International Lifestyle Medicine diploma (IBLM) since 2018.
I currently have a small private lifestyle medicine clinic in Tel Aviv, https://plantbasedlifestylemedicine.com/ as well as doing some teaching at university and medical school level. I have also contributed a chapter on nutrition to the medical textbook Nutrition and Integrative Medicine, a Primer for Clinicians. Stress management is an important aspect of Lifestyle Medicine and after study at the Benson Henry Institute of Mind Body Medicine, I have been teaching the Stress Management and Resiliency Training since 2021, mostly to small groups of doctors. I very much enjoy teaching and sharing the stress management methods with others, and I especially enjoy offering something that really makes a difference for individuals.
Since my teenage years I have explored a variety of mind-body methods such as yoga and meditation in traditional settings. I have a deep and abiding respect for these traditions while agreeing with Dr Benson’s view that there are aspects of these methods that can be presented in a secular way and be beneficial for well-being and in clinical settings.
As I approach retirement age and engage a bit less in clinical practice, I hope to be teaching stress management for many years to come.
Click here for the flyer for the next 8 week cycle
“I have thoroughly enjoyed the online SMART course with Miriam. Miriam is a true expert in this field and it has been such a pleasure to learn more about different stress management techniques and how to put them into practice in every day life – for personal use and for the benefit of my own patients. Taking part in this course has allowed me to understand the importance of and prioritize rest, relaxation and resiliency training in my own life and I have seen the benefits already. Thank you Miriam for such a wonderful opportunity to improve my personal lifestyle routines and enhance the care I deliver to my patients.”
Dr Laura Freeman
Medical Director
Plant Based Health Online
www.pbho.co.uk
“As a practising GP and Lifestyle Medicine doctor, I found the S.M.A.R.T. course to be an excellent “hands-on” course, focusing on recognition of early signs of stress. More importantly, it has taught me various techniques on reducing stress, which will be extremely valuable to me in my medical practice in addressing stress in my patients. I will also take this knowledge to my daily personal and family life. Miriam makes everyone feel at ease and the course has a very relaxed atmosphere for discussions and sharing our experiences. At the same time, Miriam is an excellent facilitator and she will make sure that you as a participant, will make the most of your valuable time during this course.”
Dr Olga Morton
Getting started and getting in touch
To register, or for any questions, please feel free to contact me by email at [email protected]
I aim to answer within one working day.
Adaptations for small groups
I am happy to adapt the program to accommodate individuals, and small groups, to suit different time zones, etc.
Just want to learn more at this stage?
I am also happy to lecture to small groups, and can provide a one-hour lecture in Zoom format, which would be partly didactic and partly experiential.
Can’t make this course but would like to join in the future?
If you are not able to attend the next cycle but would like to be notified when future cycles are taking place, please also email me and I will make sure to notify you when these happen.
Looking forward to hearing from you!