Frontline Initiative Dual Diagnosis

Promoting good mental health through stress reduction and self-care


Elisabeth Dykens, Ph.D. is Professor of Psychology and Psychiatry, Vanderbilt University, conducts research on stress intervention in families.

Negative emotions drain our energy, like a car guzzling gas. Chronic negative emotions can affect our health. Feeling positive about one’s self and one’s life can be learned and practiced. How we feel affects those we interact with daily. Direct Support Professionals (DSPs) can feel less stressed and help individuals they support to feel less stressed and more posi­tive.

We can learn and practice ways to take better care of ourselves by living more attentively and finding things for which we can be grate­ful. We can focus on the joys and pleasures around us, which we often miss when we focus on our troubles.

Think of the nervous system as having an accelerator - the stress response, and a brake - the relaxation response. It is helpful to take our foot off the accelerator some of the time. Just 3 minutes of deep belly breathing turns on the relaxation response and turns off the stress response. Conscious breathing is our most important stress reduction tool. We can practice it anywhere, anytime. Our breath is our “go-to tool” because we always have it with us.

We can reduce stress by learn­ing to be open to whatever life brings without judging it as good or bad. This does not mean we have to like what happens, but we can manage even painful or difficult experiences one moment and one breath at a time.

The tips here can help you learn to live moment to moment. Do not try to do everything at once. Practice Tip 1 for Week 1. In Week 2, add Tip 2, and so forth. Practice these tips yourself and with the individuals you support, adapting for their abilities. If it is difficult, be kind to yourself. There is no right or wrong way to practice these tips. Experiment and find what works for you.

Tip 1: Practice relaxation twice a day

Schedule a time twice daily for a 3- to 5-minute breathing space. Lie or sit comfortably. Breathe slowly and deeply. Count si­lently or softly aloud on the inhale matching the same count on the exhale. Gradually extend the count to deepen the breath. Or use words like “breathing in, heal­ing” on inhale, and “breathing out, release” on exhale. Choose words that work for you.

Tip 2: Be in the present moment

When we are fully in the present moment, we are not revisiting the past or worrying about the future. You can train your mind to be in the present moment. For example, try walking to where you are going while being fully aware. Practice noticing the mo­ment your foot hits the ground, or pay attention to sounds you hear while walking. Choose one routine in daily life and try to bring moment-to-moment awareness to that activity each time you do it. With practice, you will be present in the moment more often and for longer times. If you get lost in your thoughts, begin again.

Tip 3: Take hold of your mind

Our thoughts and feelings are like the weather. They come and they go like clouds. We can’t control the weather, but we can choose how to meet it. Getting stuck in negative thoughts adds to stress. When you notice you are stuck in negativity, name how you feel. Then try using your breath to move your attention from your thoughts to your breath. For ex­ample, breathing in: “Frustrated.” Breathing out: “Kindness.” Shift­ing your focus from your thoughts to your breath gives your mind a break. Like our bodies, our minds need rest.

Tip 4: Cultivate lovingkindness

Lovingkindness is our capacity to feel friendliness to ourselves and others without conditions. Sit comfortably. Bring attention to your breath and allow tension to flow out of your body. “Breathing in, may I feel peaceful. Breath­ing out, may I be in a space of well-being.” Picture persons who have cared for you. Imagine them around you. Say to yourself, “May I be filled with lovingkind­ness. May I be peaceful. ” Repeat these wishes for others.

Tip 5: Practice gratitude

At the end of each day, name one to three things for which you are grateful.