Psi man mascot

Stress Reduction

Stress management techniques fall into two categories. Category #1 might be called physical or bodily stress reduction. It consists of techniques for achieving a quiet or relaxed state, or (alternatively) burning off steam with exercise. Either approach can work well.

Category #2, re-appraisal, was discuss­ed on the previous page. Re-appraisal is another name for cognitive restructuring. It was the main technique used by Albert Ellis, Aaron Beck in his treatment for depression, and Martin E. P. Seligman in promoting learned optimism, all described in Chapter 13 (Therapies).

To change one's appraisal is to re-arrange the thought process to reduce stress. If re-arranging objective, stress-causing conditions in the world is not possible, then re-appraisal of the situation is the other option.

What are two categories of stress reduction technique?

Category #1, relaxation techniques, include the lowest-tech remedy: sleep. Stage 4 sleep–the type of deep sleep during which there is deep breathing, a slow steady heart rate, and little body movement–increases after stressful events and helps people recover from stress.

Stress such as pulling an all-nighter to finish a term paper can be addressed by even a minimal amount of REM-type sleep. Fortunately, the first few minutes after going to sleep is REM-like in some ways: dreams are likely during this time. A brief nap can be restorative after heavy cognitive work.

Conversely, lack of sleep can cause stress. This can be due to voluntary sleep deprivation or a sleep disorder such as sleep apnea (periods of breathlessness due to closure of the throat during deep sleep).

In both cases, the solution is simple. For sleep deprivation: get some sleep. For apneas, get a CPAP (constant positive airway pressure) machine.

Meditation is endorsed by many people as a stress-reducer. We discussed mindfulness therapies in Chapter 3, and one of their best documented claims is stress reduction.

Relaxation training can have similar effects. Herbert Benson of the Harvard Medical School made a career out of promoting the relaxation response which is simply the ability to let go of muscle tension and stressful thoughts in a "physiological state of deep rest."

People who learn to relax have reduced adrenaline levels when stressed, although their heart rate and blood pressure responses are similar to other people (Hoffman et al., 1981). This should reduce health risks for people who learn to relax, because it is the adrenal response to an emergency that affects immune and cardiac systems in negative ways, not temporary changes in heart rate and blood pressure, and not exercise in itself.

What are techniques for producing calm feelings?

Exercise can reduce stress. For many people, the after-effect of exercise is a satisfied feeling, followed by a good sleep at night. Different forms of exercise can have this effect. Weightlifting, although it activates anaerobic muscle fibers different from those activated by jogging, has much the same stress-reducing effects as jogging.

How can loving interactions benefit people? Rabbits?

Loving interactions reduce stress. Re­laxed, friendly conversations, hugs, or patting a puppy or kitten can reduce stress. There is probably no better stress reducer for a cat lover than putting an ear next to a purring cat, although other loving inter­actions with animals might be equally effective for different people.

When humans stroke animals, the humans may experience a drop in blood pressure. Animals also seem to benefit from this type of interaction.

In one study, rabbits fed a high-choles­terol diet did not develop atherosclerosis (fat in the arteries, which can lead to heart disease) if they were petted and handled every day by the same person (Nerem, Levesque, and Cornhill, 1980). A control group given the same diet developed serious heart disease.

Stress Reduction Through Cognitive Restructuring

Cognitive restructuring is at the heart of most cognitive behavior therapies (CBT). Cognitive behavior therapies are cur­rently the most popular psychological therapies, proudly cited as evidence-based because many research studies show they produce measurable changes in behavior or emotions.

That assumption has been challenged with suggestions that success rates for CBT might be inflated by file drawer effects. File drawer effects are due to a tendency not to publish research showing no effects from a treatment. Therefore, most published results of research show positive effects.

Tolin (2010) looked into that and found that CBT was consistently superior to psychoanalysis, but not other therapies. CBT consistently produced reduction in symptoms for depression and anxiety, but not other disorders. He found no evidence that file drawer effects affect­ed those conclusions.

CBT may not be a cure-all, but it does produce effects that can be measured. It also provides a coherent theoretical framework for interpreting those effects.

The underlying basis of stress-reduction using cognitive restructuring is that we respond to events according to how we interpret them, in accordance with what we believe to be true. Change what we think is real, and our reactions change, including bodily reactions.

The beneficial effects of re-appraisal are shown by people who interpret an unexpected set-back as an opportunity rather than a catastrophe. This is like the often cited "fact" that the Chinese char­acter for crisis contains the character for opportunity.

That turns out to be an error, based on a misunderstanding of the Chinese characters. However, we can re-appraise that error as indicating an insight so powerful that people made up a story about it. The fake fact is cited over a million times on the web.

What fake fact contains a grain of truth?

Reframing a crisis as an opportunity may open the door to constructive decision-making while simultaneously reducing negative emotions and stress. As Albert Ellis liked to say, we are not kings or queens of the universe; we cannot change every negative situation to be neutral or positive. "Reality often stinks." But it may stink less if we re-appraise a situation.

A re-appraisal can be realistic (most teachers are not, in fact, intentionally trying to do students harm). It can also be stress-reducing (once a student realizes the teacher is not out to do harm, a difficult class may seem challenging but not so stressful).

Ideally, changing an emotional script means coming up with a more accurate version of reality that also lessens stress reactions. Suggesting ways in which a script might be re-written does not take long, so this type of counseling can be accomplished in brief therapy.

Consider Bloom's recommend­ations about brief therapies in Chapter 13. Bloom said one goal for the therapist is to identify a focal problem quickly and offer an interpretation that expands a patient's awareness with the goal of starting a problem-solving sequence. He claimed to be able to do all of this in a two-hour session.

What is the "anxiety script"?

Suppose a student is anxious about doing poorly in school. In a two-hour session, one might replace the anxiety script with a hope script.

The script for anxiety involves (1) an event in the future (such as being expelled from school) and (2) a threat to one's well-being (such as "my parents are going to kill me").

Borrowing Ellis's technique of disputing irrational ideas, a therapist could challenge that last statement. The parents will not really kill the student.

Then one might attempt to re-write the anxiety script into a hope script by giving a different scenario of future events. The re-appraisal should be realistic but it must also provide a less negative perspective.

One might point out, for example, that all those older, so-called non-traditional students on campus (who are usually excellent students and a delight to professors) must come from somewhere. Obviously they are people who never completed college at an earlier age.

Therefore it is not a life-ending tragedy if one is expelled for low grades. It is a chance to re-assess one's plans, maybe enter a different type of school such as a technical school instead of a university, or perhaps do a little growing up before returning to college.

In truth, if a student is performing at a marginal level, leaving school might be the best thing that could happen. It could prevent the student from wasting the opportunity to get an undergraduate education.

Few people obtain more than one undergraduate degree. Instead of sliding through with Cs and Ds, as an 18 or 19 year old, a student might come back and get more value out of the educa­tional process as an older person.

How might cognitive restructuring be used with a student in danger of flunking out?

As a form of therapy with a student who is distressed about flunking out, this is more than just wishful thinking (although it might be for some people, if they never return to school). It is a plan for the future offering hope of a positive outcome.

It is also more accurate than thinking, "If I flunk out, my parents will kill me" and stressing out over that. So this type of reappraisal is an attempt to do what Bloom recommended: offer a new perspec­tive to a person in distress, help the person start thinking about future goals, and initiate problem solving (such as looking for educational alternatives). All of this might relieve some anxiety at the end of a disastrous school term.

---------------------
References:

Hoffman, J. W., Benson, H., Arns, P. A., Stainbrook, G. L., Landsberg, G. L., Young, J. B., & Gill, A. (1982). Reduced sympathetic nervous system responsivity associated with the relaxation response. Science, 215, 190-192.

Nerem, R. M., Levensque, M. J., & Cornhill, J. F. (1980) Social environment as a factor in diet-induced atherosclerosis. Science, 208, 1475-1476.

Tolin, D. F. (2010) Is cognitive-behavioral therapy more effective than other therapies? A meta-analytic review. Clinical Psychology Review, 30, 710-720. http://dx.doi.org/10.1016/j.cpr.2010.05.003


Write to Dr. Dewey at psywww@gmail.com.


Don't see what you need? Psych Web has over 1,000 pages, so it may be elsewhere on the site. Do a site-specific Google search using the box below.