Taking Down Giants By Aiming At An Abundant Life
At Good News Community Health Center in Portland, Oregon, our greatest joy is to present the Good News of our LORD and Savior, Jesus Christ. Our patients come to us with many needs – physical, emotional and spiritual. One common denominator especially in these times, is stress. Stress accounts for the majority of our patients’ medical and emotional symptoms, aggravating chronic medical conditions, and worsening addictions, if not managed wisely. People who live in impoverished neighborhoods like ours deal with levels of stress that many of us can only begin to imagine. Stress is the breeding ground for anxiety, depression, violence, addiction, physical and mental illness. Many are in a vicious cycle; e.g., smokers say that they smoke more because they are under stress, but in fact, smoking worsens stress because smokers repeatedly experience nicotine withdrawal and poor health.
Challenged to find a way to more consistently present Jesus Christ as the answer to people’s deepest needs, and to provide whole-person care for our “guests”, we developed a tool that has become a foundation in our approach to care that we call “Aim for Abundant Life”. The more we use this tool, the more the Spirit guides us to refine it for sharing the One who alone is the giver of Shalom. It is easy to use, addresses physiologic mechanisms of stress, and is utilized by our volunteers, many of whom have limited medical training. It empowers our “guests”, who see real changes as they learn to use this tool. It opens new opportunities to share the Gospel of hope to those looking for hope.
Why Stress Management?
- Stress could be likened to a land of giants, i.e., Fear, Anger, and Terror. The limbic system of the brain is involved in processing and regulating emotions, memory and sexual arousal. It includes the amygdala, the hippocampus, and hypothalamus. This system is responsible for the body’s response to stress and is highly connected to the endocrine and autonomic nervous system, which includes the sympathetic and parasympathetic systems. This meeting place of the physical, emotional, and spiritual realms is like no other body system. Fight, flight, and freeze are the high-energy emotions that fuel addiction, abuse, and panic attacks. This part of human nature is most vulnerable to temptation and despair, and is where burnout lives. Stress is ubiquitous in modern society. The need to manage stress is a common ground where we can serve one another, not from a lofty theological place, but from the place where we are all related regardless of our other differences.
- Stress management is a popular and universally accepted aspect of patient teaching and medical practice. Stress contributes to many common medical conditions, such as hypertension, heart disease, diabetes, anxiety, depression, etc. Our uninsured and often homeless patient population lives with life stressors compounding their physical health conditions. Addiction, abuse, and depression are issues that we are able to approach without being judgmental, by focusing on the effects and physiology of stress behind these issues. While we may need to recommend other resources for addiction recovery or mental health treatment, our stress management tool gives us a platform to discuss crucial issues as a component of the patient’s overall health.
The Stress Thermometer
The Stress Thermometer is a vivid graphic used to explain the physiology of stress. It is used in three ways:
- As an assessment tool, similar to a pain scale, where patients can identify their levels of stress.
- To explain the physiology of stress and its connection to emotion and behavior.
- For training volunteers to consider the stress level of the “guest” that they are caring for.
In a short time of using the stress thermometer with “guests”, it is enlightening for them to recognize themselves in the sympathetic nervous system’s flight/fight and freeze reactions. They learn that addictions are not driven primarily by the rational brain (or pre-frontal cortex), but by the “nervous energy” controlled by the “survival” brain (the amygdala). Some have learned how their own uncontrolled eating and credit card spending habits are driven by the same dynamics that drive drug addiction.
Young and old alike are remarkably perceptive about where they are on the stress thermometer once it is explained. We not only use this to bring the “guest” self-awareness, but also as a way to better understand his needs based on his current level of stress. Stress emotions range from mild anxiety of the early “flight” stage to the paralysis of “freeze” where terror is the dominant emotion.
Once we have described the stress scale to our “guests”, there is often a cathartic outpouring of thoughts and emotions that seem to be released by the discussion. For even our more timid and introverted “guests”, we see recognition and contact made on a deep human level. They understand themselves better and feel understood; something changes in that moment. Understanding is a bridge—it communicates acceptance, and when flavored with grace is redeeming love.
We use the stress thermometer to explain that God made our bodies with the capacity to respond to times of stress with the energy to fight or flee danger. In our day and age the dangers are difficult to fight or flee—an unpaid bill, living in a dangerous neighborhood, or an unexpected illness. These situations trigger stress reactions and create restless energy that needs release. The idea we propose with stress management is that we can choose new ways to deal with that stress or slow it down. This is especially important when our current ways of operating under stress cause more stress. For example, smoking, alcohol use or over-eating can be driven by stress, and this heightened energy level must be addressed and redirected when overcoming an addictive habit.
The Stress Management Personal Planner
After explaining the physiology of stress, we direct our “guest” to solutions for lowering and redirecting stress in healthy ways. We use the Stress Management Personal Planner, a five-column planner that encourages the “guest” to approach his health and stress from five angles—body, mind, will, emotions, and spirit. The Planner frames these five areas of health and moves us into a discussion of the non-medical lifestyle changes that can influence overall health and well-being. We instruct our “guests” to create self-directed, personal plans to reduce stress in these five areas, even if they are just small changes. As David was able to slay Goliath using five small stones, we have seen our “guests” make giant changes one small step at a time. They do what they can and trust God with the rest. Our over-riding Scripture verse is also a prayer for our patients: “May God Himself, the God who makes everything holy and whole, make you holy and whole, put you together—spirit, soul, and body...”.1 The planner is self-directed because our goal is to promote self-respect and responsibility for self-care, which is a flexible process.
What can I do to manage my stress? (Circle or write in ways that you can begin to slow down or redirect your stress energy in healthy ways.)
Physically - Stress creates physical energy so I can slow, release or direct it by:
- sustained exercise
- deep breathing
- enough sleep
- a healthy routine that includes good hygiene and a low fat diet
- cry, laugh
- withdraw from crowds
- withdraw from alcohol or drugs
- Simplify, de-clutter, clean
- Separate from abuse.
- Take a break, vacation, rest
- Sex, if married
- Hot tub, massage
- Listen, talk it out
Emotionally - Refocus on what brings you healthy comfort or pleasure:
- Natural beauty
- Music, art, dance
- Play (learn from a child if you forgot how to play!)
- savor a conversation
- seek out comforting or fun people
- create, cook
- rent a comedy
- read for fun
- sing loud, cheer, celebrate
Willfully - What do I "want to" do with my life?
Am I: depressed, abused, abusing, co-dependent, too busy, confused?
- What can I plan today to improve my life?
- What is a healthy goal for me?
- What resources do I need and who can support me?
Intellectually - Am I intellectually stimulated too much or too little?
- What do I want to learn about?
- How can I be smart about learning to manage my stress and improve my health or situation?
- What is a good resource for learning this?
- Who can I learn from?
- How can I learn from my past mistakes?
- Is my mind overstimulated
- Or understimulated?
- Can I make adjustments to my plans?
Spiritually - Do I have a spiritual life? Is it healthy?
Do I need:
- To receive spiritual life?
- To learn to pray when I am anxious or guilty?
- To learn how to release anger or control?
- To forgive?
- To trust?
- To worship?
- To receive forgiveness from God?
- To find spiritual resources?
- To find help to process unresolved issues?
- Would I like someone to pray for me?
“May God himself, the God who makes everything holy and whole, put you together- spirit, soul, and body…” 1 Thess 5:23
We encourage an integrated approach to selfcare. One may be physically fit and yet spiritually lifeless. Another may have a strong sense of purpose but be physically frail. Another may be spiritually fit but emotionally depleted. Viewing health as a whole-person issue and encouraging a plan that involves the whole-person, we promote healing and improve our community one person at a time.
The five sections of the Planner
Physical. Other stress management models emphasize the physical remedies for stress, and we include the same basic considerations of exercise, breathing techniques, and other practical considerations. Exercise enhances endorphin release resulting in “the runner’s high”. Sometimes a “guest” will realize a simple solution like relieving sleep deprivation. At other times, this section might lead to a discussion about a safe detox from alcohol or the need for a cleaner living environment. These ideas complement the management of chronic conditions.
The human body has a remarkable capacity for stress and a built-in recovery system called the Parasympathetic Nervous system. To counter the effects of stress, we recover through processes that allow our bodies to rest and digest. The physical choices we encourage our “guests” to make allow their bodies to slow down, rest, and recover.
It is not only our bodies, that need recovery time. Our minds need to process new information, our emotions need time to recover from trauma or loss, and our spirits need to be cleared of offenses and worries. We promote physical recovery as an important part of healing.
Emotional. The stress emotions of anxiety, anger, terror and the reactive depression of burnout make life gray. It is a joy to help our “guests” mix in the brighter colors by deliberately budgeting in times for the people, places, and things that bring comfort and pleasure. Those who know how to laugh, dance and find beauty in even the desert places, thrive. Activating these pleasure centers of the brain releases restorative endorphins. Sometimes just talking and thinking about the people or things that bring pleasure to a patient can cause a transformation of their body language, countenance, and even vital signs! For the Christian there is supernatural benefit.2
The more stressed someone is, the less they think they can afford time for pleasure or comfort. The truth is they can’t afford not to.
Will. The will is not often discussed, but for many of our “guests” it is often critically ill. The will refers to the “want to” of desires, goals, and a sense of purpose. Many of our “guests” are broken by abuse, addiction, co-dependence, or even demanding schedules. The simple act of co-operating in the development of a simple plan for their own stress management can be empowering. Others may need to soften a hardened will and be willing to give a little, or accept new information in order to progress to health. Planning is the first step, but activating the plan is the remedy road for any victim who wants to become a victor.
Intellectual. Learning is an important aspect of remaining vital and growing through all of the developmental stages and adjustments of life. We embrace the fact that wisdom, knowledge, and understanding are important components of abundant life. Jesus stated in John 17:3 that abundant life is to know the only true God, and Jesus Christ, whom God sent. Our “guests” are encouraged to choose a way that they can learn to improve their health or situation. Our Center offers an area called “Compassion Café” where “guests” are invited to research community classes or resources that may be of benefit to them, and Cafe helpers come alongside them to succeed.
Spiritual. Some of the most debilitating issues that cause stress can only be unlocked spiritually. The terror of the fear of death that makes the night another sleepless one, the dread of guilt, the demoralizing stranglehold of an addiction all require resources that no man possesses. When these kinds of issues are brought to the surface, we are on holy ground. It is vital as Christ Centers that we have a pure safe environment that is free of any toxic judgment, pride, or legalism.
It is here where our own will, physical energy, emotions, intelligence fall short. Like David, we come in the name of the Lord and the authority He has granted us to pray for our patients’ freedom from these deadly giants.
For those who are spiritually dead, Jesus offers eternal life. For those who are stuck in anger, Jesus offers the open door of forgiveness. For those who are anxious, Jesus offers to catch what we cast. For those who are depleted, Jesus restores. What a friend we have in Jesus. He gives us the privilege to offer to pray for the deepest of human needs with our “guests”. Even when one is in the last days of his life we are able to pray with him as he moves from death to life—we encourage him, knowing he can “Aim for Abundant Life”.
When training non-medical volunteers, we emphasize the importance of avoiding theological arguments or counseling in our setting. We are licensed for medical care, and have limited pastoral and behavioral health providers on site on a daily basis. We do encourage our volunteers to share the simple truth of the Good News that Jesus has opened up the throne of grace to everyone who asks. We offer to pray for any of the issues that our “guests” would like us to.
We encourage our volunteers to be models of abundant life themselves with healthy stress management in their own lives. In this way, we seek to be a healing and encouraging environment of healthy change—a refreshing oasis in a world of stress.
Good News Community Health Center was started when our founding physician left his medical practice to serve the poor and needy, believing that Christ desires His “called out ones” to enjoy abundant life by serving others and modelling a life of kindness, adventure, generosity and grace. Abundant life is not something many of our “guests” have seen or experienced. We hope that they desire His offer of abundant life as they experience it abounding in the lives of those serving at Good News with love for one another and for those who come for help; and that they experience Christ’s life overflowing into their own.
1 1 Thessalonians 5:23. Scripture taken from The Message. Copyright © 1993, 1994, 1995, 1996. Used by permission from NavPress Publishing Group.
2 See Philippians 4:8-9.
Laura Rau, RN works as a nurse and case manager at a hospital in Portland, Oregon. She is one of the founding board members of Good News Community Health Center in Portland, Oregon, where she does staff training, patient education, and is part of the prayer team.