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StressManagement

Page history last edited by PBworks 13 years ago


Stress Management

 

Introduction

People use coping and defence mechanisms in more or less spontaneous ways. There is no shortage of popular self-help guides concerning how to deal with stress. Some are based firmly on research findings about stress itself and coping mechanisms, while others are more anecdotal.

One influential way to classify the wide variety of is in terms of Lazarus & Folkman (1984) suggestion that there are two coping strategies that people use to deal with stress:

  • Problem-focused coping: An attempt is made to control stress by trying to change the event or situation that produces the stress.
  • Emotion focused coping: Focuses on changing the person’s response to stress. This may be the only realistic option when the source of stress is outside the person’s control.

 

Activity

 

Psychologists and medical researchers have examined a range of ways of stress management. For convenience these can be divided into physical approaches (e.g. drugs, biofeedback) and psychological approaches.

 

Physical approaches to managing the effects of stress

In some cases, chronic stress reactions are treated by the use of anti-anxiety (anxiolytic) drugs. This might occur, for example, in post-traumatic stress disorder. The most commonly prescribed drugs are the benzodiazapines: Valium (diazapam) and Librium (chlorodiazepoxide). They act by facilitating the activity of GABA, an important chemical transmitter in the brain. They do this in a complex way, binding with receptor sites in a way that enhances the effectiveness of GABA. Barbiturates and alcohol have a similar effect. Because GABA is an inhibitory neurotransmitter, the effect of benzodiazapines, barbiturates and alcohol is neural inhibition. It is suggested that anti-anxiety drugs mimic the effect of the brain’s own anti-anxiety compounds that are released in times of stress, though no-one has yet been able to find these compounds.

 

Disadvantages of anti-anxiety drugs

Anti-anxiety drugs have a number of disadvantages. They can have serious side effects and can be very addictive. Although helpful in the short term, their disadvantages may sometimes outweigh their advantages. For example, benzodiazapines may be used to treat insomnia (frequently a consequence of stress) but the sleep they induce is not as refreshing as natural sleep. In fact, it has been claimed that the most common cause of insomnia is dependency on sleep medication.

The problem with all physical methods is that they treat the symptoms of stress and not its causes (i.e. coping with stress rather than managing stress). Someone suffering from stress at work would be better advised to examine his or her work patterns and relationships than to take tablets for stress symptoms.

 

Biofeedback

Another physical approach to stress management is biofeedback. This is based on the idea that giving a person information about the state of their body (for example blood pressure readings) provides them with the potential means to control it. Biofeedback has been shown to be successful in treating some stress related conditions, such as migraine and high blood pressure, but the results are no better than those of conventional relaxation training. Since it requires complex and expensive equipment, critics argue that there are more simple and more cost effective remedies for stress.

 

Psychological approaches to managing the effects of stress

Psychological methods of stress management include various types of cognitive therapy. The aim of these predominantly emotion-focused techniques is to replace irrational and negative thoughts with more positive ways of thinking about a problem. The assumption is that in many cases there is little that a person can do about the objective situation, as stress is an inevitable consequence of modern life (a single-women trying to cope with young children can’t just abandon the children and go off to live in Ibiza). What can be changed is the way that she thinks about the situation (e.g. seeing child-rearing as a time of opportunity and taking satisfaction from the childrens’ progress). Restructuring beliefs about a problem can make that problem disappear, or at least become more manageable.

 

Stress inoculation training (Meichenbaum)

Unlike many cognitive therapies, stress inoculation training (SIT) is a more problem-focused coping strategy. It was developed by Donald Meichenbaum and the basic idea is to prepare individuals to cope with potential stressors. According to Meichenbaum (1985), the best way to cope with stressors is to go on the offensive and try to pre-empt them. People should try to anticipate sources of stress and have effective coping strategies ready to put in place. Meichenbaum describes SIT as:

 

“analogous to the concept of medical inoculation against infectious diseases… It is designed to build ‘psychological antibodies’ or coping skills, and to enhance resistance through exposure to stimuli that are strong enough to arouse defences without being so powerful as to overcome them.” (1985, p. 21)

 

SIT usually involves a therapist working with a client. The training takes place in three phases, each of which has the aim of achieving specific goals. The phases are:

  • Conceptualisation phase
  • Skills acquisition and rehearsal phase
  • Application and follow through phase

Although there were initially few studies that have evaluated SIT, recent research has shown it to be effective in a range of settings, including helping people deal with stressful jobs such as teaching, nursing and the police, as well as with professional athletes (e.g. Cox, 1991). However, SIT takes time and effort and as clients have to go through a rigorous program of training over a long period, it can only work with people who have a sufficiently high level of motivation and commitment. It also may not suit certain individuals, for example those whose basic personality makes them resistant to changing cognitions (see locus of control, below).

 

Developing hardiness

Much research into stress has shown that there are significant individual differences in the way that people respond to stress. Since some individuals seem to cope better than others, it makes sense to try to isolate the reasons why they can do so. The hope is that more effective ways of coping can be passed on to help those who are not as well prepared. Kobasa has identified such individuals, who she describes as hardy, as those whose cognitive strategies are better suited to dealing with stress. For example, they are more able to identify the symptoms of stress (so avoiding action can be taken in time). They make more realistic assessments of stressors, including being aware of the positive aspects of stressful situations (opportunities and new challenges). Kobasa suggests that hardiness can be improved with appropriate training.

 

The concept of hardiness has linked to the idea of control (see below) and, critics would say, it is somewhat difficult to distinguish the two. There is little direct research evidence on the effectiveness of hardiness training and what research there is, has tended to be confined to white middle class managers, so may be difficult to generalise to women and cultural groups. Also, like SIT, the approach requires lengthy training and strong commitment on the part of the client.

 

Control and stress

Both Meichenbaum and Kobasa’s approaches to stress management place great emphasis on the individual gaining control of a stressful situation because it is more often the sensation of being ‘out of control’ that takes a situation beyond a persons ability to cope. There is important animal research to support the idea that events over which we have no control are aversive (e.g. Seligman, 1975), and also to suggest the reverse: that knowing that you are in control can reduce stress.

There are important individual differences in locus of control. Certain individuals may be more likely to see themselves as being in control than others (Rotter, 1966). Hardy people are more likely to have an internal locus of control.

 

References: Stress

 

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