Stress

Critical Issue:
Stress Management
 How do you cope with stress?
• Brainstorm the ways you use to cope with
different stressful situations
 Problem - focused Coping
Stress is treated as a problem to be
solved.
• Seeking social support – discussing a
problem helps make more sense of it, puts
problem in perspective.
• Taking control – e.g taking steps to deal
with debt, finding out about a disease,
looking for a new job.
 Problem Focused Coping
• Evaluating the pros and cons of different ways
of dealing with the stress – e.g. planning a new
life after bereavement, choosing whether to have
surgery,
• Suppressing competing activities – e.g.
avoiding the temptation to put off going to the
dentist because of work commitments
• Anticipatory coping – work out what triggers
stress, train ourselves to anticipate and deal with
it e.g working out your route to a new location,
anticipating possible roads to avoid e.t.c
 Problem Focused Coping
These strategies are often achieved
through Psychological Therapies
• Cognitive Behavioural Therapy – CBT
 Emotion – focused Coping
Avoidant methods, used when a person feels there
is nothing that can be done to change the problem.
Treats the symptoms not the problem

1. Defence mechanisms – tend to be negative

• Denial – e.g going on as if nothing has
happened
• Distancing/distraction – e.g just not thinking
about it
• Focusing on and venting emotions e.g crying,
anger, praying
• Wishful thinking – dwelling on what might have
been if this hadn’t happened
 Emotion – focused Coping
2. Reappraisal/reinterpreting – taking
another look at the situation may change
the way you feel about it. A positive
approach.
3. Arousal reduction – heightened
reactions associated with stress are
reduced, so the person becomes less
stressed e.g meditation, relaxation,
exercise, biofeedback or drug therapy
 Gender differences in coping
• Do you think males and females may cope
differently?
• Research has evidence that ...

• Males more likely to use Problem-focused

methods, whereas women use emotion-
focused
 Gender differences in coping

1. Socialisation theory – women taught to

show emotions openly, men taught to
approach stress in a more active way.
2. Role constraint theory – coping strategy
matches roles males and females occupy.
When males and females
have same role – used same
strategies to cope with stress
There is a very, very tall coconut tree,
and there are 4 animals passing by:

King Kong, Ape, Orangutan and Monkey  

They have a competition to see who is

the fastest to get the banana. Who do
you guess will win?
Your answer will reflect your
personality. Try and answer within 30
seconds
Got your answer?
 If your answer is ....

Orangutan = Dumb

Ape = Foolish

Monkey = Idiotic

King Kong = Stupid

Why ?????
A Coconut tree ........ doesn't have bananas!!  

It's obvious you're stressed by your work.

Go home!  
 
 What is Stress
Management?
The process by which an
individual attempts to cope with
(manage) stressful demands.
• Psychological – CBT (e.g Stress
Inoculation, Hardiness training and
REBT)
• Physiological – Drug therapy,
Biofeedback, exercise
 Psychological Methods
• Use techniques that help the person
cope with the situation itself rather
than just dealing with the symptoms.
• Patients find ways of changing or
avoiding stressful situations in the
future.
• Or learn techniques to minimise
negative effects of stressful
situations
 Psychological Methods
Stress Inoculation Training (SIT)
Meichenbaum (1985) – cognitive-
behavioural therapy – person can change way
they think about certain stressors.
Suggested client should develop a form of
coping before the problem arises – inoculate
yourself against the disease of stress like
vaccinations to prevent infectious diseases!
Use clients’ existing coping skills.
 Evaluation of Research
Strengths Weaknesses

• It works! –Meichenbaum • Time consuming and high

(1996) successful with levels of motivation
acute and chronic stress. needed –only suits a small
• Combines cognitive and range of determined
behavioural therapy – individuals. Expensive.
powerful method of stress • Difficult to change some
management behaviour
• By gaining new skills gap • Complex – may not need to
between demands and do all aspects of the
coping resources narrows therapy – e.g. may be
– more confidence in sufficient to just talk
handling previously more positively and relax
stressful situations more
 Psychological Method 2:
Hardiness Training
Kobasa and Maddi (1977)
1.Focusing – client taught to spot signs of
stress (e.g. muscle tension, increased heart
rate, anxiety). Allows client to recognise
stressful situations and thus sources of
stress.
2.Reliving Stress Encounters – clients analyse
recent stressful situations in terms of how
easily they were resolved and how they might
have turned out better or worse. Gives client
insight into their current coping strategies
and how they might be better than they
thought.
 Psychological Method 2:
Hardiness Training
Kobasa and Maddi (1977)
3. Self-improvement – The key to
hardiness is the belief that we can cope
with life’s challenges.
Client taught to focus on seeing
stressors as challenges and thus learn
to take control.
Control, commitment and challenge are
the basis of hardiness training.
 Evaluation of Hardiness Training

Strengths Weaknesses
• Deals with the problem • Much of research
rather than the carried out on male
symptoms – teaches executives or soldiers in
clients to manage all US. Low ecological
stressors in their life. validity.
• More adaptable and • High control can be
effective than drugs stress inducing for
• Long-term some people.
effectiveness • Difficult to modify
learned habits.
• Does hardiness exist? –
is it just being in
control?
 Comparison of SIT and
Hardiness Training
• Both treat the • Both require lengthy
problem not the training and highly
symptoms. motivated clients.
• Both teach clients • The success of SIT
skills to provide may be mainly due
lasting and varied
to positive thinking
strategies to cope
with stress • The success of
• Both teach clients hardiness training
to view stress as a may be due to
problem to be increased control
solved
 Physiological approaches to
stress management
These methods focus
on getting rid of the
emotions associated
with the stressful
situation, but the
situation may not be
changed.

They directly target

the stress- response
systems.
 Anxiolytic* Drug Therapy
Benzodiazepines (BZ’s)
Librium, Valium, Halcion, Xanax
Short term relief of severe anxiety.
1.Enhance action of natural brain chemical, GABA.

2. GABA tells neurons to slow down or stop firing

– general quietening influence on brain.
3. Action of GABA is supported by BZ’s to
inhibit neuron activity even more
4. The brain’s output of excitatory
neurotransmitters (e.g serotonin) is reduced
and person feels calmer
Anxiolytic – anti-anxiety drugs, GABA – gamma-amino-butyric acid
 Anxiolytic* Drug Therapy

Beta-blockers
Treat high blood pressure
1. Reduce activity of adrenaline and
noradrenaline, which are key agents in
sympathetic (ANS) arousal.
2. By blocking ANS arousal, beta-blockers slow
the heart beat, lessen the force with which
the heart contracts and reduces blood vessel
contraction.
3. This results in a fall in blood pressure and
less stress on the heart.
Also given to sportsmen and women to reduce
arousal which can affect performance
negatively.
 Anxiolytic* Drug Therapy

1.What do you think are the

advantages and disadvantages of
using drug therapy to manage
stress.

2. Do these methods really manage

the stress? Explain.
 SSRI’s
• Selective Serotonin Reuptake Inhibitors
– e.g Prozac
• Prevent the recycling of Seratonin
• Leads to more Seratonin in the synapses
• Helps depression as people suffering this illness
have low levels of Seratonin.
Trivedi et al 2006 – 3000 depressed patients given
Citalopram. 47% halved their depression score.
BUT - Effectiveness did depend on type of
person.
 Evaluation of Drug Therapy
Strengths
• High efficacy (work on
range of anxiety disorders)
Kahn et al (1986) – BZs
superior to placebo
• Work quickly to reduce
disabling effects of stress
related anxiety.
• Low toxicity
• Rai et al (2005) – Beta
Blockers increased survival
of patients with certain
serious heart problems.
• Can be prescribed
immediately for acute
stress
• Easy to take
Weaknesses
• Addictive –BZs
psychological and physical
dependence can develop
within a few weeks – Ashton
1997 – BZs limited to 4
weeks use
• Side effects – drowsiness,
dizziness, tiredness, dry mouth,
diarrhoea, changes in sex
drive/ability, seizures, severe
skin rash, irregular heartbeat
• Can prevent normal
psychological adjustment –
treats the symptoms not
the problem
 Biofeedback
Person learns to exert voluntary control over
involuntary (autonomic) behaviours
Biofeedback involves 4 processes:
• Feedback – patient attached to machines that
give feedback about ANS activities –
heartbeat, blood pressure
• Relaxation – patient taught relaxation
techniques – reduces activity of sympathetic
nervous system and activates parasympathetic
NS – reduced heart rate, blood pressure and
symptoms related to stress
 Biofeedback
• Operant conditioning – relaxation leads to
target behaviour e.g. reduced heart rate,
which is rewarding.
• This will increase likelihood of same
behaviour being repeated. This learning
(conditioning) takes place without conscious
thought.
• The reward results in an unconscious
‘stamping in’ of the behaviour. (Like Pavlov’s
dogs)
• Transfer – The patient transfers the
skills learned to everyday situations.
 Evaluation of Biofeedback
Strengths Weaknesses
• Non-invasive • Expensive –the cost
• No negative side of equipment and
effects time needed
• Provides patient • Treating the
with long lasting symptoms not the
means of dealing problem – does not
with stress treat the source of
symptoms stress
 3. Which is best Emotion-focused or
problem-focused methods?
Problem-focused Emotion focused
• Aim to remove • Control symptoms –
problem problem still there
• No side effects • Quick and effective
• Last longer • Relatively cheap
• Slower • May have side effects
• More expensive • May cause addiction
• Ppts need to be • Biofeedback – no
motivated to stick with addiction or side
them effects, more
expensive than drugs