ABOUT ANXIETY AND STRESS
Harry L. Mills, Ph.D.
NATURE OF STRESS
Stress can add excitement to your life or it can become the bane of your existence. Whether it is the one or the other depends on the source of stress and on you. Any event that makes a demand for a response that may exceed your capacity may be experienced as a source of stress. These range from daily hassles, like the commute to work, or a dysfunctional cell phone, to the pain of a cancer. Most people handle daily hassles with ease, but almost anyone can become overwhelmed by the pain of cancer. Most people can manage to cope with a fender bender but those same people will find being shot at in a war a significant challenge. However, even daily hassles can sum in a way to become a challenge in a vulnerable person. How vulnerable we are depends on a number of things, including skills that can be learned.
Selye and the GAS
The father of the modern scientific concept of stress was an immigrant physiologist named Dr. Hans Selye. While studying the physical reaction of the body to disturbances, he found a pattern that seemed to occur over and over. The body undergoes a generalized physiological response as it tries to adapt to the demands and pressures and he called that response the General Adaptation Syndrome or GAS. The first step is the initial alarm reaction followed by resistance, as the body tries to adapt and, if the disturbance continues, a final stage of exhaustion sets in. He labeled the response the body makes to any demand that is taxing as stress and coined another word, stressor, to describe the events that produce the stress reaction.
To Selye stress is part of life. If you are alive, you have it. It is neither good or bad. Stress just is. You cannot hide from it. Trying to avoid it can lead to boredom which in it self is a stressor. However, Selye was a pioneer in pointing out that stress could result in diseases of adaptation. In the 1950s that was a revolutionary notion. Germs were viewed as the cause of disease. Selye pointed out that stress could weaken resistance and thus make it more likely a germ would lead to disease. Much later researchers actually injected cold germs into the nostrils of groups of subjects under high stress levels and groups under no significant stress. Guess who caught the colds? The subjects under stress. Hans Selye was right.
Biology and Psychology of Stress
We are built to respond to stress. However, we are designed for a different kind of stress than the type that we experience in our modern technological society. Our bodies are the same as it was for our prehistoric ancestors, but the world has changed greatly over during that same period. We have the same automatic reaction that our tribal ancestors possessed. We are "wired" to respond to threats with what physiologists call the fight-or-flight response. If we encounter a rattle snake while hiking along a trail our bodies prepare us to react by either trying to kill the snake or trying to get away from the dangerous situation. Our nervous system orchestrates these changes to prepare for either event:
Psychologists who conduct research on stress say there are three basic ways we respond to stress: (1) we fight; (2) we flee; or, (3) we freeze. Fighting is the power response, we try to influence the source of stress by attack or counter attack. Sometimes it is better to escape--to run away and fight another day. When the threat is overwhelming, flight may be the wiser option. When fighting or running is not appropriate we may simply freeze. In sports this is called choking.
The flight-or-fight response is an automatic alarm. How we respond, when the alarm sounds is critical to health and happiness. We may fall into mindless reactions that become a destructive, vicious cycle. External events of biological, social, physical or economic origin impinge on us from outside our bodies. These events may be highly predictable or they may be unpredictable. These lead to activation of changes in your nervous system, as well as your cardiovascular, musculoskeletal, immune and digestive systems.
However, we are not mechanical robots. Our response to stress is not hard wired. In over 30 years of research Dr. Richard Lazarus at University of California at Berkley found that it is our lightening fast appraisal of the nature of the environmental event that determines whether we experience stress. That appraisal has two components. First we ask is this event a threat to me? Then we ask, do I have the resources to cope with it? If the event threatens our well-being or exceeds our ability to respond then we experience psychological stress.
If events are appraised as threatening, the changes in the body come about because of the activation of a particular branch of the autonomic nervous system (ANS). This branch is called the sympathetic nervous system (SNS), and it functions to prepare us for action. The other branch, called the parasympathetic nervous system (PNS) acts as a brake. Its function is to slow things down -- to calm the body. The hypothalamus, a master control switch, controls the activity of both branches.
It is the SNS that kicks into action in situations you find threatening. It serves the goals of vigilance, arousal, activation and mobilization. The PNS provides for body maintenance. It promotes growth, energy storage and other activities important for longer term survival.
Hormones, called glucocorticosteriods, provide the chemical basis for the fight- or- flight response. At the same time both the pituitary and the brain secrete a class of morphine like substances called endorphins and enkephalins which help blunt pain perception and make us feel very, very good!
The hypothalamus is part of a region in the brain called the limbic system and it is the limbic system that is thought of as the seat of our emotions. There are complex interconnections between the limbic system and the higher cortical centers, where we do our thinking and problem solving, as well as, the endocrine system and our musculoskeletal system. Mobilization of our response to stress involves magnificent orchestration of all of these systems. The way we have learned to think is part of the process and the way we feel is intimately involved. How we think depends on whether the stress leads to an abbreviated event that is quickly over and done with or whether the experience lasts and is replayed over and over in our minds.
It is useful to view stress as having four stages:
Stage 1- Environmental demand
Stage 2- Perception or appraisal of the demand
Stage 3- Physical and psychological response to stress
Stage 4- Behavioral consequence or performance
An event in the environment makes a demand on the person. That demand is not automatically a source of stress unless the person views the event as a threat or that an adequate response may stretch the capacity of the person. In Stage 3 the body may show signs of increased tension and arousal (e.g. increased heart rate, perspiration, rapid breathing) and a flood of thoughts. Finally the person acts in a way that may either reduce the level of tension or increase it further, and the cycle renews at Stage 1. If the behavior succeeds in meeting the demand, the person will approach similar demands in the future with greater confidence. Learning is very important in determining our response to stress.
HEALTH RISK OF STRESS
There is growing evidence that stress is a major factor in maintaining health and well-being. Health means more than the absence of illness. In China and in ancient Greece health was thought of as being in balance with nature. The vital task was seen as maintaining equilibrium in the face of extensive demands. The World Health Organization (WHO) definition of health is a state of complete physical, mental and social well being.
It seems increasingly clear that the naive notion that a germ automatically leads to illness is no longer acceptable, although much of the lay public subscribes to the theory. Today we know that the idea of a single external cause, such as a germ, is oversimplified. The presence of the germ does not always cause the illness. The vulnerability of the person or the host animal is a major factor and that vulnerability is influenced by such factors as immunity and stress levels. So the cause of illness is not quite as simple as we once thought.
Stress vs. Distress
Another important distinction that came out of the seminal work of Hans Selye is between stress and distress. Both involve demands on the person to adapt to a challenging event. However, when we appraise the situation as being something we can handle it can be an exhilarating experience. When a person appraises the event as beyond their ability or as exceeding resources the situation is experienced as distress. Another way to look at it is that stress is positive and distress is negative. It is a valuable distinction since many people believe all stress is bad for you. It is not.
The diathesis-stress theory
The diathesis-stress theory of the origin of certain illnesses holds that we are born with certain biological predispositions but that whether or not an illness manifests itself is dependent on the level of stress one experiences and the resources one can use to overcome the stress. For example, although a person may have inherited a genetic deficiency in metabolizing alcohol, whether that person becomes an alcoholic or not also depends on the types and levels of stress they experience. Another person may have inherited a problem with glucose metabolism; however, it is factors such as the level of stress, or a sedentary life style or a combination of the two that result in development of type 2 diabetes. We may be born with certain vulnerabilities; it is stress that tips us into active illness.
Impact of stress on illnesses
Certain ailments have been recognized for some time as being influenced by stress. The most common example is intestinal distress such as indigestion and colitis. Other disorders like migraine, tension headaches, high blood pressure, arthritis and certain skin disorders may also be influenced by stress. In some instances, stress emotions seem to make an ailment worse, while in others stress may be a factor in bringing on illness. Research increasingly supports the hypothesis that stress may have at least some impact on many diseases.
There are several reasons for believing that stress contributes to the development of cardiovascular disease. First, stress emotions increase the level of low-density blood cholesterol and this leads to clogging of the arteries of the heart. Second, stress emotions result in maladaptive coping behaviors such as smoking, drinking and overeating, which can damage the heart and surrounding vessels. Finally, stress emotions result in the release of powerful hormones which result in increases in heart rate and blood pressure. One of these stress emotions is anger, and anger expressed in the form of hostility is known to increase the risk of cardiovascular disease.
Several hypotheses are being explored in the role of emotions in cancer. Again stress emotions may play an indirect role leading the person to smoke or drink excessively. More direct influence is attributed to a tendency to suppress or deny emotions. There is some evidence that those who suppress emotions are more susceptible to cancer. Again the mediating factor is hormonal activity.
At the 2002 meeting of the American Psychological Association a group-based stress management study was presented that indicated that group stress management training could lower blood glucose levels in Type 2 diabetes. Patients that received instruction regarding the health consequences of stress and instruction in the use of cognitive and behavioral skills such as deep breathing and recognition of major life stresses as well as instruction in progressive muscle relaxation lowered their glucose levels more than patients that did not have stress management training. Thirty-two percent of the patients receiving stress management lowered their A1C glucose levels by one percent or more as compared to 12% of the patients who did not receive this training. This modest change is larger than the half percent change that has been associated with significant reduction in microvasclar complications that can accompany out of control diabetes. While this change might move someone with tightly controlled diabetes to near normal levels; even those diabetics with poorer control would benefit from the reduction in glucose levels with fewer diabetic complications.
In summary, if you are a type 2 diabetic, learning to manage stress should have special health consequences for you. Although this was a group program, if none is available in your area, individual stress reduction strategies should be beneficial, especially if you have a friend or family member trying to learn stress management with you.
Stress and the immune system
The immune system has been called our liquid nervous system. With our growing knowledge of the human body has come an increasing conviction that stress may be a factor in susceptibility to colds, flu, mononucleosis and other infectious illnesses. It appears that some of the hormones secreted in the presence of stress emotions impair or weaken the immune process by reducing the number of disease-fighting components such as lymphocytes (white cells) thus leaving us more vulnerable to infection. This may be one of the reasons why so many people die within a year or so of their spouse's death. Recently there has been research into why some HIV positive patients develop full blown AIDS while others do not. One interesting finding is that patients with a more effective style of coping with stress seem to have stronger resistance as a result. It is now reasonable to hypothesize that stress emotions increase secretion of certain hormones. These hormones weaken the immune system and that weakness results in an increased likelihood of infectious illness.
Recent research indicates that brief time-limited stress that may be viewed as a challenge (e.g. passing an exam, good performance in sports, solving a difficult puzzle under pressure) may actually enhance the body’s immune response. However, chronic stress seems to reduce the effectiveness of the immune system and thus make the person more susceptible to diseases.
LESSONS FROM SPORTS PERFORMANCE
Sports teach us many valuable lessons about the relationship between stress and performance that we can apply to other aspects of our lives. On one hand brief, time or event-limited stress can be beneficial, while on the other hand, chronic, excessive stress can be very detrimental. Learning how to determine which type of stress we are experiencing is a valuable skill indeed.
Participation in sports challenges the body and mind which creates stress. Anyone that thinks there are no mental aspects to sports activities has obviously not participated in competitive athletic endeavors. Whether it is learning plays or making decisions about pacing oneself during a race, or trying to figure out the complexities of making an uphill putt in the wind on a fast green, sports require considerable mental concentration. Fortunately most of the stress caused by sports falls in the form of eustress, which is good stress as opposed to distress, which is bad stress.
Our response to significant demands is the body’s fight or flight response. We become aroused to action. Heart rate increases to send more blood to muscles, we breathe more rapidly to make the blood richer in oxygen, we perspire to cool our bodies, we spill blood sugars to give us energy and our attention becomes more focused. It is this arousal to action that is one of the keys to performance. A certain level of arousal seems to enhance performance. But after a certain point there are diminishing returns and eventually performance declines. Stress leads to arousal and arousal levels have a major impact on performance.
For many years psychologists believed that the impact of stress on performance was like an upside down U. Stress leads to arousal and that improved performance initially, then it leveled off and at very high levels of stress performance declines. However, psychologists who study sports have learned that the upside down U does not always apply. For simple activities like sprinting a hundred yards, stress seems to improve performance longer, before a decline sets in. On the other hand for complex activities like swinging a golf club stress results in a much earlier decline in performance. Another dimension is how well learned the activity may be. Golfers who practice their swings a lot will get more of a performance boost than the new golfer who falls apart even under minimal stress and arousal (e.g. on the first tee when people are watching). Put the two together and it seems the best way to be sure to get a boost from stress is to practice the activity frequently.
More recently Sports Psychologists have discovered that there are zones of optimal performance under stress that vary from individual to individual. A lot seems to depend on the level of anxiety a person brings to the performance. Anxiety is anticipation. We have more anxiety when we anticipate a negative performance outcome. While most of us worry about the possibility of failure, some of us worry more than others. Excessive worry intensifies our level of anxiety while we are participating in the sports activity. In other words some of us begin the task with more arousal, even before the performance begins. If you begin the performance with high arousal you will quickly reach your optimal zone and your performance will begin to decline sooner than if you begin with low levels of arousal. If you start out with relatively low levels of arousal and respond to the pressures and cues of intense competition by getting pumped up, you will achieve optimal zones of performance at critical times. In fact, people who worry may actually do better initially but they are not able to maintain peak levels and their performance deteriorates very, very rapidly.
Stress also influences performance through attentional focus. For sports activity with a significant mental component, the effects of stress can be catastrophic. The body’s natural stress response is to narrow the focus of attention to better attend to a threat. That is great if the stressor is a bear and the response is a simple one like climbing a tree or running. Understanding this mechanism is important. A quarterback dropping back for a pass must be tense enough to focus on the patterns being run, but if too aroused, his focus will become too narrow and instead of seeing an open receiver not planned in the play he only sees the runner who is exactly where he expected. Interception and touchdown. When there is too little stress or arousal the attentional field is too broad and there is too little focus. Too much and the field is too narrow; options are missed.
There is no better illustration of the effect of stress on sports performance than in golf. What could be more stressful than making a putt with a million dollars at stake? Is there any movement in sports more complicated than a golfer’s swing? A certain level of stress and arousal helps to sharpen attentional focus. However, since the fine motor movements are so complex performance rapidly declines as stress and tension increases. The key is learning to control tension levels by becoming an expert at relaxation. The other key seems to be practice, practice and more practice with the swing. It must be overlearned so that the boost from stress will last longer and performance will decline more slowly.
Stress can be a friend or an enemy in sports. The more you know about it the more likely you can make it your ally.
METHODS OF STRESS REDUCTION
One of the most important methods of managing stress is to develop your capacity to calm yourself down and remove yourself emotionally from stressful events. In this section we will describe many of the methods you can use for soothing yourself such as constructive thinking, relaxation, deep breathing, meditation, auto-hypnosis, exercise and yoga, massage, vacationing, getting into the natural world, time management and making time for the simple joys of living.
One of the most important of all methods is humor. Norman Cousins, who was editor of the Saturday Evening Post, was diagnosed with a debilitating disease. However, Norman Cousins refused to surrender to his illness. Rather than accept the sterile and cold atmosphere of the hospital in which he was confined, he had favorite comedy films and humorous books brought to him. He not only recovered but went on to be appointed to the faculty of UCLA medical school where he taught medical students about the "laughter cure."
Dr. Lee S. Birk of Loma Linda University conducted a study of two groups. One watched an hour-long humorous video and the other a neutral video. After the session the presence of several hormones known to increase during the classical stress response were measured. The levels were significantly lower for those exposed to the humorous video.
Research suggests you are less affected by stress if you use humor in your daily life. There are three mechanisms that explain this:
Much of human suffering is a product of cognitive distortions. By learning more about the common kinds of distortions, we can learn to think more constructively and reduce suffering. Much of what we have learned about such matters has been based on the work of psychiatrist Aaron Beck. The following types of distortions are harmful:
Learn to challenge the distorted thoughts that amplify the effects of stress. Many people find if useful to keep a diary of irrational thoughts for a week. Try to record the situations in which you find yourself using any of these cognitive distortions. At the end of the week count them. Now look at the categories. Do you tend to catastrophize? Are you a blamer? Do you tend to personalize things that happen? Learning more about how you think can be a major step in managing stress better.
Dr. Herbert Benson, a Harvard cardiologist, has made a study of the counterbalancing mechanisms of the body's stress reaction. He discovered that while the fight-or-flight response is part of the hard wired response to stress, there is an opposite response, he called the relaxation response. The relaxation response causes the body to calm itself. Metabolism decreases, heart rate decreases, blood pressure decreases, breathing rate decreases and muscle tension decreases. Dr. Benson has discovered that the relaxation response can be elicited by a number of techniques including:
Those who elicit the relaxation response regularly, such as on a daily basis, report these kinds of changes:
There are the basic steps in learning to elicit the relaxation response:
The basic steps necessary to elicit the relaxation response are:
Lie down on a bed or on the floor. Bend your knees and relax your toes. Keep your spine straight. If need be put a small pillow under your lower back for support. Scan your body for tension. Imaging the tension just draining away. Place on hand on your abdomen and one on your chest.
Inhale slowly and deeply. Notice which hand moves the most. For many people it is the hand on the chest.
Continue breathing deeply. Concentrate on moving the hand on your abdomen more than the hand on your chest.Continue this for 5 or 10 minutes. This is a way to learn abdominal breathing and to learn to breathe yourself into relaxation.
There are many books and tapes on relaxation and breathing. One of the best things you can do for yourself is to begin to develop your relaxation skills.
You have meditated. You just do not know it. However, when the word is used you may think of saffron robes and bearded gentlemen in contorted positions. If so that is too bad. Meditation is simply putting your mind at ease by using special methods of attention. It is a skill and is tied to no particular religious point of view. And it is a skill that can be learned.
While many viewed meditation as an activity for kooks, Dr. Hebert Benson, a cardiologist at Harvard Medical School and Deaconess Hospital in Boston, decided to study it systematically. As a result of his research, meditation has enjoyed widespread acceptance in the west. School teachers meditate, CEOs meditate, and people concerned about stress are making meditation a part of their lives.
Meditation allows you to develop greater control over your thoughts, worries and anxiety. Americans like to stay busy and judge everything by the numbers. If we are not running from event to event we feel guilty. Meditation requires pausing for at least a brief time each day. It involves sitting still and focusing your attention on what happens when you are sitting still. For a little while each day you live in the present and not the past or the future.
The best introduction to meditation is meditative breathing since breathing properly is the key to relaxing. Try these steps:
Put on comfortable loose clothing. Sit down on the floor in a comfortable position. Cross your legs in a comfortable way. Or, if you prefer, sit in a chair with good back support. Scan your body for tension. As you notice any tension just imagine it is draining away and being replaced by relaxation.
Just begin to breathe through your nostrils in a relaxed way. Breathe from your abdomen. Some people imagine a balloon just under their belly button that inflates and then deflates. As you inhale count one. Exhale slowly. Then on the next inhale count two. County silently to yourself up to ten.
If you find distracting thoughts just return to the count.
Once you have tried this exercise, you have given yourself a taste of meditation. It is a skill you can continue to learn about for the rest of your life.
Another aspect of meditation is called mindfulness. Mindfulness means focusing on what you are doing right now. One way to learn more about mindfulness is to focus on the experience of eating a favorite fruit. Many people use an orange cut into wedges for this exercise. Others people prefer to use a mango or even raisins. Pick a favorite fruit and then try this exercise:
There is a lot of hype about hypnosis. Hollywood has taken license to dramatize it. Hypnosis is simply a state of consciousness between being asleep and being awake during which you can do a number of things that can help reduce stress. We should begin by ridding ourselves of some myths about a hypnotic trance:
You slip in and out of a hypnotic trance all the time. Have you ever been driving and arrive at your destination only to realize you do not remember the drive? You slipped into a trance. Do you ever daydream and simply get lost in thought? You were in a trance. Have you been in a movie and get so engrossed you were oblivious to what went on around you? You hypnotized yourself.
There are many audio tapes and CDs that you can purchase at any book or tape shop to learn the art of self-hypnosis. If you want to learn more about hypnosis give one a try.
Exercise and yoga
When you exercise you produce endorphins, morphine like chemicals, that produces feelings of well-being and calm. By getting active you use the body’s natural fight or flight response, rather than suppress it, so you feel better. Research reveals the value of exercise in reducing stress. For example:
Whatever specific exercises you choose you should be able to answer yes to these questions:
If the answer to these questions is yes you can make it a habit or as one psychologist puts it, a positive addiction.
The best way to keep exercise going is to make some form of exercise part of everyday. Make it as natural as eating or brushing your teeth. If you have to think and plan too much it becomes easy to skip, delay, avoid or postpone exercising. Formulate a simple plan and then follow it. Many people set a time each day to engage in some kind of physical activity. Remember walking can be an excellent activity. But from the beginning you must find a way to enjoy the activity or find a way to reward yourself immediately afterwards. You will keep up activity only if there are rewards. If it is all pain there will be no gain! Until you can maintain from the experience of gain -- reward yourself.
Yoga is a stress relieving activity that affects the mind as well as the body. Yoga uses a series of gentle fixed poses, stretches and breathing techniques to relax the body and calm the mind. It is not necessary to attempt to perform some of the more advanced postures in order to derive benefits. Yoga has been demonstrated to relieve muscle tension as well as help lower blood pressure and cholesterol levels.
There are many different types of yoga. Hatha is probably the most frequently encountered type in the United States. It focuses on meditation, breathing and slow focused stretches. Bikram is the type often practiced in rooms with temperatures over 80º. Ashtanga is a very active form of yoga involving a fairly rapid pace as participants move from one pose to another. Yoga Fit© is a new take on yoga that combines traditional yoga poses with the use of light weights. Sport Yoga is a type of yoga which is easy for beginners. It is based primarily on Hatha yoga but also includes some traditional sports stretching, some pilates exercises and martial art warm-ups. It is more effective than regular sports stretching because of its emphasis on structure and balance.
As in any new endeavor, a beginner should be patient with themselves as they begin their yoga study. The use of props, such a foam bricks and cloth straps, is recommended as it allows the novice yoga student to correctly approximate postures which they may not be able to do because of tight muscles. Over time a student will gradually become more flexible and able to do more and more. Physical and emotional benefits are available to all participants.
As you take class, select postures you enjoy for practice at home; if you completely understand the proper way to do some of the more difficult postures you can also work on those at home. Balance postures, like the tree asana, may be practiced with your back against a wall (at home) allowing you learn what the pose feels like and gain skill so the pose will be easier when performed in class without a prop. .
Psychologist Sidney Jovrard studied the number of times men and women touched in cafes in different countries. In San Juan, Puerto Rico he counted 180 contacts per hour. In Paris the rates were 110 per hour. In Gainesville, Florida twosomes touched only twice per hour and in London the count was zero! And yet touching seems to help reduce stress. For example, a massage by a professional or by a loved one can be excellent.
Today you can get a massage about as easy as a haircut. There are a number of approaches:
All these approaches have their origins in early medicine and healing arts. If you have money to spend you can find an expert near you and set up an appointment. If you prefer you can ask a partner to give you a back rub or you can do it yourself.
There are specialty stores that sell a variety of devices from vibrating chairs to simple hand held vibrators. These devices can help relieve the tension at the end of a tough day. However, a good friend can be of great help. Just be sure to offer to reciprocate. This is the way to get started:
The best way for your partner to learn is to do it. Give them feedback about what works and what does not. Make massage part of your stress management program.
Vacations are great. Two weeks away from the office makes you feel good and the tension is gone while you are away. However, by 2:00 PM on the Monday after you return you are tied in knots again and now you have to wait for a year for another vacation. As a way to reduce stress you are far better off to take a number of mini-vacations throughout the year than to depend on just one. Furthermore, it is better to take them before the level of stress builds rather than use them for stress relief when overwhelmed.
Start a mini-vacation notebook. Study a map of your area, go to a book store and get books on the attractions in your area, make a list of the things you really like to do that take hours, rather than days, and put those in your notebook. . Keep an eye on the articles in your newspaper about things worth doing and seeing. Put those in your notebook too.
What are the natural world attractions in your area? Where are the parks? Look for water, as water seems to be natural way for use to relax. It can be a creek, a lake, a bay, a gulf or an ocean. Plan to walk beside it, sit beside it, picnic beside it or even jump in it.
Here are some things to try:
The list could go on and on. The best vacations from stress are frequent breaks in your routine. Plan for them. Take that two weeks but don’t put all your stress reduction eggs in that one basket.
Our great-great grandparents were able to look at natural scenes and not parking lots, buildings and brick walls. Research has shown that patients have better recovery from surgery when they have hospital windows with scenes of nature rather than brick walls. We should treat ourselves to feasts like watching the clouds in the sky, or the surface of a tranquil lake or watching birds nesting. Pictures of ponds, streams and trees produce lower levels of arousal and higher alpha waves, brain waves associated with wakeful relaxation.
Researchers have found that even watching aquariums can lower blood pressure and produce a state of calm relaxation. Learn to look for and dwell upon the natural scenes in your environment. Stop by a park and walk or ride through. Let your eyes, ears, and nose soak in the pleasant scenes that are already part of your everyday world. Stop and look.
The lonely view of a mountain with snowy crests stretching upward into the sky or the blue green white capped waves at the beach and the roar of those waves as they crash onto the shore can be restorative. We seem attracted to the sound of a river as it flows. For thousand upon thousands of years these were a part of daily life. Now instead of the sounds of the wind we hear the sounds of auto horns. Instead of the colors of a forest we are bombarded with the blacks and grays of asphalt and cement. We are more likely to smell petroleum waste than the intoxicating aroma of evergreen.
Find time for nature. It can help you cope with stress.
To manage stress you need to manage yourself in the context of time. While no one would say it out loud, in many organizations time is treated as an unlimited or renewable resource. However, there is only so much time in each life, each year, each month, each week, each day, each hour, and each minute. And once it is gone, there is no getting it back. In order to make your workday more efficient, you need to identify the top time-killers in your day and how to eliminate them.
Some of the biggest time killers are:
Traditional time management gives too great an emphasis to working life and too little emphasis to a balanced life with family and to restorative activity (e.g. recreation). The old methods can lead you to the delusion that you are in control of your life when in reality you are not. Purpose, principles and values should be used to align weekly and daily priorities. Traditional approaches to prioritizing tend to lead to crisis management because it is based more on urgency than on what is vital. People and relationships are taken out of the equation and turned into objects and barriers. It often leads to a guilt trip and that in turn leads to abandonment of the time management effort. In a nutshell, the old time management adds to stress; it does not reduce it.
To cope with stress you must become a master of timing. You should:
At the end of each day you should be able to say…”the way I spent my time was a reflection of my personal values and philosophy of life.”
Develop a very personal statement entitled, ‘My Purposes in Life’. To keep you do so, ask yourself these questions and write out your answers on cards or paper:
Take what you have written and create a purpose in life statement. Review it before you set weekly and/or daily priorities. Make it a habit. Never prioritize without reviewing it. It will help keep your life in balance. More balance means a reduction in stress.
Making time for joy
We are built to gain important information and to learn important lessons from sensory events. We love sweetness such as the taste of a peach or a mango. Once we have tasted it we will go back for more. On the other hand our bodies are built such that the senses can also warn us about danger. A distinctive stench can warn us about spoiled food. Bitterness can tell us that certain foods may harm us. Loud noises may warn us to avoid a falling tree. A flash of pain leads us to recoil and thus avoid a serious burn. In short, we need not advocate mindless hedonism in order to ackmowledge that we are built to seek certain joys and avoid pain. We need a balance in the direction of joys in order to reduce stress. Many of us have fallen out of balance. We need more joy in our lives.
The belief that saunas are good for your health may have merit. Following a sauna, electrical discharges in muscles show a more relaxed pattern. In addition, saunas can also decrease pain in muscles and joints. One study revealed that 30 minutes in a sauna doubles the beta-endorphin level in the blood. Beta-endorphins are chemicals in the brain that relieve pain and produce a sense of well being. The heat may deplete the body's stores of stress hormones. After a sauna people show more brain waves related to deeper more restful sleep. If you do not have a sauna, many of the same benefits can be obtained by taking a very hot bath. It is a simple joy that can have multiple benefits.
To the ancient Greeks, Apollo was the god of both medicine and music. Early physicians used music to regulate heartbeats and music and singing were used to cure many ailments. At least part of the joy of music may come from the release of endorphins. When an experimental drug that blocks the return of those chemicals is used, the joyful experience of music is blunted.
Music is a part of all our lives whether your preference is jazz, gospel, pop, rock or Beethoven and Bach. Music is a mood mover. High-pitched music is experienced as happy and playful. Low-pitched music is experienced as sad and serious. The faster the beat the more the music heightens alertness and arousal. Slow music lowers the body's response to stress. Music influences respiration rate, blood pressure, stomach contractions and levels of stress hormones in the blood stream. Our hearts beat at 70 to 80 times per minute. Most western music is set to this tempo. Research has shown that heart rate will synchronize with music and music alters the brain's electrical rhythms. It is well worth the effort to make music more a part of our lives. Try different types of music and evaluate the degree to which the music serves to relax you. Remember mood matching may be the way to begin. If you are tense you may wish to start out with music that matches your tension and then gradually move to more soothing and relaxing sounds.
We eat not only to stay alive but also for the social and emotional pleasures eating brings us. Our emotional connections to food are one of the many reasons that following a weight loss diet is so difficult. It is very likely that our "sweet tooth" evolved to guide our ancestors toward ripe fruits, ready sources of energy and certain essential vitamins. The taste for sweet and fat in foods served our ancestors well making foods rich in calories attractive and allowing them to store fat for burning in times of famine. Fortunately for our ancestors, there were no pizza parlors, hamburger joints and ice cream shops on each corner in the forest or jungle of long ago. While our great grandparents survived on grains, fruits and vegetables we have the choice of daily feasting on fats and sugars. We must learn to eat wisely while maintaining the joy food brings us.
People seem to love variety and crave different taste sensations. Diets that are weak in flavor and variety of texture tend to fail because they fail to bring joy. Enhanced flavors and a wide variety of foods is recommended. Spicier foods, for example, not only may be pleasurable, there is also evidence such foods burn more calories.
You like chili peppers so much they must be bad for you, right? Wrong! The hot cuisine of Szechwan, India, Thailand, Mexico and the American Southwest may be a joy you should seek. Chili pepper may very well lower your cholesterol levels and there is evidence such peppers may help prevent blood clots.
You can increase joys and reduce your waistline by slowing down to enjoy your food while you are eating. Savor every bite. Be mindful of what you are eating, bite-by-bite, rather than wolfing down the meal. Since much of the flavor of food comes from odor you will find that slowly and thoroughly chewing your food not only breaks it down but creates air currents that carry the aroma of foods to olfactory receptors. Turn eating into a joy.
Carbohydrates are a natural stress food. They raise the brain levels of tryptophan, a building block of the calming chemical serotonin. A small carbohydrate snack can make you feel calmer and relaxed during a trying afternoon. Proteins seem to provide for alertness. It adds stimulation but it may also increase levels of stress. Carbohydrates may also be useful at the end of the day to set the stage for a good night's sleep.
Studies of Laboratory animals and humans show that generous doses of garlic can reduce dangerous LDL cholesterol levels while increasing the heart saving good HDL cholesterol. Other evidence suggests garlic may boost immune functions and may even provide some protection against cancer. So whether you like pepper and/or garlic you can clearly enjoy the simple joys of food without loss of health.
In your time mastery program include approaches with these joys to reduce stress:
Start your own list of the joys that mean the most to you. Get a notebook and carry it for a week. Jot down the activities as the come to mind. Then make an appointment with yourself to recharge your batteries.
Perhaps it is as simple as this: Joy recharges our batteries and prepares us to cope more effectively with the stresses of daily life. Seek joy. Find it. Relive stress.
PICKING THE PROGRAM FOR YOU
Stress is a significant factor in contemporary life. Many types of programs have been developed in response to this need. The following list is but a sampling of the many, many alternatives available to individuals, groups and businesses interested in dealing with this important issue.
Stress Education Center
Stress Education Center offers a variety of stress management tools and techniques.
Their Stress Management Solutions for Individuals include Tapes/CDs, MyBooks, Classes and Trainings. Relaxation Audio Cassettes/CDs are offered for Basic Progressive Relaxation; Basic Autogenic Training, learning to use especially formulated phrases to control your stress response; Ten to One Countdown, a technique to control muscle tensions, like tension headache, jaw pain, neck/shoulder pain, sleep disturbance; Visualization for Deep Relaxation, how to use positive mental images to enhance the body’s natural healing. The audio tapes are sold for $11.95 each plus $1 per tape for shipping and handling; $13.95 for each CD plus shipping and handling. A set of the first three tapes sell for $32 plus $4 for shipping. All four CDs sell for $50 plus $4 shipping. California residents must pay 7.50% state sales tax.
They also sell tapes and CDs for Prenatal Stress; Stress Management for Chronic Pain; Stress Management for High Blood Pressure; Stress Management for Sleep; Panic/Anxiety Control (CD only); Stress Management for Headache Control (CD Only); Stress Management for G.I. Disorders (CD Only); Healing with Imagery (CD Only); Pre-Post Surgical Stress Management Program (CD Only). This second group sell for $13.95 for tapes and $15.95 for CDs. Purchase of two or more reduces the price to $13 for tapes and $15 for CDs as an internet special. $1 per tape/CD is required for shipping and California residents must pay the 7.50% state sales tax.
Stress Education Center also offers business stress management tapes/CDs: Ten Minute Stress Management for Work, with practice this relaxation approach can be done in only a few minutes, without the tape in all but the most difficult situations; Commuter Stress Management, this product helps the driver maintain driving vigilance while being helped to focus on relaxing, positive thought; Time Management & Stress, provides basic information to organize yourself and set priorities; Overwhelmed? Reboot Now! (CD only), provides two especially designed guided relaxation techniques to help control work related stress. These products cost $11.95 for tapes, $13.95 for CDs if bought separately plus $1 per tape/CD. A set of three business related tapes are combined for an Internet special of $32 ($38 for CDs) plus $3 for shipping. California residents must pay 7.50% in sales tax.
It is recommended that you should allow 4-6 weeks of regular use to determine whether the program has benefit for you. Eight to 12 weeks of regular use, or longer, is recommended for best results.
Stress Education Center’s web site is located at http://www.dstress.com/tapes.htm for more detailed information about these products and ordering information.
Stress Education Center also offers a Stress Management Online Course. Each program is unique and specifically designed for the participant. Each program contains 3 stress surveys; combined powerful approaches for managing stress; 5 audio tapes or CDs that give instruction in proven stress management techniques; a biofeedback monitor to measure your success; exercises to help you at work; email feedback from the instructor and additional tape selected just for you; a signed copy of Dr. L. John Mason, Ph.D.’s book “Guide to Stress Reduction” (New Edition). The program cost $195 with reduced rates for multiple registrations. There is a 100% money back guarantee. More information and ordering information may be obtained at http://www.dstress.com/callinter.htm.
Stress Education Center’s Stress Management Programs -Training in a Resort/Spa Environment
Some of Stress Education Center’s Stress Management programs are offered in Sonoma County’s Wine Country. The training is advertised as taking place in a resort/spa environment. Training includes stress management, guided relaxation, work/life balance, enhancing performance, wellness through nutrition and exercise, massage and spa treatments (as available), tapes or CDs to take home, and assessments aimed at creating awareness and developing a continuous lifelong learning plan. Communication or Time Management Skills are available.
Most programs are offered at preferred Sonoma County properties which offer wonderful ambiance, massage/spa facilities, great food and access to the coastline, the Redwoods and the Wine Country. It is described as the ultimate relaxation experience. Prices vary based on services rendered and retreat facility selected. The length of say and amount of training per visit will affect the price. Most executives who receive this coaching report they save time and increase personal productivity in addition to having their quality of life enhanced.
A customized Executive Coaching program can be developed as a follow through based on the principles. An additional monthly fee would be required based on the services provided.
For more information about these programs or his many other offerings, check L. John Mason, Ph.D.’s web site at http://www.dstress.com/sonomacounty.html .
Mind Tools states that since 1999 they have helped improve and advance the careers of more than 8,500,000 visitors and invites you to join them. They go on to state that 500,000 people a year learn how to master stress using their Mind Tools. Their goal is to give you simple but effective relaxation techniques for you to use to tackle stress as well as essential skills to stress-proof you life.
Their products deal primarily with workplace stress, although there is a great deal of information about relaxation strategies and useful links for purchasing materials. There are two major Mind Tools products offered. The first is an e-book version of all the tools found on the Mind Tool site which can be downloaded as an Adobe Acrobat PDF file. These tools include more than 100 thinking skills divided into nine essential areas, one being stress management. They are located in a commercial web site format online but in an easier to use PDF format for offline use or printing. It is possible to read these materials online and down load those that interest you the most. It costs $4.99 to download each section, or $19.95 to download the entire set of tools.
There second major offering is their Stress Management Masterclass which is also offered both online in a commercial format or downloaded in Adobe Acrobat PDF format. The materials are free except for a nominal fee for downloading of $19.95 for the 180 page Stress Management Masterclass manual. All these materials have a 30 day money back guarantee.
Some of the stress management tools offered include: a Stress Diary to use to identify short-term stress in your life; Physical Relaxation Techniques; a Burnout Self-Test; Thought Awareness, Rational Thinking and Positive Thinking guidance; Imagery, mental stress management; Rest, Relaxation and Sleep, starting to manage long term stress.
The Stress Management Masterclass is divided into modules: Understanding Stress, Pin-Point the Sources of Stress in Your Life; Cope with Work Overload; Survive Problem Jobs; Work Successfully with Powerful People; Reduce Co-Worker and Team Stress; Manage Performance Stress and Learn Relaxation Techniques; Reduce Stress with Rational Thinking; Build Defenses Against Stress; and Avoid or Recover from Burnout. This program helps you manage intense stress, learn to identify and resolve sources of stress in your life, deal with stress coming from other people, works on eliminates negative thinking and helps you find job satisfaction. . A side effect of these modules is that you will learn to be more effective and productive at work and these are the skills that will enhance your career.
In summary the Mind Tools site is an excellent site for information to reduce both professional and personal stress. The Mind Tools website is located at http://www.mindtools.com .
The Journey to the Wild Divine: The Passage.
This is first in a series of “Inner-Active” computer adventures that use biofeedback to create a truly enlightening experience for the mind and body. The program uses the power of your thoughts, feeling, breath and awareness to promote mind/body health in an effort to achieve an ability to achieve deeper meditation, to reduce stress and anxiety, to enhance creativity and intuition and to improve mental and physical performance.
The Journey to the Wild Divine: The Passage uses biofeedback to teach users how to alter their brain activity, blood pressure, muscle tension, heart rate and other critical bodily functions. Skin conductance and heart rate are monitored through sensors gently attached to player’s fingers. Information is fed back to players as events on the computer screen. By increasing or decreasing or synchronizing body rhythms through techniques the characters teach a player they learn to master events and advance in the game. The knowledge learned is supposed to help enhance personal growth and well-being.
The game includes biofeedback hardware, CDROM software for PC and Mac, a Companion Guide, a User’s manual, and bonus “soul Flight” music CD. The cost is $159.95 and there is a coupon on the site for free shipping in the U.S. The Journey to the Wild Divine: The Passage may be purchased at http://www.wilddivine.com. This site provides a great deal of information about this product if you think that you might be interested in it.
The Option Institute: International Learning and Training Center-Residential Programs
The Option Institute, based in Sheffield, Massachusetts, was established in 1983 by founders/directors Barry Neil Kaufman and Samahria Lyte Kaufman. Since 1972 the Kaufmans have been teaching the Option Process® a powerful method of uncovering and changing limiting and self-defeating beliefs.
The Options Institute offers several residential stress management programs. Their program is supposed to uncover and possibly remove the root causes of your stress which is usually the result of a particular set of beliefs or ways of thinking. They attempt to change the way you perceive other people and events in your life and to move beyond stress by uncovering and discarding the perceptions and thinking modes that got you there in the first place.
The institute is located on a beautiful 95-acre campus in the Berkshire Mountains of western Massachusetts. The campus offers trail hikes, waterfalls, woodlands, etc. There is also a complete spectrum of fitness equipment in their fitness facility on campus. In addition to the beautiful setting and New England country charm, the surrounding area is said to have both year-round recreational seasonal sports opportunities as well as summer cultural opportunities, such as theatre, dance, and music, including Tanglewood, the summer home of the Boston Symphony Orchestra. Lots of shops, galleries, and antique shops are nearby.
Housing is in comfortable, modern guest houses; two people (occasionally 3) to a room are standard. Bathrooms are located in the hall. Many units contain kitchens. There is also a selection of larger rooms with baths in a new residence. A few single private rooms, with and without baths are available for an extra fee. Three delicious healthy, mostly vegetarian, meals are served a day.
Their Revitalize Your Spirit program is designed to give you the tools to find a sense of peace, an oasis of calm and a different way to be effective. The program is conducted at the Option Institute as a group retreat limited to 25 people. All attendees are provided private time with a certified Option Process Mentor/Counselor. Attendees learn to Stop Cracking the Whip-or how to eliminate “shoulds” and self-judgments that generate feeling of pressure. Attendees also learn how to De-Magnetize themselves and stop attracting stressful situations and unsupportive people. Tuition for this 6 day retreat is $1,795 which includes meals and lodging.
A second program offered is the Inward Bound Program/Seminar, a weeklong program/seminar. The Inward Bound Program/Seminar is a self-reflective, contemplative journey to enable you to find your own personal life mission. The Kaufmans feel that stress occurs when you live other people’s missions. The goal of this program is to help you stop living other people’s goals and begin living your own. Participants discover who they really are and quit stressing out about the near or distant future. Tuition is $1,795 and includes meals and lodging.
They also offer their signature program, Living The Dream which is a 4 and 8 week training program. This is marketed as a total life makeover program. How does this relate to stress management? They believe that stress is relate to our whole network of beliefs and perspectives and this program allows you to take the time to look at every place that stress interacts with your life. This will probably be the last year for this program. The 4-week course is $6,300 and the 8-week course, $11,400. Both tuition amounts include room and board.
For more information about these programs and about The Option Institute in general visit their web site at http://www.option.org/stress_programs.html Recent information on the site indicates that they are reconfiguring programs and will keep interested parties advised as what’s in store for 2005.
STAGES OF CHANGE AND STRESS
Changing the way you manage stress usually begins with a challenge to your old ways of doing things. Perhaps you become overwhelmed with a presentation at work and you blow it. Perhaps your doctor says these illnesses you have been having are because of overwork. Perhaps you have a heart attack. There is usually some signal that stress is becoming a major factor in your life and you need to change.
In the awareness stage you begin to learn more about stress and its impact on your health and performance. Reading this is just such a step. Perhaps you go to a seminar or buy a book on the subject. This stage is very important. The more you learn about your body and mind when you are under stress, the better you can guide your own process of change. Take the challenge and change.
Make a list of the things you need to do to get ready for making changes. Perhaps you need to buy a cassette tape or CD with relaxation exercises on it. You may need to study your schedule to see if you need to make changes to ready yourself for a more balanced lifestyle. You may need to obtain a personal organizer or a digital assistant.
As with other lifestyle change programs you should set a date to start your new program. Since there are more dimensions of change with stress you may set a series of dates. You might start with doing daily relaxation and then a week later begin a thought diary to change thinking patterns. Keep records of your changes even if only in a diary form. Such records help if you lapse to get back on track.
Maintaining your gains
Keep in mind change is like a spiraling road to the top of a mountain and not a steep trip straight up. You may lapse but just get back on track as soon as you can do so. Even if you feel discouraged, get back in the spirit and move on.
CREATING A PRESCRIPTION FOR YOU
The best prescription for reducing stress is one created by you based on your growing knowledge of stress. You should begin by setting prescriptive goals such as the following:
This is a bare minimum prescription, so if you would like to be more ambitious you are welcome to do so. You might want to start a new goal or two each week for three or four weeks.
MAKING A COMMITTMENT
Do not keep you plans a secret. Find at least one person who cares about you, such as a good friend, a sibling or a spouse, and share both your goals and how you will try to achieve those goals. While it may seem silly at first, write out a contract with your goals spelled out and any deadlines specified. You sign and then have your partners in change also sign. Make copies and carry one copy with you in your calendar or organizer. Post a copy on your refrigerator. Keep one in the car.
If you change your goals or the methods you plan to use, redo the contract, sign the new version and put it in places where you will be reminded of your program for change.
STARTING YOUR CHANGES AND TRACKING PROGRESS
Start a diary in which you record two aspects of your stress reduction program. Set up the pages so that after the first page as you open up the diary humor is on the left page and thinking is on the right. Put the date in the top center of each page. Put ‘Humor’ or put ‘Thinking’ on the appropriate page. During the day or at the end of the day make a list of the opportunities for humor that you either create or to which you respond with humor. On the right page make notes about when you use stress escalating thoughts like catastrophizing, filtering, overgeneralization, polarized thinking and other examples of negative thinking. Write down the time, the place, the preceding event, the thoughts you had and the potential negative consequences of the thoughts. Keep the diary for two to four weeks. You will be amazed at how much you learn.
If you use an organizer system like Day Runner, Day Timer OR A Palm Organizer you can use that system for scheduling and recording. If you do not use one of those systems you may find becoming a time master more difficult. So go to an office supply store and look over the systems. You must begin by placing your life goals and your goals for the stress program in a prominent place so that as you schedule events and set priorities you can refer to them. Then not only enable your business schedule in the calendar but also the planned events in your stress program. Schedule times for these:
When you complete the activity scratch it from your list just like a business appointment completed. By integrating your stress program into your time management you are much more likely to succeed.
MAINTAINING THE GAINS YOU MAKE
Once you start your stress reduction program you can maintain your gains if you remember that you have to get back on the horse if you fall off. Make reminders and posters for yourself with the reasons why stress reduction will pay for you. Write down a list of the top ten reasons for keeping work going on managing stress. The big two reasons are:
Keep those in mind when the going gets rough. Many people find it easier to maintain their progress by starting with time mastery. Then they fit the elements of their program into that personal development project.
Recommended Reading and Bibliography
Benson, H. (1976) The Relaxation Response. New York: Harper Torch.
Carlson, R. (1997) Don’t Sweat the Small Stuff and Its All Small Stuff. New York: Hyperion.
Cartwright, S. & Cooper. E.L. (1997) Managing Workplace Stress. Sage Publications: Thousand Oaks.
Charlesworth, E.A. (1991) Stress Management: A Comprehensive Guide to Wellness. Ballantine Books.
Covey, S.R., Merrill, A.R. & Merrill, P.R. (1995) First Things First. New York: Fireside.
Davis, M., Eshelman, E.R. & McKay, M. (2000) The Relaxation and Stress Reduction Workbook. New Harbiner Publications.
Harvey, J.R. (1998) Total Relaxation. New York: Kodansha International.
Kabat-Zinn, J. (1990) Full Catastrophe Living. Delta.
Kabot-Zinn, J. (1995) Wherever You Go, There You Are. New York: Hyperion.
Loehn, J. & Schwartz, T. (2003) The Power of Full Engagement. Free Press.
Reivich, K. & Shatte, A. (2002) The Resilence Factor. New York: Broadway Books.
Sapolsky, R.M. (1994) Why Zebras Don’t Get Ulcers: A Guide to Stress, Stress-Related Diseases and Coping. New York: Freeman and Company.
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