177 terms

stress mangement and prevention

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What are the different ways that stress can
be defined and conceptualized?
What are the different ways that people
respond to adversity in their lives?
How can you assess the signs and symptoms of stress as they
occur in yourself
and others?
Stress is ordinarily thought of as a fairly negative state, something to be
avoided whenever possible.
. But how can stress be highly functional and
operate as a survival mechanism?
What is the general adaptation syndrome (GAS)
and how does it function
during times of stress?
l What is the primary goal of stress management?
Can such a program
completely eliminate stress?
What are major sources of stress
and how are they recognized?
How do you interpret the following statement:
"Stress is not what exists on
the outside, but how you perceive a situation on the inside?"
stress is
a psychological and a physiological
reaction to a real or perceived threat that requires some action or resolution. It
is a response that operates on cognitive, behavioral, and biological levels that, when
sustained and chronic, results in significant negative health effects
Stress is actually a survival mechanism,
programmed a long time ago, to increase
internal awareness of danger and transform all the body's resources to a heightened state
of readiness. It is, essentially, the experience of perceived attack. It doesn't matter
whether the threat is real or not; the autonomic nervous system (think "automatic")
is activated. This system works well only when it turns itself on and off within a reasonable
period of time so as to not wear out its welcome (and deplete your energy).
general adaptation
syndrome (GAS)
This means that when someone is stressed by a crisis, perceived
danger, or threat, the brain activates more than 1,000 different chemical responses to
deal with the situation
(GAS) Immune system is depressed
• Increased susceptibility to
infection
• Slower healing
(GAS) Digestive system slows down
Mouth ulcers or cold sores
• Upset stomach
(GAS) Brain becomes more alert
Stress hormones can affect memory
and cause neurons to atrophy and die
• Headaches, anxiety, and depression
• Disrupted sleep
(GAS) Reproductive system
• Menstrual disorders in women
• Impotence and premature
ejaculation in men
(GAS) Heart rate increases and blood pressure rises
• Persistently elevated blood pressure and
heart rate can increase potential for blood
clotting and risk of stroke or heart attack
• Weakening of the heart muscle and
symptoms that mimic a heart attack
(GAS)Adrenal glands produce stress hormones
• Cortisol and other stress hormones can
increase central or abdominal fat
• Cortisol increases glucose production in
the liver, causing renal hypertension
(GAS)Breathing quickens
• Increased susceptibility to colds
and respiratory infections
(GAS)Muscles tense
• Muscular twitches or nervous tics
stages in general adaptation syndrome
Phase 1: Alarm reaction
The body's first exposure to the stressor that disrupts its homeostasis starts a series of
physiological reactions through the autonomic and endocrine systems. The endocrine
system will produce corticosteroids that will supply the body with resources to fight
or flee. Unfortunately, these corticosteroids may weaken the immune system.
Phase 2: Resistance
The continued presence of the stressor will activate the stage of resistance during which
the purpose is to sustain life and make necessary adaptations as long as the required
fuel and biochemical material are available. It is like a gun that keeps firing over and
over until it runs out of ammunition, or the shooter's finger cramps to the point it can
no longer function.
Phase 3: Exhaustion
If the stressor remains present (or is believed to be present), the body will deplete
its stored energy to the point that it is no longer capable of mounting any resistance.
Mental and physical energy are on empty. Exhaustion sets in. Permanent damage will
result, leading to illness or even death
Physiological responses to stress
-Heart palpitations
-Sweating
-Dry mouth
-Fatigue
-Insomnia
-Nausea
-Dizziness
-Loss of appetite
-High blood pressure
-Personality traits
-Weight loss or gain
Cognitive responses to stress
-Impaired memory
-Disorientation
-Unrealistic demands
-Disasterizing
-Illogical thinking
-Externalized blame
-Obsessiveness
- Loss of humor
-Suicidal ideation
-Surrender
-Excessive fantasies
Emotional responses to stress
-Fear
-Worry
- Panic
-Guilt
-Anger
-Denial
-Hopelessness
-Numbness
-Depression
-Despair
- Impatience
Behavioral responses to stress
-Crying
-Rage
-Withdrawal
-Substance abuse
-Self-medication
-Impulsiveness
-Phobias
-Hyperactivity
-Lethargy
-Aggression
- Rambling
Everyone reacts to stress in different ways, even if there are some common signs
and symptoms. Some people have difficulty sleeping or lose their appetites,
while others sleep too much and go on eating binges.
Some people have
thoughts of doom and gloom, imagining the worst, and others keep an upbeat
state of mind
What are your
typical reactions?
Where do you feel
stress in your body?
What is the usual way that you think when
confronted with a crisis or stressful situation?
How do you respond emotionally to stress?
Which feelings are dominant?
How do you typically behave when confronted with stress?
If you are inclined to
"act out," or respond dysfunctionally in some way, what does that look like?
summary of major flight or fight responses
1.Eye dilation
2.Increased blood pressure
3. Increased heart rate
4.Muscle tension
5.Heavy breathing
6.Sweating
7.Adrenaline surge
8.. Increased serum glucose
9. Release of free fatty acids
10. Vasodilation of arteries in arms and legs
11.Digestive system shuts down
12.. Inhibition of sexual desire and reproductive capability
13.Immune system shuts down
14. Blood coagulation
short-term stress—
—the kind activated by a sudden threat or danger.
Long-term stress
when the system is turned on at high volume,
and then remains that way even when the initial
danger has passed. There is the sort of wear
and tear on the body and mind you would expect
when a mechanism that was designed for "sprints"
is told that it has to run a "marathon." Invariably,
parts start to break down and the system fails.
Prolonged stress affects the body in a number of predictable ways that can be
deduced from your prior understanding of what happens during arousal of the fight-or-
flight reflex
1. Muscles tense to prepare for battle or flight. Over time this can lead to muscle
fatigue, cramps, and chronic back pain.
2. Digestion shuts down since it won't be needed. Over time, the system can
develop ulcers, colitis, spastic colon, irritable bowl syndrome, and acid reflux.
3. Increased blood and oxygen flow brings more nutrients and hormones that can
be mobilized. This can create high blood pressure over time.
4. Blood vessels constrict to prevent bleeding in the event of injury. In a chronic
state, a person can experience dizziness, blackouts, headaches, and skin lesions.
5. The liver produces and distributes sugar and nutrients in order to provide energy
to combat the perceived danger. Over time, hypoglycemia or diabetes can result.
hyperstress
s means an excessive amount that overloads the system,
hypostress
is
not enough to keep the body tuned and ready for action.
Distress
is what you usually associate with the word "stress." This is the destructiveand harmful sort that means trouble, especially if it moves beyond acute arousal to a chronic condition. Distress occurs when our ability to cope with stressors is insufficient.
Distress causes anxiety and confusion and decreases your performance in daily activities. Distress is often associated with stressful events that occur unexpectedly. Even when
good news strikes too suddenly, it may shock the recipient and cause stress. Distress also may occur when you try to manage too many things simultaneously and lose control
of the situation. The degree to which you feel you can control your life influences the
valence of stress.
Neustress
is, just like it sounds, rather neutral. It has little impact, or lasting effects, one way or the other. It might be upsetting for others, in another location or context, but has little measurable effect on your life. Alternatively, you might find yourself in a performance situation in which the added presence of an audience is below your radar
because you are concentrating so hard on your job.
Eustress
is the kind of stress that inspires or motivates you to go beyond present
levels of functioning. This is what happens with the so-called "clutch" hitter in baseball,
or the "pressure player" in other sports: the presence of an audience, combined with high
stakes on the line, motivates the athlete to unparalleled performance. The same could be
true for artists, actors, writers, and others who are required to perform under pressure.
Typically, stress can be activated
by
(1) an external source, (2) an internal source, or (3) the interaction of internal
and external sources.
Physical stress
occurs when the human body is affected by sleep deprivation, overworking, excessive physical exertion, physical injury or trauma, viral or bacterial infections, inflammation, physical disease, or chronic pain. It is under such circumstances
that the body begins to lose functioning and to break down
Psychological stress
is often used synonymously with mental stress or emotional
stress because they share many common features. Psychological stressors are related to
how we interpret the events in our life; they are determined by our values, beliefs, attitudes,
and philosophies of life. Given the same situation, different people may react very
differently due to their outlooks on life. Emotional reactions such as anger, fear, low
self-esteem, and hostility are also influenced by our beliefs. The good news is that you
can change your thoughts (Chapter 6), thereby changing your reactions to the events in
your life. The bad news is that some thought patterns have been deeply engrained in your
psyche and they require a consistent effort to be modified.
It is important to be able to identify the sources of stress in your life, and their
origins,
before you can develop a plan to prevent and manage the negative effects. This
is easier said than done considering that there are often complex interactions between all
the sources.
Stress prevention
•Proper diet and rest
• Lifestyle choices
• Regular physical exercise
• Effective communication
• Time management
• Skill development
• Problem solving
• Cognitive restructuring
• Spiritual well-being
Stress management
• Monitoring changes
• Lifestyle changes
• Conflict resolution
• Relaxation
• Massage
• Coping with anxiety
• Managing anger
• Overcoming fear
• Cognitive restructuring
• Treatment of illnesse
Stage 1: Life situations/Chronic stressors
Before a major event disrupts your life, you need to do everything you can to prevent the formation of a stressor. You may have heard the saying, "Discipline weighs ounces
while regret weighs tons." An exam is a major stressor for those who are unprepared and for whom it may have a serious consequence, while it may be a minor annoyance, or even a fun challenge, for those who are prepared. No matter how hard you try, certain adversities and traumatic events will inevitably occur in your life. In most cases, you will not have a choice about whether you are subjected to the stressors but you can choose, to some extent, how you respond to them. Obviously, a pleasant stressful situation such as getting married (eustress) will be handled with more ease than a negative stressor like a divorce (distress). In this first stage it is critical that you have an accurate and comprehensive view of the stressors in your life, as well as the characteristic ways you respond to them. It is important to know where and how you are most vulnerable.
Stage 2: Perception and evaluation
people will perceive the
same stressor in a variety of ways and, therefore,
react to it differently. An event will be overwhelming
to one person and exhilarating to another. For some people, the fear of speaking in front of a group is greater than that of death. Others live to get up on stage in front of a crowd.
Your perception of a situation or a chronic stressor also depends on your personality type, your resilience, life experience, health status, and mental and emotional
resources. In general, healthy, competent, and optimistic people will cope with stress more successfully than those who tend toward pessimism and negativity In this second stage, it is critical for you to have a solid background in the theory,
research, and mechanisms of stress so that you can better prepare yourself for what lies
ahead.
Stage 3: Stress response
This stage will demonstrate an individual's emotional, psychological, and physiological responses to the perception of the stressor. The magnitude of the responses from the endocrine and autonomic nervous systems depends on the perception of the response. Your major task, in the face of stress, is to reduce pressure and release excessive physical and psychological tension through a number of options (such as meditation, exercise, and other relaxation techniques described later in the book). It is not enough to merely know how to apply stress management and prevention strategies; you will have to practice and rehearse them on a daily basis so they will become part of your repertoire when you need them most.
Stage 4: Consequences
At this stage, you experience the frequent results of stress responses. These can range from behavioral consequences such as accidents to physiological consequences such as a heart attack or ulcer. The final stage of stress development feeds back to the first stage and then repeats the cycle. Without proper prevention and management interventions, the cycle will perpetuate itself to the point where you feel like one of those Chinook salmon swimming upstream
until the point of collapse. Unlike this fish, however, you have choices along the way that allow you to change direction, take a snooze onshore, or take a boat, or even decide you
don't feel like spawning after all.
Prevention is more effective than management.
Prevention is a more proactive
approach since you start to change your living habits before you have serious
health issues. Prevention is also cheaper than treatment, as it is well known
how expensive it is to treat a serious disease. Once stressors strike, manage
your reactions to them and tap all your resources to deal with them; don't allow
them to become a chronic condition that wreaks havoc on your body.
Small changes can lead to big effects.
Mathematician and meteorologist
Edward Lorenz coined the term "the butterfly effect" to refer to the notion that
a butterfly flapping its wings in a remote place such as Beijing, China may
cause a hurricane in Texas, USA (Hilborn, 2004). In other words, small
changes in the initial condition of a system can lead to a chain of events that
will produce large-scale alterations to the system. If you apply this idea to
stress prevention and management, a small change in your lifestyle may have a
long-term benefit to your longevity and well-being. Since many of your health
habits are deeply engrained, it can take considerable effort to initiate and maintain
changes. But starting small will eventually lead to a fundamental change
Don't count on a magic solution for solving all your stress problems
Good
health and well-being characterized by abundance of energy and low stress
come from the interactions of all the body systems and a harmonious relationship
between you and your environment. There is no single panacea that, once
learned, will make all the difference. It takes discipline to make systemic
changes in every aspect of your life. This course offers a comprehensive way to
prevent and manage your stress that is designed to keep you healthy throughout
your lifetime
. Tailor a program to your own schedule and means.
You hear people tell you all
the time that you should do what they're doing, but often such advice is not
particularly helpful. Everyone is unique and you must adapt any program, no
matter how successful, to your particular lifestyle, values, interests, strengths,
and resources
Develop a comprehensive plan for stress prevention and management.
Since the sources of stress come from within as well as from without, it is essential that you have a plan to change your thinking, modify your diet, improve relationships,
and acquire new skills throughout the lifespan. Like a good mechanic who possesses a variety of tools for different jobs, you also need to develop all kinds of skills for stress prevention and management. You may use one or more
techniques more frequently, but being open to different skills offers you more flexibility and resources. Also, you should consider short-term improvements as well as those for the long term. It is always good to have multiple options,
depending on your mood, circumstances, and needs
There are three elements in the definition of stress:
the stressor, the response, and
the person experiencing the condition. The stressor can be a real physical threat or an
imaginary or symbolic one. The same stressor can be good for one person and bad for
another, depending on how capable the person is in coping with the situation.
The allostatic view
suggests that the stress response can trigger a series of bodywide
changes to bring the organism back to a resting condition. This idea also implies
that even small, consistent episodes of wear and tear carry long-term consequences for
the body.
The stress response varies
from person to person. The consequences of a stress
response represent the composite effects of the individual characteristics such as personality,
health status, and the nature of the stressor. A comprehensive stress management
program proposed in this text cannot realistically eliminate all stress in your life.
To do so, even if possible, would make for a very dull and dreary existence. Stress
can be the scourge of your life, but also the lifeblood for everything you find stimulating
and exciting.
Why is it important to study the
physiological basis of stress responses?
How can you apply what you learned in this chapter to
understand better why
people struggle so much in their lives?
How can studying the physiology of stress assist you in making
sense of your
own stress reactions, as well as those you witness in others?
How do chronic stress and anxiety affect
the various systems in the body?
How do the nervous and endocrine systems
work together to coordinate the
body's responses to stress?
How do the sympathetic and parasympathetic nervous systems work
in
concert to control physiological stress responses?
What are the body's sequential steps in
responding to perceived threats?
How is the immune system affected
by chronic stress?
What are the risk factors associated with heart disease
and other chronic
health conditions?
How is sexual functioning affected
by chronic or acute stress?
What are some ways that
stress is helpful?
The body reacts to stressors in a number of ways. These effects can be most logically
described according to the specialized systems that serve different functions. The
major body systems include the following.
-The nervous system
-The endocrine system
-The circulatory and cardiovascular systems
-The respiratory system
-The immune system
-The musculoskeletal system
-The digestive system
-The reproductive system
The nervous system
provides overall "executive management" of other systems
and communicates orders to coordinate activities. Stress experience often begins in the brain, even though the stressor often appears in
the external environment or outside world. The senses connected to the brain make it possible for you to know what is happening around you, and within you. Your hearing,
sight, smell, touch, and perhaps intuition signal you that danger is near.
The endocrine system
works in partnership with the nervous system to control
functions.
The circulatory and cardiovascular systems
are concerned with transporting
nutrients, waste, and other chemical messengers within and out of the body.
The respiratory system
provides oxygen and nourishment to the body's cells
The immune system
does exactly what it sounds like: provides defense against
invaders.
The musculoskeletal system
(including skin) provides support and movement
for the body
The digestive system
processes food sources, converting them into usable
energy.
The reproductive system
is concerned with sexual functions and reproduction.
The human nervous system is organized into several different subsystems.
-central nervous system,
-peripheral nervous system
- somatic nervous system
-autonomic nervous system.
- sympathetic nervous system
- parasympathetic nervous system,
-enteric nervous system
central nervous system,
which is exactly like it sounds—centrally located
and housing the brain and spinal cord . The average adult human brain weighs about three pounds and contains 100 billion nerve cells (neurons) in addition to
trillions of "support cells" called glia. The spinal cord is located within the vertebrate column that receives messages from, and sends motor commands to, the peripheral
nervous system.
peripheral nervous system
is divided into two major parts: the somatic nervous
system and the autonomic nervous system.
The somatic nervous system
consists
of peripheral nerve fibers that receive information from the sensory organs and send
information to the central nervous system and motor nerve fibers that communicate
with skeletal muscles.
The autonomic nervous system
is so named because it operates on "automatic,"
meaning beyond your conscious awareness and control. It handles many of the regulatory
functions that keep you alive—your breathing, blood flow, digestion, and so on.
The autonomic system branches off into three other divisions, each with specialized
functions: the sympathetic nervous system, the parasympathetic nervous system, and
the enteric nervous system. They are all designed to control your various internal
organs and glands
he hypothalamus and the
thalamus
If you are following this on the figure, we are now at the point where the spine connects into the skull. The hypothalamus, about the size of a grape or olive, plays a disproportionate regulatory role considering its small size. It controls body temperature, as well as regulating emotions, hunger, thirst, and sleep rhythms. It is also the part of the brain that is most involved in responding to stress by controlling the pituitary and autonomic nervous system. The thalamus receives sensory information and relays this information to the cerebral cortex. The cerebral cortex also sends information to the thalamus, which then
transmits this information to other areas of the brain and spinal cord.
The limbic system
consists of such structures as the amygdala, the hippocampus,
mammillary bodies, and cingulate gyrus. These areas are important for controlling
the emotional response to a given situation. The amygdala is located at the base of the
temporal lobe and controls anger, fear, and aggressive behavior. The hippocampus is
important for memory storage and retrieval.
a stress response is to secure
the safety of the organism. A stressor can be any stimulus, real or imaginary, that is
perceived to threaten the existence of the organism. The body follows a predictable
sequence of reactions in the face of a stressor.
- Step 1. The brain perceives danger.
-Step 2. The first pathway is directed to the muscles,
-Step 3. If the threat continues beyond a few minutes,
Step 1. The brain perceives danger.
It doesn't matter whether the threat is real or a
figment of the imagination; the senses bring in distressing information that is interpreted
as potentially harmful. Naturally there are false alarms, but the brain is programmed to
react defensively. It sends out warnings to all systems to activate emergency conditions
(the fight-or-flight response). The Greek word for messenger is hormone—chemical
signals that are launched from the thymus, pituitary, thyroid, and adrenal glands. They
are the scouts, like Paul Revere and his compatriots who were sent out all over the countryside
during the British invasion to warn of impending attack. The chemical agents are
launched through three separate pathways, making certain to mobilize maximum response
to the threat.
Step 2. The first pathway is directed to the muscles,
resulting in immediate tension
that might be useful for actions such as sprinting, ducking, kicking, punching, biting,
and screaming. When the brain perceives a threat, this information comes through the
thalamus to the hypothalamus, which in turn activates the autonomic nervous system.
For the immediate reaction, the sympathetic nervous system carries signals to the adrenal
medulla (i.e., the SAM complex) that secretes epinephrine (better known as adrenaline)
and norepinephrine into the bloodstream to be circulated to target organs. These hormones
increase the heart rate, raise the blood pressure, accelerate the rate of respiration,
dilate bronchial tubes, and inhibit digestive activities. This is the alarm phase, according
to Selye, and it involves the autonomic nervous system.
Step 3. If the threat continues beyond a few minutes,
he hypothalamus triggers
a series of events to prepare the body for the second phase of the stress response
that involves more pervasive activation of the bodily functions. At this point, the body
realizes that what seemed, at first, to be a short skirmish is now turning out to be a prolonged battle. This second pathway goes to the immune system, preparing for
possible wounds.
The anterior (front) hypothalamus releases a hormone called CRF (corticotrophin
releasing factor),
which then stimulates the pituitary gland to secrete ACTH (adrenocorticotropic hormone). ACTH then stimulates the cortex of the adrenal glands to produce cortisol (a glucocorticoid) and aldosterone (a mineralocorticoid). When you put this chain reaction of chemical responses together, what you end up with is a control pathway called the HPA (hypothalamus-pituitary-adrenal) axis. This is the central core of the body's reaction to stress. It is the resistance phase in Selye's general adaptation syndrome in which the body is engaged in a prolonged battle with the stressor.
The brain is the most important feature in the stress response,
directing every other
process. It controls the endocrine system and regulates the rate of metabolism. It directs
the activity of the cardiovascular system by influencing the autonomic nervous system. The immune system is also under its direct stimulation by nerves or indirect influence
through hormones. Finally, the cerebral cortex interprets external data in particular ways,
making almost instantaneous decisions about the most appropriate response.
The areas of the brain responsible for memory include the hippocampus and
amygdala.
People who are experiencing severe stress, such as test anxiety, distracting
worries, or lingering trauma, tend to make more errors in tasks that require concentration.
They have difficulty making decisions. They are more prone to accidents, more inclined
toward addiction, and experience a host of physical and psychological complications
The amygdala is the first structure to be activated during fear responses.
It functions
to avoid and detect danger and is also involved in forming emotional memories related
to fear and social situations. It evaluates threats unconsciously, at lightning speed, before
conscious thoughts have time to get into the act.
Another important structure responsible for fear, anxiety, or emotional memory is
the prefrontal lobe.
It forms a partnership with the amygdala, which is the first-response
organ. Among humans, the frontal lobes of the brain are the latest in our evolutionary
development and unique to our species: they are the source of reflective thought. This is
both a benefit and a burden: on the plus side, the frontal lobes of the cortex permit us to
scrutinize our surroundings systematically, consider possible threats that might develop in
the future, predict the consequences of certain actions we might take, and plan particular
courses of action. This is all very well, but such capacity for imagination and forethought
also results in our sometimes engaging in improbable and irrational fantasies about
things that could happen The frontal lobes are thus our greatest gift when
it comes to anticipating and avoiding danger, but also our greatest liability when they
become overstimulated.
prefrontal lobe has the capability to override the signals sent from other systems
It also
explains how, even with the best of intentions, you might feel helpless to control certain
impulses that are overridden by another source of power.
the major effects of hippocampus atrophy
that occurs with sustained stress
1.It can create severe depression, the kind that doesn't go away after a short
period of time, but reappears unrelated to any stressor. It is considered endogenous;
that is, biologically based, as opposed to triggered by grief or loss.
2.Soldiers or abused children who experience posttraumatic stress have been
found to have smaller hippocampus tissue than those who have not experienced
it. The more devastating the trauma or crisis, the more deterioration takes place.
3.Cushing's Syndrome is a form of cancer that excretes excess quantities of
glucocorticoids, affecting all the usual suspects: memory, blood pressure, sexual
functioning, the immune system.
4.Cushing's Syndrome is a form of cancer that excretes excess quantities of
glucocorticoids, affecting all the usual suspects: memory, blood pressure, sexual
functioning, the immune system.
the autonomic nervous system (ANS)
regulates all the organs
and tissues not controlled by the central nervous system. It innervates the actions of
glands, the smooth muscles of hollow organs and vessels, and the heart muscle.
The ANS is divided into two major branches, namely,
y, the sympathetic and parasympathetic
nervous systems.
The sympathetic system
operates as an "on" switch. Its partner is the parasympathetic system, the "off"
switch, which turns down the energy when it is no longer needed.
endocrine systems
mobilize recruits from all over the body to turn
up the heat—whatever it takes to get your attention and get you to stop doing what you
are doing that is not working very well, or to start doing something else.
How do the nervous and endocrine systems work together
to coordinate the body's responses to perceived dangers?
Explain why chronic stress has such devastating
effects on the various body systems.
. How do the amygdala and prefrontal lobes of the cerebral cortex function
differently in their assessments of potential threats?
Diagram how the body operates
during the fight-or-flight response.
What process, when affected by stress, can cause diarrhea or constipation?
Explain
the underlying mechanisms.
What are the ways that stress can be helpful and enhance performance
and enjoyment of activities?
so far we have been talking about stress in the most general terms. We have
discussed the ways the body responds to stress,
described how neurological and
endocrine systems function, and outlined the mechanisms of the fight-or-flight
reflex. Each of these descriptions refers to how people (or organs) behave, without reference
to particular differences in the individual. Yet you know that not everyone acts the
same way in given circumstances, nor do their bodies react identically.
What determines the differences in individual responses to stress?
are constructed
exactly the same way. The heart and accompanying coronary connections are located in
the chest, usually a bit off center to the left; but in truth, there are exceptions to this rule
where particular organs end up a few inches in one direction or the other. Personality
is another variable that influences stress responses, as are your background, gender,
ethnicity, religion, and culture.
How is human development reflected
in a series of sequential stages?
What are the "developmental tasks" of childhood? Adolescence?
Young and
middle adulthood? Later maturity?
l How do primary and secondary appraisals of stress
affect a person's emotional
responses?
What are the major sources of stress
throughout the lifespan?
What are the most reliable indicators of serious suicidal
intent among those who are overstressed?
How are drugs and alcohol used
as forms of self-medication?
How does stress impair
sexual functioning?
What is the "family life cycle" and how does it influence
the individual's stress
reactions?
Stress is prevalent all through life and, as you have seen,
this is not altogether a bad
thing. Every phase of human growth benefits from the presence of a reasonable amount
of stress. Without the pressure of gravity, for instance, your skeletal system would lose
calcium and become very brittle. If you did not experience resistance, you would never
develop muscular strength and endurance. Likewise, without transcending adversity,
you would never mature intellectually, emotionally, and spiritually. It is precisely the
same challenges in life that create stress that help you to build resilience and personal
resources.
As you age, you go through a series of rather predictable stages.
These changes are
physical, but also involve emotional and cognitive functioning. In the first month of life,
the newborn will already respond to stressful overstimulation by emotional bursts of tears
to signal distress. By the second month, the baby learns to cry to get needs met. During
the third month of life, the baby can determine cause-effect relationships, and by the
fourth month she starts exploring the world by putting anything and everything in her
mouth to taste it (the most highly developed sense at that point).
developmental tasks.
These are specific challenges
that are supposed to arise at a particular stage in life. If the person does not
manage to master this task, then he is going to suffer and experience problems later in
life. If you follow the progression of locomotion, for instance, scooting is a developmental
task in infants that leads to crawling, then standing, walking, and running.
The developmental-task theory
emphasizes the importance of lifespan education
that requires the individual to be engaged in formal or informal learning for the sake of
resolving life's most stressful challenges. The theory also puts forth the concept of
"teachable moments"; that is, that people have a certain readiness to deal with challenges
that they would not be able to do during an earlier stage. You can't force a kid to walk
or talk, or learn calculus, until such time as she has developed the necessary cognitive
and physical skills. Keep in mind, however, that developmental tasks are derived not
only from biological maturation, but also from the expectations of your culture, peer
group, and personal goals. In some settings, surfing or playing video games might be the
major developmental tasks of a typical ten-year-old in Huntington Beach, California,
whereas hunting springboks might be crucial in the Kalahari Desert in Namibia.
A number of other theorists have developed stage models to explain the evolution of
gender, spirituality, cultural identity, moral reasoning, or career choices.
In each case, theorists have described the ways that people at various ages and stages most often function—what
they are able to do at that age and what tasks they must complete before they
can move on to the next stage. All of these developmental theories follow similar
assumptions that growth is progressive, incremental, and becomes increasingly complex.
Infancy- Birth to
3 years
Developmental tasks-Learning to trust, master physical tasks of feeding, communicating, movement, talking,
crawling, walking
Major stressors- Helpless to meet needs, body
control, environmental obstacles
Early childhood 3-6 years
Developmental tasks-Getting along with age-mates, social skills and roles, developing independence, control own
behavior, gender role, learning right from wrong

Major stressors- Manage frustration, first conflicts,
guilt, self-restraint
School age 6-12 years
Developmental tasks-Develop sense of competence, basic values, learning to read, develop social circle, adapt to
siblings, learn abstract reasoning

Major stressors -Feeling inferior, school and sports
performance, emotional control,
delay gratification
Adolescence 13-18 years
Developmental tasks-Identity development, plan for future work, organizing time, sexual orientation, peer roles

Major stressors- Social pressures, drugs, emotional
volatility, hormonal changes
Early adulthood 19-23 years
Developmental tasks-Developing intimacy, education and
apprenticeship, career plans, learning to love,
friendships

Major stressors-Loneliness, sexuality, career
confusion, financial independence
Young adulthood 24-38 years
Developmental tasks-Marriage/partnership, launch career, commitment to life goals, creativity and productivity

Major stressors- Moving away from home, forming
own family, parenting
Mid-life transition 39-50 years
Developmental tasks-Productive years, social and civic responsibilities, taking leadership roles

Major stressors- Promotions and advancement at
work, family conflicts, economic
pressure
Later maturity 51-65 years
Developmental tasks-Mentoring next generation, using authority for others' welfare, grandparenting

Major stressors- Loss of parents, empty nest,
declining health and functioning
Old age 66 to death
Developmental tasks-Retirement, coping with death and illness, reduced
physical functioning, increased leisure time,
coming to terms with life's meaning and worth

Major stressors- Dealing with losses, adjusting to
changes in health, being
marginalized
The transactional model of stress
developed by psychologist Richard Lazarus
(1991) helps to shed light on the mechanisms through which changes in life may be converted
into either subjective stress or a source of euphoria. Lazarus places great emphasis
on the importance of cognitive appraisal in the stress response (more on cognitive
approaches will be discussed in Chapter 6). This means that stress is the result of a
"transaction" between an external event and an internal event. The mediator between the
two is the cognitive appraisal or interpretation.
This theory helps explain why a similar event, say the loss of $100, can trigger very different emotional and physiological responses for two different people;
it all
depends on their cognitive appraisal. For someone who is broke, this loss can make
him sick to his stomach while, to a millionaire, the loss can represent an insignificant
nuisance
In order for the stress response to be evoked, there are two separate but related
cognitive events:
the primary appraisal and the secondary appraisal.
The primary
appraisal
will identify the nature of the environmental demand on the person, or the relationship
between the event and one's personal goals. This initial perception of the event
can be plotted along a continuum, depending on the extent to which the situation is viewed as dangerous or benign

If the primary appraisal looks at the situation or object to assess its potential as a threat, the secondary appraisal considers your own resources to meet the challenge. In
this second stage, the severity and immediacy of the threat are considered, as well as
whether you are in a position to deal with it effectively
The secondary appraisal
determines the severity of a problem and the degree of
stress reactivity. A millionaire perceives the loss of $100 as a minor event because she
is "resourceful" while to an economically disadvantaged person, this loss of money
represents a catastrophe. Another example of this secondary appraisal could occur if
you recently discovered that you would never become a great gymnast, but this did not
particularly upset you because it was in no way related to your goals
Primary appraisal
Perceived susceptibility
Perceived severity
Motivational relevance
Causal focus
Secondary appraisal
Perceived control of outcomes
Perceived control of emotions
Self-efficacy
Coping effort
Problem management
Emotional regulation
Meaning-based coping
Coping
Adaptation including:
Emotional well-being
Functional status
Health behaviors
The transactional model of stress includes three major developmental stages
1. An individual faces a challenging event or potentially threatening task.
2. The person determines first the nature of demand (primary appraisal), as well
as the resources and skills available to cope with the demand (secondary
appraisal).
3. Based on the previous appraisals, the person initiates a strategy to cope with the
situation in the most effective way possible
When the situation is resolved successfully,
y, the person is able to move on to the next
series of tasks without lingering effects. If, however, the demands of the situation exceed
the capabilities of the person, physical and psychological damage can result. This could
impede future coping with new developmental tasks for all the reasons you have learned
previously, including ongoing health and self-esteem difficulties.
How do your unresolved issues from the past influence
your stress and coping
in the present?
Why do we often make the same mistakes
and adopt maladaptive behaviors?
When faced with stressors, which perspective do you take on: looking into the future or dwelling on the analysis of the past?
? Running away or facing reality
and trying to solve the problem?
l If you accept the fact that stress can never be eliminated,
what kinds of
resources are available for you to cope with life challenges?
How do your thoughts and beliefs
affect the way you cope with stress?
What are some predictors of
maladaptive behaviors under stress?
What are some consequences of maladaptive behaviors
and how do they
affect every aspect of your life?
Have you ever analyzed the way you live? Do you know that everything in your life,
including the environment you live in and the relationships you are engaged in, is related to your stress experience?
theoretical models of coping and adaption
Adaptive behavior is a constructive adjustment in thinking and behavior to a stressor
experienced by an individual, which allows him or her to exert more control over certain
aspects of life. On the other hand, a maladaptive behavior is an adjustment of thinking
and behavior that may temporarily reduce symptoms of stress but carries negative longterm
consequences.
There is an assortment of explanations as to why and how some people cope reasonably
well with stress in their lives, and others fall apart. This section provides a brief
survey of some popular models.
psychoanalytic model
Freud's theory, stress results from internal conflicts as well as those
initiated in the outside world. Freud theorized that we spend our life trying to reconcile
instinctual drives (id) with our conscience (superego). The ego acts as the negotiator and
mediator of these two often conflicting forces, constantly attempting to find compromises
that allow us to pursue pleasure without doing harm to ourselves and others.
As mentioned previously, another key part of this theory has to do with unconscious
desires that operate beyond our awareness to motivate behavior. When people suffer
trauma, or experience stressful events early in life that are too difficult to deal with at the
time, defense mechanisms such as repression bury these memories so that they are no
longer felt as threatening. Although this can act as an adaptive mechanism initially,
eventually such hidden material can become toxic, leading to a host of maladaptive
behaviors
Psychoanalytic
Sigmund Freud
Carl Jung
Alfred Adler
Goals- Resolve conflicts from the past;
change character; promote
insight; strengthen ego

Philosophy-Past influences the present;
basic drives; role of the
unconscious; developmental
history
Humanistic
Carl Rogers
Rollo May
Victor Frankl
Goals- Create authentic relationships;
increase awareness; express
feelings; development of self;
explore core issues that give life
meaning; address barriers to
freedom and responsibility

Philosophy-Humans as growth-oriented;
increased awareness of self and
others to improve self-esteem
and personal functioning; search
for underlying meaning
Behavioral
B. F. Skinner
Joseph Wolpe
Albert Bandura
Goals- Identify target behaviors;
modify dysfunctional behaviors;
learn adaptive responses

Philosophy-People shaped by environment
and experience; all behavior is
learned and reinforced
Cognitive
Aaron Beck
Albert Ellis
Richard Lazarus
Goals- Increase awareness of cognitive
activity; identify and challenge
irrational beliefs; teach
adaptive behavior

Philosophy-People learn maladaptive
patterns; thinking precedes
feeling and action; problems
stem from core beliefs
humanistic
In direct contrast to the fatalistic
Freudian approach that looks at the past and
instinctual drives as the primary factors that influence
behavior, the humanistic approach remains
in the present. One of its founders, Carl Rogers,
advocated stress reduction primarily through the
establishment of trusting relationships with others
—the kind that permit you to honestly and genuinely
talk about how you feel, in a context of acceptance and respect.Like the psychoanalytic approach to coping with stress, the humanistic model shares the belief
that catharsis, or expression of pent-up feelings, is
important to resolve life's difficulties. Taking a far more optimistic rather than fatalistic approach to life, humanists see people as basically growth-oriented. The times you are
most likely to experience stress are when you are either not aware that tension is building inside you or when you do feel this pressure but are not inclined to express yourself
in healthy, authentic ways.
One subgroup within humanistic thought consists of the existentialists, who see
maladaptive lifestyles developing as a result of a lack of meaning in life. They are less
concerned with eliminating stress than with helping people to live with the normal anxieties
that are part of being fully alive.
The following are some important existential ideas.
1. Living in the present moment. Being fully alive means being totally focused and aware of what is happening in the here and now. It is when people get stuck in the past, when they avoid full engagement with what is going on, that they deaden themselves. People who are stressed spend too much time thinking about what has already happened, or what might happen in the future, and not nearly enough time appreciating the precious moments of the present. Some of the stress reduction methods such as tai chi, yoga, and muscle relaxation are intended to help one focus more on the here and now.
2. Accepting anxiety as part of life. The term angst is used to describe the normal dread that is part of life. Rather than escaping or denying the stress that we sometimes feel, it is sometimes healthier to accept it as part of life. This is especially useful when it involves things you cannot change, such as fears associated with an uncertain future or the prospect of death.
3. Accepting responsibility. Stress can result as often from avoiding responsibility as from taking on too much of a burden. Many people do not want to make their own choices; neither do they want the responsibility that comes with choice Yet to the existentialist, true freedom means living with our decisions, as well
as their consequences, without complaint.
4. Making contact with others. Each of us is born alone, and we will die alone. What we do between these two points is make the best effort we can to have intimate relationships with others. Stress arises from conflicts with others, but even more from isolation.
5. Finding personal meaning. This is the most important theme of all. Pain, discomfort, annoyances, even tragedies, are an inevitable part of life. There is no way to avoid getting hurt as long as you take risks, as long as you allow yourself to love others, as long as you engage with life. The key to coping with such stessors, however, is creating some purpose and meaning to the experience.
cognitive model
stress coping involves processes that combine features of
behavioral and cognitive action. After becoming aware that a stressor exists in the environment,
you make some internal assessments about its degree of threat, as well as your
resources to deal with the situation. He called this self-efficacy, which represents all your
internal capacities for managing stress that might arise. This includes prior experience,
self-confidence, skills and abilities, creativity, optimism, faith, persistence, resilience,
and self-discipline.
Another model of cognitive coping shares the belief that your interpretations of the
world determine your perception of stress, as well as how you manage it. Rather than
arising from a theory of emotions, however,
cognitive behavior therapy (CBT) and
rational emotive behavior therapy (REBT) were developed by Aaron Beck and Albert
Ellis respectively as schools of psychotherapy.
All of the cognitive methods share the premise of behavioral theory that poor
responses to stress are learned behaviors, or rather, learned irrational beliefs.
The essence of the theory is that all feelings (except instinctual fears that are routed through the
amygdala) are preceded by thoughts. If you are overreacting to a situation in your life,
this occurs because of the way you are choosing to interpret the situation. Emotional
disturbance takes place during those times when you exaggerate threats or overgeneralize
from limited information
emotional responses to stress
of the theory is that all feelings (except instinctual fears that are routed through the
amygdala) are preceded by thoughts. If you are overreacting to a situation in your life,
this occurs because of the way you are choosing to interpret the situation. Emotional
disturbance takes place during those times when you exaggerate threats or overgeneralize
from limited information—with yourself and with others.
fear and phobia
Fear can be described as the unpleasant, distressing feeling that is evoked by the
perception of danger. As you have learned, it can be stimulated by actual threats to life
and safety (a truck heading directly toward you in a head-on collision), or simply by the
interpretation or misinterpretation that impending threats are present (the startle response
from a honking horn). Whereas fear can be highly adaptive in terms of igniting the fightor-flight
response, phobias, or irrational terrors, arise way out of proportion to the actual
threat. Washing your hands a few times per day can be useful in preventing infections
and warding off germs, but doing so a dozen or more times a day, scrubbing the skin
with brushes until the skins bleeds, is more than a little eccentric.
You learned in Chapters 1 and 2 that fear evolved as a protective mechanism to
signal immediate mobilization of all the body's resources to deal with a perceived threat.
You may recognize the following fear-related behaviors which begin as highly adaptive
instincts but can become self-defeating
- Escape. This is the flight response that is usually the first course of action. If you run into a predator or other creature that is potentially dangerous, the best option is to avoid the threat altogether. However, avoiding all conflicts, or
anything remotely challenging, would be unhealthy and prevent significant
growth and productivity.
-Aggression. This is the fighting alternative when escape is not advisable. If you feel backed into a corner, or feel unable to avoid a danger, the next best option
is to fight back, perhaps preemptively to discourage an attack. When this strategy is misused, a person can become verbally or physically abusive towards others, a bully, who hurts others before she can become harmed.
-Submission. Observe animals in the wild, whether chimpanzees, moose, or lions, and you will see their rituals designed to establish a dominance hierarchy for
priority in mating privileges—only the fittest are allowed to reproduce their genes, which preserves the strength of the group. Surrendering to a stronger foe is a sensible alternative to almost certain defeat and injury. However, some
people become passive, submissive, and withdrawn in order to avoid rejection or threat of any kind
-Freezing. When confronted with a sudden threat, such as a snake or predator,
the most immediate reaction is to freeze. This gives you time to assess the level
of threat, at the same time that you reduce the possibility of an attack. After all,
many animals attack only in response to movement. What may once have served
a useful purpose can still be found in the tendency of some people to become
immobilized, or freeze, under pressure.
We evolved certain fears, and instinctual responses to them, based on life-threatening
situations our ancestors faced in their daily lives
It makes perfect sense,
for instance, that you would develop intense fears, or even phobias, of snakes or spiders
since they could be quite dangerous. Likewise, it seems reasonable to develop into a
hypochondriac (a person with an exaggerated fear of disease), or for children to develop
separation anxiety, school phobia, or stranger anxiety, since all of them might involve
increased threats from the environment. In other words, being cautious and vigilant when
it comes to avoiding sick people or strangers, and sticking close to your parents, was
probably a good idea.
Existential Angst
If so-called "simple stress" is a temporary response to perceived danger, then the condition
of angst is something else altogether: it is a relatively permanent feeling of dread
that is part of being alive—at least for those who are reasonably self-conscious. Angst is
the inevitable, constant anxiety that always lies just beneath the surface, but rears its
head most often whenever you consider the "big" questions of life: Why am I alive?
What is the meaning of my life? Is there a God? What happens after I die?
Any time you read a novel, or see a movie, in which the main character is struggling
with issues related to finding meaning, breaking free from feelings of alienation, dealing
with the consequences of freedom, or expressing terror at the prospect of impending
death, this is angst in action. It is a kind of stress that we have to live with as part of the
package that comes with being alive.
Monitoring Anxiety
Most forms of anxiety produce both physical and emotional symptoms. Not surprisingly,
the physical symptoms resemble "fight or flight" as we summarized previously:
• muscle tension and aches
• fatigue and insomnia
• headaches, dizziness
• heart palpitations
• stomach problems
• sweating.
The emotional symptoms are also consistent with what you would expect in a hyperaroused
state. In other words, the body believes that imminent danger is lurking around
the corner so this produces corresponding activation:
• jumpiness and irritation
• sleep disruption during hypervigilance (being on constant guard)
• dread, despair, apprehension
• impatience
• difficulty concentrating
• distressing images of impending disaster.
The key to diagnosing stress constructively, whether in yourself or others, is to recognize
the symptoms as they are occurring.
Some people live with tension so long, or have
become so accustomed to their symptoms, that they don't notice anything unusual about
their maladaptive behavior. They grind their teeth in their sleep. They break out in hives.
They bite their nails. They go without sleep for long periods. They worry about things
incessantly. They live with a short fuse, exploding at a moment's notice. They walk
around like nervous wrecks. And yet they remain in denial.
Before you can ever hope to manage the stress in your own life, you will have to
become much more aware and sensitive to the times when you are feeling pressure or
strain. Keeping a stress journal is one way to increase this awareness (see Stress
Management Technique 4.1). Another is to become more aware of the tension you carry
inside your body.
One way to tell the difference between normal sadness or grief and a serious depressive
disorder is the presence of physiological signs that include the following:
1. sleep disruptions (early morning waking, frequent awakening, sleeping
constantly)
2. appetite disturbances (significant weight loss or gain)
3. fatigue or general lack of energy
4. impaired concentration and inability to make sound decisions
5. lack of pleasure in daily activities
6. decreased sex drive
7. feeling especially bad in the morning on awakening (with the prospect of
having to survive another day).
Anger Management
Since anger has the potential to cause tremendous harm to yourself and others, it is
worthwhile to learn strategies to moderate the intensity and frequency of such outbursts.
Here are several suggestions.
1.Accept what is unchangeable.
2.Try to understand the deeper causes of your anger.
3.Learn to be more empathic
4.Realize that anger does not solve the problem.
5.Maintain realistic expectations.
6.Contemplate the consequences of anger.
7. Use the "time-out" method.
8.Express anger in more constructive ways.
Accept what is unchangeable.
Self-righteous people often get angry about things
that are totally outside their control—the weather, a natural disaster, rush-hour
traffic, or similar events. You may demand that the world treat you in a particular
way that you consider just and fair, and then become irate when things
don't go your way. Ranting and railing about a flat tire, snow storm, high interest
rates, or someone you believe slighted you not only doesn't make the situation
any better, but gets you worked up to the point that the negative effects
are magnified.
Try to understand the deeper causes of your anger.
Since your erroneous
beliefs can lead to anger, the choice of healthy thoughts may also help control
and prevent unnecessary eruptions. Fear and lack of self-confidence may
underlie your anger experience. Many angry people remain angry because they
direct their energy at the wrong sources.
Learn to be more empathic.
Anger is almost always a response of self-indulgence
in which you are so focused on your own experience that you can't appreciate
what others around you might be feeling. Getting mad at someone who cut you
off on the freeway need last only as long as it takes you to realize that the act
was unintentional. Feeling upset with a friend who you believe was rude to you
is easily dissipated when you realize that he had just gotten some terrible news.
We are not saying that you should allow people to walk all over you, or treat
you disrespectfully; just that you can reduce the intensity of emotional responses
by keeping things in better perspective.
Realize that anger does not solve the problem.
Anger may have once served
our ancestors well as they engaged in the fight-or-flight survival response to
mobilize energy for warding off danger, but it is considerably less functional
today. In many family and work situations anger and rage may initially intimidate others into surrender, but often with many negative side-effects (lingering
resentment, retribution, injustice).
Maintain realistic expectations
Disappointment often comes from expecting
things from life or from others that are not reasonable or realistic. Likewise,
anger can arise from expecting people to behave in ways that they are not
willing or able to do.
Contemplate the consequences of anger.
Consider the price you pay for becoming
angry. In the short run, you may enjoy some relief. But what happens in the
long run to your health, your relationships, and your peace of mind?
Use the "time-out" method.
When two people are angry with one another, it is
highly unlikely that a mutually satisfactory resolution of the situation is going
to occur. That is why professional mediators attempt to reduce the emotional
arousal during negotiation sessions. It is difficult, if not impossible, to hear and
respond to one another in respectful, caring ways when one or both parties are
out of control. By definition, anger represents a loss of control.
Express anger in more constructive ways.
During those times when you can't
help yourself and you feel yourself becoming indignant or angry, try to find
alternative ways to release that energy rather than taking it out on others.
Physical activities are particularly well suited to working off the steam.
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