More threads by David Baxter PhD

David Baxter PhD

Late Founder
Stress-Management Techniques

You're at your wit's end. All day your boss was on the warpath, and all night your kids screamed and fought with one another. Now it's 10 p.m., and there are piles of bills on the counter and dishes in the sink, but all you want to do is relax. You plop yourself in your favorite chair, reach for the remote and start surfing.

Sound familiar? Playing couch potato is one of the most common responses to stress. But it's not necessarily an effective one. In fact, most stress-management experts say real stress reduction requires more skill and discipline than flipping on the television. For example, it requires participating in a daily exercise regimen, expressing your emotions, socializing, performing relaxation exercises and eating a healthy diet.

None of these methods may entirely eliminate your stress, but what stress reduction can help you do is balance your stress with more positive experiences to help you maintain a healthy mind and body.

Research shows that practicing stress management is not merely about helping you live a more pleasant life. It also can help you live a longer one.

How To Determine Your Personal Stressors
As obvious as it sounds, stopping to think about what stresses you can help you cope for several reasons:
o First, uncovering the roots of your stress gives you the information you need to avoid the stressful situation, if that is what you want to (and can) do.
o Second, knowing the sources of your feelings makes you feel more in control, and feeling more in control generally helps lessen stress.
o Finally, recognizing that the cause of your behavior is stress, not something else, can reduce your anxiety about the behavior itself. For more information, see Sources Of Stressors.

To identify the source of your stress and its severity, see The Stress Scale.

This scale, known as the Social Readjustment Scale, ranks the severity of stress caused by ordinary events, such as marriage and divorce, birth and death, going to college and changing employers. Events near the top of the scale - those related to death, injury and illness - are associated with greater risk of stress-related physical illness than those at the bottom of the scale, which include obtaining a mortgage, retiring and receiving a traffic ticket. For this reason, figuring out what's stressing you can offer vitally important information; people who have high-risk stressors would be wise to take stress management seriously. To determine this, calculate the number of stressors near the top of your list - the higher the number, the greater your risk is for experiencing trouble related to stress.

Stress-Reduction Techniques
Relaxation techniques are one of the most common approaches to stress reduction. These include meditation, progressive muscle relaxation, visualization and breathing exercises. Most are easy to learn. Often you need longer periods of practice when learning new approaches to stress reduction, and eventually it becomes a conditioned response.

Practice The "Relaxation Response" And Similar Techniques
Recognizing that some people who practice meditation are capable of reducing their heart rate, blood pressure and oxygen consumption, Harvard University physician Herbert Benson set out several decades ago to understand how they do so. As a result, he developed and popularized a type of relaxation response, a simple practice that focuses on the qualities in meditation that create a sense of relaxation and stress reduction.

Here's how to do it: Every day, plan to spend some time at rest (not asleep). Sit someplace comfortable, close your eyes and relax your muscles. Then focus on your breathing, making it very regular, and continuously repeat one word. You can repeat the word aloud or in your mind. But it should be either a simple word such as "relax" or "easy", a religious word or phrase, or a brief phrase that has no meaning - such as the "om" used in transcendental meditation - or one that simply does not make you think. Then just continue to breathe regularly, with your muscles relaxed. Relaxation is a skill that requires regular practice. It is not helpful to try it for the first time when under enormous stress.

Learn Progressive Muscle Relaxation
This technique helps you focus on each muscle and become familiar with the sensation of relaxing your entire body. You can start from your head and work your way to your toes. Tense your facial muscles by biting down and furrowing your brow. Hold the tension for five to 10 seconds, then quickly release it. Next, tense your shoulder muscles by shrugging your shoulders and tucking in your chin. Hold the tension for five to 10 seconds, then release it. After that, tense your arm muscles by making a fist. Hold the tension for five to 10 seconds, then quickly release it. And so on. Simply continue to tighten a muscle and release it until you have worked all the way down your body. Mentally imagine the tension evaporating as you release the tension in each muscle. Focus on the warmth and heaviness of the body parts as they relax.

Do Visualization
Visualizing a pleasant place is a good way to remove yourself mentally from a stressful situation. To do this, sit or lie someplace comfortable and close your eyes. Practice the progressive muscle relaxation exercise. Allow whatever thoughts you have to pass through your mind without actually "thinking" about them. Breathe slowly and deeply until you feel relaxed. Imagine you are someplace that makes you feel good and relaxed. This might be someplace in nature, such as the ocean's edge or the woods, or it might be more specific, such as a spot by the ocean where you have spent many restful vacations. It also might be an image of a beautiful place that you have never visited, such as the Himalayan mountains. Focus on all five senses; what you would see, feel, hear, taste and smell. Continue to visualize yourself there for five to 10 minutes. Then gradually return your focus to the room you are in and end the visualization.

Practice Relaxed Breathing Exercises
Take a deep breath in and out. Did you feel your chest expand and contract? Did your shoulders go up as you drew air into your lungs? This is the way many adults breathe. But to breathe more efficiently, and in a way that promotes relaxation, we should look to the way we breathe while asleep.

Typically, when in a relaxed sleeping state, we breathe from our diaphragm, the muscle between the abdomen and the chest. The chest does not obviously move in and out, and the shoulders do not move up and down. Instead, the abdomen rises with each breath we inhale and lowers with each breath we exhale. It is both more effortless and more efficient than the typical waking approach to breathing; and, as a result, more relaxing.

How can you practice relaxed breathing?
Lie on your back on a bed or recliner. Place your feet slightly apart and lightly rest one hand on your abdomen, just near your navel. Rest your other hand on your chest. Inhale through your nose and exhale through your mouth. Calmly exhale most of the air in your lungs. With each breath you take, focus on your breathing and recognize which hand is moving.

As you slowly count to four, gently inhale, slightly distending your abdomen to make it rise about one inch. Imagine warm air flowing into your lungs and to all parts of your body. Pause for one second. Then as you slowly count to four, gently exhale, letting your abdomen slowly fall and your diaphragm relax upward. Pause for another second. Repeat this process five to 10 times. When you feel familiar with it, you can practice relaxed breathing while seated and, then, while standing.

Write About Your Stress
The Journal of the American Medical Association revealed that writing about stressful experiences can do even more than that: It can help reduce the symptoms of common diseases, such as asthma and rheumatoid arthritis.

In the study, titled "Effects of Writing About Stressful Experiences on Symptom Reduction in Patients With Asthma or Rheumatoid Arthritis," one group of patients was asked to write about their most stressful life experience for 20 minutes a day over three consecutive days. Another group was asked to spend an equal amount of time writing about their plans for the day. The results:
o Forty-seven percent of patients who wrote about their stressful experiences showed what physicians determined to be "clinically relevant improvement" in their conditions four months later.
o Only 24 percent of the second group showed a similar improvement.

"Although it may be difficult to believe that a brief writing exercise can meaningfully affect health, this study replicates in a chronically ill sample what a burgeoning literature indicates in healthy individuals," writes Joshua M. Smyth, Ph.D., in the Department of Psychology at North Dakota State University, and his coauthors. This growing research has revealed that writing about one's thoughts and feelings can lead to:
o Improvements in immune functioning
o Fewer visits to the doctor
o An increased sense of well-being

Commenting on the value of writing about stressful experiences as a stress-reduction technique, David Spiegel, M.D., in the Department of Psychiatry and Behavioral Sciences at Stanford University, wrote, "Ventilation of negative emotion, even just to an unknown reader, seems to have helped these patients acknowledge, bear, and put into perspective their distress." In other words, "it is not simply mind over matter, but it is clear that mind matters."

The most common experiences written about by subjects of this study were the death of a loved one, relationship difficulties, a serious problem affecting someone close to them and involvement in or witness to a car wreck or other disaster.

Deflate The Danger Of Your Fears
The next time you feel yourself in the grip of a stressful situation, encourage yourself to look closely at your thoughts to see whether the situation merits as much stress as you feel. Ask yourself these questions:
o What is the worst possible outcome that can develop from the situation?
o Is it likely that the worst possible outcome will occur? If so, how likely is it?
o How would such an outcome change your life?
o Is there anything else you can do to influence the result, or have you done all that is possible?

Asking yourself these questions can help free you from stress you cannot avoid or control, or can at least help to diminish it.

Remove Stressors
Are you are the kind of person who says "Sure!" but feels a knot in your stomach when a boss or colleague asks you to take on another project? Do you know you already have more responsibilities than you can comfortably handle? Then it may be time to set some limits for yourself.

Determine what you can realistically do, and simply stop promising more than you can reasonably handle. Be polite when you do. Just say, "No. With the current responsibilities I have, I cannot take on more at this time." Be open to observations about your work and if people observe that you seem more burdened than average by the workload, it is important to accept that viewpoint without getting angry or self-critical and figure out what the feedback means.

Manage Your Time
The more you think ahead about how to manage activities or control your time, the less stress you will experience. Or as one expert put it, "Knowing what is happening is preferable to being in the dark, having a strategy or defense ready is preferable to being unprepared and being able to avoid or terminate a stressor is better than sitting there and suffering."

One of the easiest ways to manage your time is by thinking about the demands or priorities you have and in what order you wish to address them. Some practical ways to take control of your situation is to write a list of items that need to be addressed, schedule time to work on the items you listed and organize the list and schedule by priority or necessity. Developing a plan or strategy to follow may help you focus on the issues that are most important to you and therefore, help to control the amount of stress you feel about these issues.

Maintain A Healthy Diet
If you're like many people, you probably have your favorite comfort food that you reach for when you're stressed. It might be ice cream, potato chips or a juicy hamburger. Whatever it is, chances are it's relatively high in fat, sugar or salt; in other words, from a health perspective, your comfort food may have a bad influence on your health.

Several studies suggest that maintaining a good diet may help reduce the stress you feel. It is terribly difficult to give up a comforting treat, but the treat may backfire, making you feel worse. A balanced nutritious diet and a reduced amount of comfort may result in you feeling more, not less, comfortable.

After more than 1,000 studies, experts agree that exercise can reduce your stress. For maximum effect, try an aerobic exercise (such as running, swimming or brisk walking) that increases your heart rate for 20 minutes or more. If you can't do that, even a 10-minute walk can help. Yoga and nonaerobic movement such as stretching also can reduce stress by inducing a calmer, meditationlike state.

One reason exercise helps reduce stress is because it distracts you from whatever it is that is causing stress. It also helps you eliminate excess energy, which can stem from and contribute to stress. Exercise has a calming effect and can lead to decreased emotional distress and better concentration. And it makes you feel more capable of handling challenges, such as tackling the cause of your stress.

Exercise also helps counter possible diseases that are exacerbated by chronic stress, such as coronary artery disease.

As with healthy eating, it is very difficult to maintain an exercise routine when you are depressed. Nonetheless, exercise can help you handle stress and is good for your general health. Being aware of the benefits of exercise may provide the motivation you need to stay physically active.

Because we are social creatures by nature, we need other people, particularly during stressful times. Having supportive friends, family members and colleagues is one of the most significant ways to reduce stress.

Discussing your difficulties with someone you trust helps relieve tension and may also help you begin to solve your problems. Or you may prefer to participate in a larger social activity, such as a sports team, a spiritual group or a group that gathers around a common interest in a hobby or some other pursuit.

Many people use happy hour as a way to reduce stress. Although having one glass of wine with dinner may be helpful, excessive alcohol consumption does not help reduce stress and can make it worse. Using happy hour simply to be with friends can help lessen your stress. However, some social situations may not be beneficial. Situations that make you feel uncomfortable, where you cannot relax and enjoy yourself, may be harmful and increase your stress.

Seek Therapy
If you've tried numerous stress-reduction techniques but continue to feel more stress than is comfortable, you might want to talk to a therapist about:
o How to cope with stressful conditions with less difficulty
o How to better handle conflicts, manage anger or simply communicate with other people
o How to resolve some of the problems that are causing you stress

Or you might want to talk to a therapist who can meet with you and your spouse, child or co-worker if the relationship is a stressful one.

One way that therapists help people better handle, or even prevent, stress is to educate you about the sources of your stress and how to manage it. The therapist can teach you about stress and reactions to stress, with an emphasis on how your thoughts about the situation can influence your stress level and how, consequently, changing your thoughts can alter your experience of stress.

Next, the therapist teaches you coping skills, such as cognitive restructuring, a technique that seeks to change negative thoughts and beliefs and encourage positive ones. Typically, the therapist works with you to examine and change the statements you make to yourself about your expectations and how you evaluate a situation for yourself.

Finally, the therapist works with you as you apply coping skills to stressful situations. Initially, the therapist will use imagery or role playing so that when stress actually occurs, you will have an idea about what to expect and what to do to manage its ill effects.

Therapists also can help you cope with anger by heightening your awareness of anger and teaching you a variety of methods for expressing it constructively.

In addition, therapists can help you work with other people to handle stressful marital, family and work-related conflicts. Family therapists, for example, can work with you and other family members to help you deal with a particularly rebellious adolescent, a family member's emotional problems or other issues. Although not actually seeking to resolve a problem for you, the therapist will try to help you understand and address it more effectively.

Marriage counselors, meanwhile, can help couples address problems that sometimes arise with major changes in a marriage, such as the birth of a child, the loss of parents or evolving sexual needs. Counselors who address work-related conflicts can help you address the common communication problems that underlie tensions between colleagues.


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