TOPIC 13:

TAKING CHARGE OF ONE’S HEALTH

LEARNING OUTCOMES:
At the end of the lesson, you should be able to:
 Discuss the stress model and reflect on the sources, responses to and
effects of stress
 Differentiate coping mechanisms from defense mechanisms
 Define anxiety, depression and self-compassion
 Identify your own defense mechanisms and coping mechanisms in
response to stress

TEACHING-LEARNING ACTIVITY (LESSON PROPER):

Stress, in everyday terms, is a feeling that people have when they are
overloaded and struggling to cope with demands (Nordqvist, 2018). Stress is a
common topic talked about during discussions with friends and family
members. Entering a new chapter in your life and having a new role in the
family, the community, or the society initiates more situations that are deemed
to be stressful. According to McEwen & Sapolsky (2006), stress in people can
be physical (e.g., disease), emotional (e.g., grief), or psychological (e.g., fear).
They further explained that allostasis is the process of how the body responds
to stress, whether it is acute (short-term) or chronic (long-term).

Meaning of Stress
Stress is a response to events that are threatening to one’s well-being. It
is a common experience that can be occasional or prolonged. It is the result
of an interaction between a person and the environment, in which the person
believes the situation to be overwhelming and dangerous to his or her well-
being (Matlin, 1992). The unpleasant situation that produces the stress is called
the stressor. Hans Selye (1956) was one of the first people to study and
popularize the concept of stress. He called his stress model the General
Adaptation Syndrome (GAS). The GAS includes three stages:

1. Alarm phase – the organism prepares for action. The sympathetic

division of the nervous system becomes activated in response to stress.

2. Resistance phase – the organism tries to cope with the stressor by

releasing stress hormones. In addition, blood pressure, heart rate, respiration,
and body temperature all increase. Toward the end of the resistance phase,
the activity of the sympathetic system declines, whereas the activity of the
parasympathetic system increases. These activities help the individual adjust
and cope with the stress.
 3. Exhaustion phase- this occurs if the stressor persists. The activity of the
sympathetic system declines further and now the parasympathetic is
dominant. When the organism uses up all the available resources, physical
illness or problems are likely to develop.

SOURCES OF STRESS

Stress can be brought about by many factors. Although they are not
entirely independent, the four major sources of stress are (1) frustration, (2)
conflict, (3) change, and (4) pressure (Weiten, 1992).

A. Frustration

The term frustration is derived from the Latin word, “frustra” which
means “in vain.” Frustration is a negative emotion that stems from the
blocking of a goal-directed behavior. Failures and losses are often highly
stressful to people. A person’s inability to achieve his goals or satisfy his needs
can be brought about by many factors.

1. Personal Factors. These factors include personal limitations and

weaknesses that may deter the individual to achieve his goals. Physical
unattractiveness, poor health, and personality traits are only some of the
personal factors that may hinder the attainment of one’s goals.

2. Environmental Factors. These factors refer to physical conditions of

the environment that may keep the person from satisfying his needs or
achieving his goals. Calamities, power failures, time, and distance are only
some examples of these factors.

3. Socio-cultural Factors. These refer to social and cultural factors that

hinder goal attainment. These include social norms and traditions, economic
conditions, superstitions, and laws are some of these factors that may hinder
an individual to achieve his goals.

B. Conflict
The term conflict is derived from the Latin word, “conflictus” which
means “to strike together”. Stress arises when a person cannot readily make a
choice or a decision when confronted with two or more mutually exclusive
situations that may be beneficial, detrimental, or both beneficial and
detrimental to him or her. The types of conflict are the following:
 a. Approach-approach Conflict. This is also called conflicting
attraction. This occurs when the person is attracted to two positive goals that
are mutually exclusive, that is, they cannot be satisfied or fulfilled at the same
time. This type of conflict can be resolved by delaying the satisfaction of one
goal, if possible, or by choosing one of the goals and giving up the other.

b. Approach-avoidance Conflict. This occurs when the person is

attracted to one goal but this goal has both positive and negative
characteristics. In this case, the person may be attracted to the goals but
repelled at the same time. This makes this type of conflict often the most
difficult to resolve.

c. Avoidance-avoidance Conflict. A person is confronted with

this type of conflict if he is confronted with two situations that are both
repulsive to him. In this case, the person may vacillate or attempt to leave the
conflict situation.

d. Double –approach Avoidance Conflict. This occurs when the

person has two goals or is confronted with two situations with both having
positive and negative characteristics.

C. Change
It is believed that any change in one’s life styles or circumstances can
bring about stress to people. Life changes are any noticeable alterations in
one’s living circumstances that require readjustment. According to the
findings of researches, both negative and positive changes in one’s life can
produce stress. Changes in personal relationships, work, finances, and so forth
can be stressful even when the changes are welcomed.

D. Pressure
If one is expected to perform or conform to certain standards that he
or she has difficulty meeting or coping with, then he or she is said to be
“under pressure”. Pressure involves expectations or demands that one
behaves in a certain way. You are under pressure when you are expected to
perform and execute tasks and responsibilities quickly, efficiently, and
successfully.
RESPONSES TO STRESS
People react differently to stress. Some may react negatively while
others may devise mechanisms in order for them to adjust to the impact of
their frustrating experiences.

1. Anxiety. Some people may develop a general feeling of

apprehension or uneasiness when they are under stress. This feeling of anxiety
may cause intense suffering, panic, and irrational fear on the person.

2. Aggression. According to the frustration-aggression hypothesis by

John Dollard, frustrated people may become hostile and behave violently
when frustrated. Stress produces feelings of anger ranging in intensity from
mild annoyance to uncontrollable rage.

3. Apathy. When the stress becomes unbearable, some people may

become indifferent and apathetic. These people believe that the situation is
hopeless and they just accept it since they think that they cannot do
anything to alleviate or improve their conditions. This is evident in the
behaviors of prisoners of war (POW) who accept and do not do anything
about the brutality inflicted on them by the enemy because they think and
feel that there is no more hope for escape.

4. Dejection and Grief. Sometimes stress-especially frustration-simply

brings you down. Losing in a contest and poor grades, often produce feelings
of dejection. More profound setbacks such as death and financial reversals
can leave one grief-stricken.

EFFECTS OF STRESS
Mild stress can improve behavior in some cases but severe stress can
disrupt behaviors, cognitive processes, emotions, and physiological activities.
A person maybe paralyzed after experiencing severe stress. A person is likely
to become immobile after an immobile accident. Stress can also impair
cognitive abilities. A person may choke under pressure during a competition
or performance. Stress also disrupts emotions. Stressful life events like death
can lead to depression. Physiological responses like adrenaline rush,
increased heart rate, and dilation of the pupil, heavy perspiration may occur
in times of stressful situation.
Prolonged stress can also suppress the immune system. The immune
system protects the body from viruses, bacteria, cancer cells, and other
dangers. Researches have shown that stressors can decrease the number of
lymphocytes, which are the white blood cells that attack the invading
bacteria and other harmful agents.
 Post-traumatic Stress Disorder (PTSD)

This is a disorder characterized by a delayed reaction to stressful

situations or experiences. The major symptom of this disorder is the re-
experiencing of the traumatic events like war, torture, rape and other forms
of abuse, floods, earthquakes, accidents, and the like. The re-experiencing
may take the form of recurrent painful memories of the event, recurrent
dreams or nightmares of the event, or in some cases the individual relives the
event and behaves as though experiencing the event at that moment.
Another symptom is the numbing of responsiveness or reduced involvement
with the external world. This is apparent in diminished interest in usual
activities, feelings of detachment from others and blunted emotional
responses when the individual is not re-experiencing the traumatic event
(Holmes, 1991).

FACTORS MODERATING THE IMPACT OF STRESS (Weiten, 1992)

Some people can withstand the effect of stress better than others. This
can be due to a number of factors that can lessen the impact of stress on
physical and mental health.

1. Social Support
Social support can be an effective moderator of stress. Social support
refers to various types of aid provided by one’s social networks. House (1981)
has proposed that social support serves four important functions.

a. Emotional support involves expressions of affection, interest, and

concern that tell people they’re appreciated. It includes behaviors such as
listening sympathetically to one’s problems. It presumably bolsters self-
esteem.

b. Appraisal support involves helping people to evaluate and make

sense of their troubles and problems. It includes effort to clarify the nature of
the problem and provide feedback about its significance.

c. Informational support involves providing advice about how to

handle problems. This kind of support includes discussing possible solutions
and the relative merits of alternative coping strategies.

d. Instrumental support involves providing material aid and services.

Instrumental support includes providing shelter, lending money, going along
to a social service agency, or helping to assume work or family responsibilities.
 2. Personality

a. Behavioral Pattern - Researches have shown that people with Type A

personality pattern are more prone to stress than Type B people. Type A
people are ambitious, aggressive, competitive, and impatient. Type B people
are calmer and experience life in a more laid back, less intense way.

b. Hardiness- is a personality style characterized by a sense of

commitment rather than alienation, control rather than powerlessness, and a
perception of problems as challenges rather than threats. (Santrock, 1988)

c. Optimism - is a general tendency to expect good outcomes.

Researchers found out that optimists cope with stress differently than
pessimists do. Optimists are likely to engage in action-oriented, problem-
focused coping. They are more willing to seek social support. On the other
hand, pessimists are likely to deal with stress by giving up or engaging in
denial.

3. Psychological Control
People who have a sense of control, who have more control of their
lives are less prone to illness and stress than those who are under the control
of other people or institutions (Matlin, 1992).

COPING STRATEGIES

When difficulties arise, we devise ways on how to cope with stress

generated by our problems. Coping refers to the thoughts and behaviors we
use to handle stress or anticipated stress. Researchers identified three major
categories of coping strategies employed by people under stress
(Burger,1997).

1. Active-cognitive Strategies
People using these strategies actively think about the situation in
an effort to make things better. For example, a girl who has just broken up
with her boyfriend may have coped with this by convincing herself that she
will be better off in the long run because she can use her experience as a
lesson on how to establish a happier and more lasting relationship the next
time that she gets romantically involved with another man.
 2. Active –behavioral Strategies
When faced with a problem, some people take some action to
improve the situation. The person does something to solve the problem. For
example, a student who is problematic because he is failing in his college
algebra may cope with his difficulties by hiring a tutor or attending remedial
classes in the subject.

3. Avoidance Strategies
These are strategies employed by people who keep the stress-
provoking situation out of their awareness. For example, if a loved one is
suffering from a serious health problem, one may be able to cope with the
situation by not thinking about the person or by trying to convince himself
that the illness is not really that serious.

DEFENSE MECHANISMS

When you accidentally injure yourself, your body automatically begins

several self-healing processes, aiming to restore your body to its original
healthy state. But what if you're emotionally hurt? What if you face a sudden
shock or a tremendous amount of stress? What if your anxiety becomes more
than you can handle? What if you lose a dear one?

Just like how your body has defenses against physical wounds and
injuries, it has its defenses against emotional shocks and wounds; they're
called "Ego Defense Mechanisms" or "Unconscious Defense Mechanisms".

Another means of dealing with stress that occurs on the unconscious

level is the use of defense mechanisms. Defense mechanisms are
unconscious strategies that maintain a person’s sense of control and self-
worth by distorting or denying the actual nature of the situation. The defense
mechanisms are:

a. Displacement: Displacement is transferring or discharging your

emotions on a less threatening object. For example, shouting at your
children or having a fight with your neighbor right after your boss
shouts at you means that you are angry at your boss but taking it
out on your kids

b. Rationalization. The is a defense mechanism in which the person

gives logical or plausible but false reasons in order to cover up the
real cause of his failure or frustration.
c. Intellectualization is the use of a cognitive approach (like theories and
researches) to suppress emotions and attempt to gain mastery over the
perceived disorderly and potentially overwhelming impulses. An
example might be an individual who when told of a life-threatening
disease focuses exclusively on the statistical percentages of recovery
and is unable to cope with their fear and sadness.

d. Compensation. This is a mechanism wherein a person attempts to

disguise the presence of a weakness or undesirable trait by
emphasizing a desirable characteristic to reduce a feeling of inferiority.

e. Sublimation. This is an adjustment mechanism by which unacceptable

desires and characteristics are directed into social activities that have
strong social approval.

f. Projection. This is a defense mechanism wherein the individual

attributes his unacceptable thoughts or desires to others.

g. Reaction Formation. This is a defense mechanism whereby the

individual does the direct opposite of what he feels. At times, the
actions or responses developed are exaggerated and intolerable.

h. Repression. The process of completely excluding from consciousness

thoughts, feelings, and experiences that are traumatic and
psychologically disturbing because they arouse a sense of shame, guilt,
or anxiety.

i. Regression. This is defense mechanism wherein there the person

unconsciously returns to an earlier and less mature level of
development to flee from painful realities and present responsibilities.

j. Nomadism. This is defense mechanism wherein the individual wanders

from one situation or place to another to escape from frustration.

k. Denial. This is a defense mechanism wherein the individual ignores or

refuses to accept the presence of a threatening situation or frustrating
experience.
 l. Identification. By identifying with something or someone else you can
increase your sense of ego and self-worth. Saying that a famous singer
is a friend of yours might make you admired and so cause you to feel
better about your other problems. The person enhances his feeling of
importance by imitating or acquiring the traits of a person whom he
admires.

m. Fantasy. The individual escapes to a world of dreams to avoid real-life

difficulties and provide relief from the impact of the frustrating
experience.

Incorporating stress in daily life, Nordqvist (2018) identified some causes

of stress:
1. Job issues or retirement
2. Lack of time or money
3. Bereavement
4. Family problems
5. Illness
6. Moving home
7. Relationships, marriage, and divorce
8. Abortion or miscarriage
9. Driving in heavy traffic
10. Fear of an accident
11. Fear of crime
12. Problems with neighbors
13. Pregnancy and becoming a parent
14. Excessive noise, overcrowding, and pollution
15. Uncertainty or waiting for an important outcome

In relation to academic stress, a study by Dy, Espiritu-Santo, Ferido, &

Sanchez (2017) discovered that the top five overall stressors of the Filipino
college students were academic difficulty of subject matter, workload due to
subjects, time management because of subjects, responsibilities due to being
on one's own, and time management because of both subjects and
organizations. Moreover, they also mentioned that students reacted to stress
with affective stress responses. In another research, there was a strong
association between symptoms of mental distress, academic self-efficacy
and study progress (Grøtan, Sund, & Bjerkeset, 2019).
 Knowing the causes of stress leads this discussion to the effects of stress.
Below are some health problems you may encounter when you experience
chronic stress (McEwen & Sapolsky, 2006):

1. Stomach ache
2. Diarrhea
3. Obesity
4. Weakening of immune system
5. Anxiety
6. Depression
7. Loss of sleep
8. Lack of interest in physical activity
9. Increase in blood pressure, heart rate, and blood fats
10. Increase in blood sugar levels

Aside from the previously mentioned effects of chronic stress in the

body, a literature review of Yaribeygi, Panahi, Sahraei, Johnston, & Sahebkar
(2017), highlighted some effects of stress on body functions:
1. Declarative memory disorders
2. Reduction in spatial memory
3. Weakening in verbal memory
4. Behavioral, cognitive and mood disorders
5. Decrease in reaction time

Coping with stress may be difficult when you are not aware of your
stressors. Lazarus, et al., (1986, as cited by Baqutayan, 2015) explained two
ways of coping mechanisms: Problem-focused Coping and Emotion-focused
Coping. The table below highlights the difference of the said mechanisms:
Baqutayan (2015) also emphasized the coping mechanisms proposed by
Carver and Weintraub, as seen in the table below:

With a better understanding about stress and coping mechanisms, it is

highly important that we address how to efficiently cope with stressful
situations. Cohen (n.d.) shared practical ways to help you cope with stress:
1. Get plenty of sleep.
2. Think positive.
3. Have a stress “outlet.”
4. Engage in relaxation techniques.
5. Talk to someone.
6. Avail of the free counseling services in your school.
7. Manage your eating habits.
8. Approach the people who can help you with your concern (e.g.
teachers, financial advisors, student affairs office etc.)
9. Get all the information you can.
10. Enlist help.
11. Have a good cry.
12. Make plans.
13. Find a spiritual advisor.
 Although there are different lists of ways on how to deal with stress, let
us now view stress in a cultural perspective. The following article discusses the
social and cultural dimensions of stress among Filipinos.
This is based (direct quote/paraphrased) on Dr. Tan’s article, “Stress
and the Filipino”. It was posted in Health/Psychology by kwenivarga (2009).

*Utilize community health workers for mental health.

Given some training, they can learn to help their barangay residents
with stress. That includes essentials about counseling, for example, not
resorting to that notorious “sulsol”.

*Cognitive restructuring.
Help patients to take on new lenses as they revisit their problems.
Instead of wallowing in self-pity as a victim, cognitive restructuring helps
people regain some sense of control.

*Taking control of one’s own body, and the failing spirit.

We have that in our folk therapies — note how, in bangungot (can be
very loosely translated to sleep or better yet, nightmare that results to
death), we’re supposed to try to move a finger, a toe, any part of the
body. It’s not a symbolic act; it actually means taking control. It’s a
powerful metaphor that can be used to explain other stress-related
ailments and syndromes.

*Aromatherapy.
Dr. Tan describes Filipinos as “a very olfactory people”.Since most
imported aromatic oils are expensive, it’s best to use local plants. Some
of the most expensive aromatic oils are extracted from local plants we
take for granted, like ylang-ylang.

*Hilot (traditional/village masseur-healer).

Many traditional therapies can be channeled toward stress
management. The manghihilotcan be “reinvented” so his or her skills
with therapeutic massage can be applied not just for sprains, but also
for broken hearts and weary spirits.
 *Community action.
Communities should be urged to create their own safe spaces where
people can seek some refuge. Filipino-style, such spaces need not be
totally quiet, but they do need to give some sense of safety, of sanity in
a mad world. Filipino-style, too, we need to think of how these
therapeutic spaces might work out as places where people can
engage in social activities, without becoming more agitated.
Alternatives could be offered: gardening, cross-stitching,
bingo…anything that calms the mind. You don’t need to be in the lotus
position to meditate.

Just as how stress is encountered on a daily basis, negative emotions can

also be as prominent in an individual’s life. Various situations make you feel
happy, sad, afraid, confused, angry, tired, and not feel like doing anything.
However, when these emotions are consistently dominating your life, your
experience may no longer be classified as mere stress, but may already be a
mental health concern.
The World Health Organization statistics show that half of the people with
mental disorders — anxiety, depression, mood, and thought problems develop
at age 14 (Rufino, 2018). The National Statistics Office reported that mental
illness is the third most common form of disability in the country (De Guzman,
2018).
The concept of mental health or psychological health is still dominantly
considered as a taboo in the Philippines. Expressions such as, “Nasa utak mo
lang yan.” (It’s all in your head.), “Mas mabigat pa problema ko sa’yo.” (My
problem is heavier than yours.), “Stop overreacting.” and “Stop exaggerating.”
are often given as comments to people who attempt to talk about their
feelings. These types of comments, although often unintentionally spoken, stop
people who have mental health concerns to discuss about themselves.
Eventually, without proper avenues and opportunities for them to speak up,
some individuals reach the decision to end the pain they are feeling or to stop
the problems they are experiencing by using a permanent solution – suicide.
 Last June 20, 2018, the Republic Act No. 11036, otherwise known as the
Mental Health Act, which was signed into law. The law aims to establish a
national mental health policy directed towards improving the health of the
population in schools, workplaces and communities, underscoring the basic
right of all Filipinos to mental health. It also highlights the balanced delivery of
mental health services (community-based and hospital-based) with more
focus on persons with psychiatric, neurologic, and psychosocial health needs,
and overcoming society’s attitudinal challenges that they may live free from
stigma and discrimination (IRR for Mental Health Act Signed, n.d.). Although a
law is now enacted to address mental health concerns, we still have a long
way to go in terms of mental health awareness.
Early this year, De Santos (2019) wrote an article highlighting the
statement of Department of Health (DOH) as a response to the apparent
suicide of Razorback drummer Brian Velasco:

"In the Philippines, 3.3 million Filipinos suffer from depressive disorders,
with suicide rates in 2.5 males and 1.7 males per 100,000." We need to start
talking about depression to end the stigma surrounding mental health
because, when left unattended, it can lead to suicide.”

WHAT IS ANXIETY?

According to the American Psychological Association (n.d.), anxiety is

an emotion characterized by feelings of tension, worried thoughts and
physical changes like increased blood pressure. Swift, Cyhlarova, Golie, &
O'Sullivan (2014) explained that anxiety connotes lingering apprehension, a
chronic sense of worry, tension or dread, the sources of which may be
unclear. It can be a vague, unpleasant emotion experienced in anticipation
of some ill-defined misfortune.
According to Mayo Clinic, here are some of the common signs of anxiety:
1. Feeling nervous, restless or tense
2. Having a sense of impending danger, panic or doom
3. Having an increased heart rate
4. Breathing rapidly (hyperventilation)
5. Sweating
6. Trembling
7. Feeling weak or tired
8. Trouble concentrating or thinking about anything other than the
present worry
9. Having trouble sleeping
10. Experiencing gastrointestinal (GI) problems
11. Having difficulty controlling worry
12. Having the urge to avoid things that trigger anxiety

When you or someone you know constantly feels some of the things
that are previously mentioned, it is best to seek help from mental health
professionals (e.g. guidance counselors, psychologists, psychiatrists).

WHAT IS DEPRESSION?
According to the American Psychological Association, depression is
more than just sadness. Further, people with depression may experience a
lack of interest and pleasure in daily activities, significant weight loss or gain,
insomnia or excessive sleeping, lack of energy, inability to concentrate,
feelings of worthlessness or excessive guilt and recurrent thoughts of death or
suicide.
The Philippines has the highest number of depressed people in
Southeast Asia, and that records show a high number of cases among the
youth (De Guzman, 2018). A study by Lee, Sta. Maria, Estanislao, & Rodriguez
(2013) identified frequency of smoking, frequency of drinking, not living with
biological parents, dissatisfaction with one's financial condition, level of
closeness with parents, and level of closeness with peers as factors that
increase depressive tendencies among university students.
Depression has no exact face or form. Though researchers are still working on
identifying the exact causes of depression, individuals have different
experiences of depression. Borchard (2019) identified the symptoms of
depression based on the Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition (DSM-V). In addition, you should seek help if some or all
the symptoms have been present for a period of two weeks or longer:
1. Hopelessness
2. Inability to concentrate
3. Unexplained aches and pains
4. Lack of interest and pleasure in things you liked to do
5. Alcohol or drug abuse
6. Changes in sleep habits
7. Changes in appetite and eating
8. Irritability, agitation, and moodiness
9. Feelings of worthlessness and guilt
10. Thoughts of death, suicide, or self-harm

Similar to anxiety, when you or someone you know constantly feels

some of the things that are previously mentioned, it is best to seek help from
mental health professionals (e.g. guidance counselors, psychologists,
psychiatrists).
Having discussed stress, anxiety and depression, you are now
encouraged to be a part of the movement to increase mental health
awareness in your family, social circles, and communities. Although there are
a lot more things to learn about these topics, we finish this chapter by
emphasizing on the concepts of self-compassion and practical ways of how
to address anxiety and depression among family members, friends,
classmates, workmates, and community members.

WHAT IS SELF-COMPASSION?

The leading researcher about the concept of self-compassion, Dr.

Kristin Neff, defines self-compassion as acting the same way towards yourself
when you are having a difficult time, fail, or notice something you don’t like
about yourself. Neff (2003) further explained that self-compassion entails
three main components: (a) self-kindness—being kind and understanding
toward oneself in instances of pain or failure rather than being harshly self-
critical, (b) common humanity—perceiving one's experiences as part of the
larger human experience rather than seeing them as separating and
isolating, and (c) mindfulness—holding painful thoughts and feelings in
balanced awareness rather than over-identifying with them.
 Along with the development of the Self-Compassion Scale, Neff also
provides tips on how to practice self-compassion:
1. Learn formal meditation practices such as Affectionate Breathing.
2. Allow yourself to be a slow learner in practicing self-compassion.
3. Mindfully accept that the moment is painful.
4. Embrace yourself with kindness and care.
5. If you are overwhelmed by difficult emotions, you may pull back
temporarily.
6. Engage in ordinary acts such as having a cup of tea.
7. Give yourself what you need in the moment.

In relation to depression, Tartakovsky (2018) provides tips for practicing

self-compassion.
1. Start small. Actions such as breathing slowly or simple acts of self-
care are small steps in practicing self-compassion.
2. Bring awareness to your experience without judgment.
3. Get curious. You may start by journaling.
4. Interrupt rumination by refocusing.
5. Explore exceptions. Avoid using extreme terms such as “always” or
“never”.
6. Focus on self-compassionate statements.
7. Write a letter.
8. Remember that you are not alone.
9. Practice loving-kindness meditation.

References:

Psychology Department. (2019). Understanding the self. Unpublished.

Taag, G. C., Cuyan, A. S., Awingan, W. A., Balinggan, G. T., Carrera, W.

D., & Perez, E. N. Understanding the self. Revised edition.
Meycauayan City: IPM Publishing, c2019.