Stress Management Consulting Video on PTSD Part 2

Post Traumatic Stress Disorder is caused by a severe trauma that continues to haunt and trigger the past emotion as present.  It is unfragmented elements of a moment so bad that it is not fully processed into long term memory.  Therapy helps properly process this material to long term memory so it can be properly understand by the person as the past.  One still lives with the scars of the past but are able to in a healthy way process and understand it.

Please also review AIHCP’s Stress Management Consulting Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Stress Management Training

Please review the video below

Stress Management Consulting Program Blog on Hyperarousal and PTSD

PTSD has numerous triggers.  Hyperarousal is the brains reactions to those triggers.  Individuals respond to scent, sounds, memories, visuals or even touch that tap into the dissociated mental material of trauma.  This can send the person into a flash back or even into a violent rage.  It is very dangerous for them as well as for others.  It is important to identify triggers and learn how to cope with hyperarousal and manage it.  Once the trauma is properly processed, these issues become less of an issue and eventually healing begins.

Individuals suffering from PTSD exhibit hyperarousal. Please also review AIHCP’s Stress Management Consulting Program

 

The article, “What Is Hyperarousal in PTSD?” by Christopher Bergland takes a closer look at hyperarousal within PTSD.  He states,

“Hyperarousal keeps the body and mind constantly “on guard,” which makes it hard to go about daily life. Chronically heightened states of arousal are perpetuated by the fight-or-flight branch of the autonomic nervous system. This article discusses the causes, symptoms, and treatment for hyperarousal that occurs with PTSD.”

To read the entire article, please click here

Please also review AIHCP’s Stress Management Consulting Program and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Stress Management Consulting.

 

Stress Management Consulting Blog on Anxiety and Depression

Anxiety and depression can overlap but they by themselves are two independent different mental issues which can cause extreme distress.  Anxiety is a alert state of stress when stressors are no longer present.  Depression is an overlapping sadness that persists and exists usually without reason.  Both can lead to mental states of distress and usually need treatment from a professional.

Anxiety and depression shares similar symptoms but are different. Please also review AIHCP’s Stress Management Consulting Program

 

The article, “Anxiety vs. depression: Similarities and differences” by Zia Sherrell looks closer at the differences between anxiety and depression.  She states,

“Both conditions can also cause physical symptoms. For instance, a person with anxiety may present with chest pain or dizziness, and someone with depression may experience changes in their appetite or sleep patterns.  Despite the similarities between anxiety and depression, it is crucial to understand the key differences to ensure the best treatment and management approach. Keep reading to learn about the key similarities and differences between anxiety and depression, including the symptoms, causes, and treatment methods.”

To read the entire article, please click here

Please also review AIHCP’s Stress Management Consulting Program as well as AIHCP’s Grief Counseling Certification.  Both programs are online and independent study and open to qualified professionals seeking four year certifications.  Please review and see if they meet your academic and professional goals.

Stress Management Consulting Program Blog on Cognitive Restructuring and the 13 Distortions with PTSD

Post Traumatic Stress Syndrome or PTSD is the inability of the human mind to process traumatic memory.  It remains fragmented and left to haunt the person through various triggers and arousals that return to the person to the original trauma.  Emotions remain raw and the individual is trapped in the past and it repeats itself.

The first step to recovery is to confront the trauma and begin the long and sometimes painful process of properly storing the memory and integrating it, good and bad, into one’s life narrative.  The process to dismiss the past, face it and integrate it can be difficult.  The trauma is very difficult to face but for those who take the initial steps to confront and learn new coping methods to deal with PTSD, the rewards are a return of one’s very own existence and life.

Trying to recover from PTSD can be delayed over distortions about the event. Licensed counselors through Cognitive Restructuring can help individuals find the truth to move forward. Please also review AIHCP’s Crisis Intervention Program

 

Treatment is key.  Professional counselors can help individuals through a series of treatments.  One type of treatment is Cognitive Restructuring.  Cognitive Restructuring helps the individual integrate dissociated memories with associated ones in the long term memory.  Part of the process is to remove unproductive ideas and ideals that limit the mind to restructure and keep arousal high.   Functional thoughts can help remove higher arousal, while dysfunctional thoughts prevent the individual from healthy integration.  It is not the activation to think about the trauma that causes the consequence of arousal but more the dysfunctional thinking that causes more arousal.

Automatic thoughts that enter into oneself about the event can be good or distorted.  There are 13 types of distortions to thought that can make overcoming PTSD very difficult.  These distortions need corrected so that the brain can properly integrate the traumatic event.  This blog will review the 13 types of distortions.

  1. Flaw Fixation.  This distortion forces the individual to only focus on the bad.  It is a camera lens that only sees one aspect of the full event.  It is a narrowing of all the facts of the story.  The individual only recalls the failures of the particular day, or only in the present sees bad in everything.
  2. Dismissing the Positive.  Very similar to the Flaw Fixation but this does not focus on flaws of the individual but any positivity in life itself.  Only negative is viewed in day to day life and if the event was during a particular period of time, all the other good things of that time period are dismissed based on the one bad event.
  3. Assuming.  Individuals assume certain things about an event.  In Mind Reading, they assume others think negative about them and how the individual acted or what the individual experienced.  Also within arousal, Jumping to Conclusions is common.  The individual assumes any trigger is an actual threat.  Finally, Fortune Telling, predicts negative outcomes only with any future events.  Everything is predicted in a negative light in lieu of the past traumatic event.
  4. Catastrophizing.  Individuals make any events based off the past trauma to be worst than they what they truly are.
  5. All or None.  In this, the individual rates himself only as good or bad.  Furthermore, other people are seen only as good or bad.  There is no gradation or grey area in this type of reframing
  6. Shoulds.  In this, the individual relives what he or she should have done or did not do.  This does not take into account the objective reality of what occurred and places everything on the individual.
  7. Making Feelings a Fact.  Feelings are important to listen to but sometimes they can distort and make things appear different than reality.
  8. Over Generalization.  Individuals assume everything is bad or “ALL” people are out to get them.  It comes from a lack of security but closes individuals to healing.
  9. Abusive Labeling.  The individual sees oneself as damaged.  The person does not differentiate the evil and bad between the action committed and oneself.
  10. Personalizing.  The individual asserts to much blame for the traumatic event that the person is guilty of or not guilty at all
  11. Blaming.  The individual blames the event for destroying one’s life more than the event did.  It is the opposite extreme of personalizing.
  12. Unfavorable Comparisons.  When one compares to how others would react instead of oneself.   This can lead to anxiety and regret.  Instead of focusing on the event and how one dealt with it.
  13. Regrets.  This is similar to “shoulds”.  Instead one looks at all the circumstances and holds one guilty to the event instead of healing from it

 

These type of distortions can create a mixture of emotional reactions that prevent the person from seeing the trauma correctly.  One either sees the event incorrectly, others, or oneself.  This does not allow one properly process it with the truth of the matter and hence integrate it into one’s life.  It is important to understand an event and process it.    Distortions prevent this hence in counseling and reframing of the event, it is important to discuss these issues and identify a patient who may possess a distortion.  Of course the only way to know if a distortion exists is for the individual to open up about the event and confront it.

Confronting and properly processing trauma is critical with PTSD. Please also review AIHCP’s Stress Management Consulting Program

 

If you would like to learn more about AIHCP’s Stress Management Consulting Program or AIHCP’s Crisis Intervention Program, then please review the programs and see if they meet your academic and professional goals.  The programs are online and independent study and open to qualified professionals seeking a four year certification in these two disciplines.

Source: The Post Traumatic Stress Disorder Sourcebook: A Guide to Healing, Recovery and Growth by Glenn R. Schiraldi, PhD

Stress Management Consulting Program Blog on Helping Ease PTSD

PTSD or Post Traumatic Stress Syndrome is a serious condition where trauma is never processed.  In previous blogs, we have discussed its causes and symptoms.  In all cases, the memory is fragmented and unable to process due to its extreme nature.  When it is unable to become processed, it continues to haunt the individual through flashbacks, dreams, arousals, disassocation and emotional instability which leads to a variety of personal issues

Once known as Shell Shock from WWI, the horrid event is so traumatic, that those who experience PTSD are unable to come to grips with the magnitude of the event or loss.  This leads to multiple symptoms.  It is important to help treat people and guide them who experience PTSD from war, crime, or traumatic loss beyond one’s control.  Healing and treatment are a long road but there are first steps that can be taken as well as strategies to help manage symptoms.  These strategies can help someone cope till the fragmented memories are properly stored and allow the person to function without the adverse effects of PTSD.

Learning to cope with the symptoms of PTSD can lead ultimately to healing. Please also review AIHCP’s Stress Management Consulting Program

 

Healing begins when the person starts to apply skills to manage the ongoing symptoms and traumatic memory is slowly integrated.  Integration takes time and requires special therapies with a licensed specialist who can help someone process, assimilate and reframe the trauma.  In addition to utilizing skills to manage symptoms, the individual must confront the feelings and harmful coping behaviors such as drugs.   Others need to be willing to give up the secondary gains of their condition.  Some may earn government pay, others may feel the sympathy and pity of others would be lost if they sought help.  One needs to be able to give up these additional gains to become healthy and on one’s own.

One needs to also establish safe boundaries.  Only in a spot correlated with safety can someone with PTSD begin healing.  Someone who was raped may have a difficult time finding a safe boundary.  Establishing this is key as one faces the trauma.

Ultimately what is preventing treatment?  Is there a fear that treatment is a sign of weakness, especially if a soldier?  Is there a fear of discovery of the source of the pain?  Some may fear opening up to a therapist or anyone.   Others fear they may also lose the good memories with the bad.  Ultimately, a therapist can help guide the PTSD patient through the maze of feelings.

In addition, once an individual has learned to manage basic arousals, flashbacks or potentially dangerous outbursts, one may consider a support group.  Support groups have multiple benefits for PTSD victims.  The group and its autonomy grants a sense of control that one and one therapy sometime lacks.  It aids against alienation, provides security and a mutual acceptance beyond any preconceived stigma.  There secrets can be revealed, progress made and coping ideas shared.  Friendships can also blossom from the mutual pain and stories.

Many strategies during the healing process can be done alone and do not require professional treatment.   Professional treatment in aiding integration are still extremely important but learning to manage basic arousal, flashbacks and trauma are key in learning to retake one’s life.

Affect Management looks at controlling one’s own emotions by personally facing them.  In it, one names the feeling and recognizes and feels them without judgement.  The feelings are to be felt but also understood.  They are not to be deemed good or bad but experienced.  The feelings are to be seen as normal, but also in analysis constructive to understanding.  Feelings make sense if we hear them and try to better understand what they are trying to tell us.   Control of feelings is key as well.  Anger Management and its many useful strategies are key in understanding why one is angry and how to better utilize it in a constructive way.  Many individuals with PTSD are angry over what happened.  They may seek revenge, or they may feel misunderstood or jealous of others who are not victimized.  Anger at the world, the perpetrator or anything is very common.  This anger needs managed but it also needs to be allowed to vent in a healthy way and be heard in a constructive way.

When certain triggers cause arousal it is also important to learn to cope with these issues.  Breathing Retaining is a way to control one’s breath and avoid hyperventilating which is common during arousal and extreme anxiety caused by PTSD.   Other forms of relaxation and meditation can also be useful to manage arousal symptoms.  Progressive Muscle Relaxation is an excellent tool in gradually relaxing all muscles through contracting and relaxing muscles from head to toe.  Autogenic Training is also a mind body connection similar to self hypnosis that looks to calm the mind.  Another successful tool is eye movement.  Eye movement works by visualizing the trauma and not allowing to exceed an anxiety ranking about the SUD scale of 5 which is irritating but bearable.  After this is reached, one focuses on two objects and switches back and forth, moving the eyes slowly.  For many, 2/3rds to be precise, feel some type of relaxation after this procedure is experienced multiple times.

PTSD is trauma not processed. Please also review AIHCP’s Stress Management Consulting Program

 

In regards to flashbacks, many also utilize eye movement, but grounding is an equally effective method.  Grounding involves one touching something in the present, whether the arm of a chair or the soft touch of a carpet on one’s feet.  Stomping one’s feet, or even naming things in one’s surrounding can help one ground oneself in the present.  Another way to combat flashbacks is through safe place imagery.  Safe place imagery is a pre-arranged place one can go.  It first requires one to select an image that confirms safety and focusing on it and the feelings.  One should then find this safe place in their mind.  Another mental option is split screen, which one mentally portrays within one’s mind.  In it, one screen is the past and the other screen is the present.  Realizing that the past is the past can sometimes let one focus on the present screen.  Finally, a feeling dial imagery can also help some.  In it, one imagines a radio or numerical dial in which they visualize lowering from ten to one in regards to how they feel.

These are just coping strategies and it will take a far more deeper treatment plan to eventually help one with PTSD but these coping strategies open the door and help the person begin the long process to complete integration of trauma material into the long term memory.  They are useful in allowing the person to enter into society, face fears and find the healthy outcome they wish.

Ultimately, healing and treatment will  lead to less intrusive thoughts, flashbacks, dreams and distressful associations.  It will help individuals remember without detachment.  It will help one to recall feelings without arousal and detachment.  It will aid with anxiety, sexual discomfort and depression, as well with isolation from the company of others.  Ultimately, treatment will help one integrate the loss, reframe it and move forward into the future.  In future blogs we will review common treatments for PTSD

Please also review AIHCP’s Stress Management Program and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Stress Management.

Related source: The Post Traumatic Stress Disorder SourceBook by Glenn Schiraldi, PhD

Stress Management Consulting Certification Blog on PTSD

Post Traumatic Stress Syndrome is a severe reaction to a stressor so intense that it imprints upon the mind and brain its terrifying nature.  The long lasting effects can result in intense anxiety as well as for some dissociation disorder.  The effects can last months after or continue to haunt the person throughout life.   In previous eras, it was referred to as Shell Shock as experienced by WWI soldiers but while many soldiers experience PTSD, it can happen to any group of person.

Traumas can be related to war but also to any type of traumatic event than can happen in civilian life as well.  Among the type of traumas imposed upon the person include intentional traumas caused by other humans which are the hardest to overcome, as well as human caused accidents and acts of nature, which are usually easier to recover.  It is more difficult to overcome intentional acts of humans because these acts of trauma are most associated with evil itself.   War, abuse, rape, incest, torture, criminal assault, hostage, bombings, terrorism, suicide, kidnapping, riots, participating in violence, and death threats are a few examples of these severe types of trauma.

Human caused traumas not associated with evil intent still can cause trauma but they are not as mentally crushing to the individual.  These types of traumas include industrial accidents, fires, explosions, motor vehicle or plane crashes, nuclear disasters or collapses of buildings.   Less traumatic but still impactful or acts of nature, which include any type of storm or geological event, or sudden deaths not associated with evil intent.

Trauma so severe can cause anxiety and dissociation. Please also review AIHCP’s Stress Management Program

 

Many individuals suffer greatly in this world and the above stressors and trauma inducing events are well above one’s average bad day but are life altering events in many cases.  This can cause severe trauma and not allow the mind to properly process the event.  The exposure to this stressor leads to an intense fear or horror to the event itself.   In assessing PTSD, the events must be re-experienced via intrusive recollections, dreams, and hallucinations that can be activated due to similar cues.   The individual in turn will attempt to avoid numerous things to escape these intrusive reminders.   The individual will try to block thoughts, feelings, places,  and activities to avoid it.  They will disassociate in events and people and try to detach themselves.

In essence, the PTSD interrupts life in all aspects.  Individuals will have trouble sleeping, become irritable easily, not be able to concentrate, become hypervigilant, and have exaggerated responses to some stimuli.  This type of behavior can last acutely for one month, chronically for six months or more and can even be delayed, well after the event and re-emerge months later.

Those who suffer from PTSD face two major symptoms, high levels of anxiety and dissociation.

Severe anxiety leaves the person in constant distress even if the stressor is no longer present.  It can manifest physically upon the person through fatigue, tension, nausea, digestive track inflammation, hyperventilation, suffocating feelings, and a wide array of panic attacks.  Emotionally it can cause irritation, fear, exaggeration of emotions and loss of confidence.  Mentally, anxiety can cause confusion, lack of concentration, poor memory and inability to make decisions.  Spiritually, one may encounter hopelessness and despair.  Many look to avoid stressors that naturally cause these feelings and the person will become more reclusive.

In regards to dissociation, most healthy individuals possess an associated consciousness that engages in life, but when a trauma so terrible occurs, the mind does not process the terrible event in long term memory and it is trapped in short term memory.  Without proper processing, the trauma continues to haunt the person.  It is hence natural, during a horrible event to dissociate from it.  When something is so horrible to comprehend, the body for its own protection will tune out.  Unfortunately, the unprocessed and walled off trauma is highly unstable and very accessible.  It is also very emotional and non verbal and hence impressionable via our senses.  The trauma is very fragmented and associated with multiple triggers due to this.  The senses of sight, sound, smell, taste, touch, pressure and pain can all awaken these fragmented traumas and cause recollections.  The trauma can also be re-awakened by significant dates or seasons or events, as well as tied to strong emotions, thoughts and behaviors.   Sometimes the arousal is due to a combination of senses.

Dissociation looks to defend the individual from the horrific nature of the event itself.  During a horrible event, the person may depersonalize from the event itself, as if separating from oneself and watching.  Another form of this is derealization where the person real believe the event was not real but a dream.  Some individuals actually lose parts of the memory itself.  Amnesia and forgetting the event looks to help the person forget the horrific nature of it all together, while some may enter into a fugue where an individual has no memory whatsoever of how one got from one place to another during the episode.

The worst type of trauma is the type caused intentionally by other people. Please also review AIHCP’s Stress Management Consulting Program

 

The most severe form of dissociation is Dissociative Identity Disorder when a person actually creates multiple identities to deal with the trauma itself.  Also known as Multiple Personality Disorder, one creates other personalities with stronger characteristics to protect the host from the trauma itself.

Associated with dissociation and anxiety are a variety of associated features that can become attached to PTSD.  Many individuals who suffer from PTSD also exhibit a variety of these features in their behavior.

When severe trauma occurs, many have a death imprint that forever changes their outlook on life.   This leads to repeating within the mind how they wish they behaved or acted.  In this, they may feel extreme shame or guilt, or survivor guilt.  Others will develop a severe anxiety with any topic of death itself.   With severe trauma, others may also experience shattered world views.  One may doubt his or her faith or question how one exists.  Such an existential crisis is very common.

There are also a variety of mood disturbances that one may encounter fights with depression and also addiction. Impulsive behaviors can also occur  where individuals try to make sudden changes to escape the pain as well as over compensations in other roads of life.   Some will also try to relive their trauma and re-enact them in contrast to others The mind also can negatively affect the body and there are a multitude of physical ailments that occur from chronic pains to fatigue and exhaustion.

To escape the mental pain, many will turn to other forms of pleasure.  In addition to addiction, some become overtly sexual to find value, while others may turn to self mutilation.   These cries for help are attempts to express pain that cannot be visualized or seen.   In other cases, this type of behavior looks to cover mental pain with physical pain.

Ironically, it can paradoxically relieve pain and help individuals become addicted to self harm.  Others remark it helps them feel alive or makes them feel empowered and in control.  Others reiterate it can be used to make themselves less attractive to prevent further abuse or imitate what was seen or experienced.

Unfortunately, without guidance and help, these symptoms and unhealthy coping mechanisms will continue with individuals with PTSD unless helped.  They need to face the trauma and understand it.  Guidance is required to help process the horrible memory to the long term processing centers of the brain.

If you would like to learn more about AIHCP’s Stress Management Certification, then please review and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Stress Management.  AIHCP also offers programs in Crisis Intervention as well.  Remember, that even if certified, one still need to be a licensed professional in the mental health fields to work with individuals suffering from PTSD.

Related Text

The Post Traumatic Stress Disorder Sourcebook: A Guide to Healing, Recovery and Growth by Glenn R Schiraldi, Ph.D

 

 

Stress Management Consulting Program Article on Calming Oneself

Calming oneself down is an important skill in stress management and anger management.  The body when angered or stressed produces hormones in the body to prepare it for fight or flight.  When prolonged, or unnecessary over long period of times, this can harm the body.  It is important and critical to be able to calm the body.

 

Learning to calm oneself is a key coping skill in life. Please also review AIHCP’s Stress Management Consulting Program and see if it meets your goals

 

The article, “How to Calm Down: Ways to Relax Your Body and Mind” by Heather Jones takes a closer look at how to calm the body down through a variety of practices and methods.  She states,

“Stress can cause muscles to tighten, sometimes leading to discomfort or pain. These tense muscles then tell the body that it’s stressed, creating a cycle. Muscle relaxation can stop this cyclical response by relieving muscle tension and overall anxiety. It may even help you to fall asleep more easily.Progressive muscle relaxation is a technique used for this purpose. To do progressive muscle relaxation:”

To read the entire article, please click here

Please also review AIHCP’s Stress Management Consulting Program and see if it meets your academic and professional needs and goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Stress Management.

Stress Management Consulting Article on Stress and Diet

Good diet is essential in every aspect of life.  Stress is no different when it comes to eating.  Certain foods can reduce cortisol and help with stress itself.  Eating according to a stress reducing diet can be an important part of one’s overall health.

Better diet can reduce stress. Please also review AIHCP’s Stress Management Consulting Program and see if it meets your professional goals

 

The article, “Eat These Foods to Reduce Stress and Anxiety” from HealthEsssentials of the Cleveland Clinic looks closer at certain foods that help the body reduce stress.  The article states,

“If you’re trying to lower your stress levels, you probably already know to start with the basics: self-care, sleep management, and exercise. But did you know there are some foods that lower stress levels, too? Dietitian Courtney Barth, MS, RDN, LD, CPT, explains how certain foods can help reduce your levels of cortisol — the primary hormone responsible for stress.”

To read the entire article, please click here

In addition to better diet and avoiding certain foods, it is also important to remember not to miss meals.  Missing meals and needed nutrition to fight stress can cause long term problems in health.

Please also review AIHCP’s Stress Management Consulting Program and see if it matches your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Stress Management Consulting

Stress Management Consulting Program Article on Stress and Resiliency

One’s ability to overcome, cope and be resilience to stress is important in mind and body health.  The ability to bounce back from stress and resume normal activity is key.  Stress is a killer in the world, whether at home or work and those who are more resilient to stress have a far better chance of a longer life.

Resiliency to stress is key to a healthier and longer life. Please also review AIHCP’s Stress Management Consulting Program and see if it meets your professional and academic goals

 

The article, “How to Improve Your Resilience to Stress” by Kieran Alger looks at resiliency to stress and how to improve it within one’s own life.  He states,

“Modern life is stressful, even without the pressures of a global pandemic. You can take measures to reduce your daily exposure, but shooting for a totally stress-free existence is about as realistic as expecting everyone at the gym to re-rack their weights. Your next best option: learn how to spot the signs, manage your response and build resilience. Find out how to upgrade your anti-stress defenses below.”

To read the entire article, please click here

Please also review AIHCP’s Stress Management Consulting Program and see if it matches your academic and professional goals. The program is online and independent study and open to qualified professionals seeking a four year certification as a Stress Management Consultant.

In the meantime, monitor stress, reduce it and cope in healthy fashion for a longer and healthier life.

Stress Management Consulting Program Article on Stress and Mental Perception

One can never escape stress but one can interpret the data around stress and find a different outlook and perspective.  This ideal was in the classical age and many philosophers and stoics understood the nature of stress and what one can do mentally to reframe that stress.

How one perceives stress is key to how one will respond to it. Please also review AIHCP’s Stress Management Consulting Program

 

The article, “These 5 Stoic Strategies Will Help You Slay Your Stress” by Ryan Holiday looks at five different quotes from the ages of philosophy and how one can incorporate that wisdom in regards to stress today.  He states,

“Stress was a factof life. But suffering because of stress? To the Stoics, that was a choice.  They mastered the discipline of perception, the ability to see things simply and straightforwardly, as they truly are: neither good nor bad. Marcus Aurelius wrote in Meditations: “Today I escaped anxiety. Or no, I discarded it, because it was within me, in my own perceptions — not outside.”

To read the entire article, please click here

How stress is perceived and one’s world view is a big indicator how one will deal with adversity, stress, worries and anxiety.

To learn more about Stress Management, then please review AIHCP’s Stress Management Consulting Program.  The program is online and independent study and open to qualified professionals seeking a four certification in Stress Management Consulting.