Understanding and Coping with Stress: A Comprehensive Guide, Exercises of Psychology

Download Understanding and Coping with Stress: A Comprehensive Guide and more Exercises Psychology in PDF only on Docsity! Pride in our care A member of Cambridge University Health Partners Coping with stress Updated August 2017 Introduction Stress is a common experience in modern life. It is our emotional response to demands that are made of us by others, by outside events, or even by ourselves. Feeling over-burdened at work, reacting to a major life event or coping with a difficult situation we were not expecting are some examples of things people report as causing a high level of stress. Humans are good at problem-solving, it is something we engage in without even realising it and short-term ‘stress’ can be healthy as it can help us meet daily challenges and motivate us to reach our goals. Some people are able to accept the inevitability of stress in day-to-day life and resolve it as it arrives. For other people stress is a continuous and intrusive problem and can sometimes be out of proportion to the event. It can reach such high levels that it interferes with everyday life and can disrupt relationships with others. Stress can lead to a feeling of despair and can provoke a strong physical reaction from the body. If stress is prolonged it may even lead to illness. This manual is designed to help you develop a good understanding of stress. It will explain how life style alterations and changing the way you think about things can be used to reduce the stress reaction. It will also describe techniques of relaxation that can be used to reduce the physical symptoms of stress. Contents Education about stress Introduction What Is stress? Identifying the components of stress Strategies to cope with stress How to cope with daily hassles Time management Being assertive Balancing competing tasks Social support Taking care of yourself Relaxation Summary Section A Section B Section C Page 3 Page 7 Page 31 2 Look at this list. Are you surprised by how much stress these events caused? Perhaps you are surprised by how well you coped with such events. What other factors do you think contributed to your overall levels of stress? Make a list of them below: .................................................................................................................................... .................................................................................................................................... .................................................................................................................................... .................................................................................................................................... Now think about what’s causing most of the stress in your life at the moment. Is it a single life event, or smaller day-to-day problems? For most of us it’s a combination of larger and smaller issues. Identifying the components of stress It is worth being exact when you think about major cause of stress in your life. If there is an element of your job that is causing your stress it is important to realise exactly what that is. Rather than saying ‘work’ has become stressful, think about what aspect of work is causing the stress. If the cause of your stress at work is trying to reach a deadline that seems unreasonable, make a note of that. Think of it as: ‘the deadline at work’. Write below what it is exactly what is causing your major life stress at the moment. .................................................................................................................................... .................................................................................................................................... .................................................................................................................................... .................................................................................................................................... It is usually fairly easy to identify the big or major sources of stress in our lives. However, the smaller stressors can be harder to see. It can be difficult to understand how the “smaller issues” can combine and build up to affect us. It is important to keep in mind that it may be harder to cope with the smaller stresses in life when there is a major stress at the same time. Because of this it is a good idea to keep a record of these day-to-day problems and how you respond to them. 5 Making a note of your your day-to-day problems The first stage in dealing with these smaller problems is to identify them clearly. It will then become a little easier to put them in some perspective and see how they combine to make your overall stress level worse. Use the headings shown below to record problems that led to you feeling stressed. It may not always be possible to record every stressful situation at the time it occurs but it is useful to make a note of them later. Have a look at a typical problem (below) to see how keep a record. At the back of this manual you will find a ‘Recording Problems sheet’. You may find it helpful to photocopy this page so that you have some to fill in when they are needed. The more you do, the clearer your picture will be of why your stress has reached such a high level. Date: 24 July Time: 8.30 Hassle number 3 What happened? A car coming towards me. I had to pull out to overtake a double-parked taxi at the station. I had to brake quickly. How did I ‘see’ it? It was my right of way. How did I feel? Angry and a bit scared. What physical symptoms of the stress response did I have? Heart beat quickened. Stress score out of 10 for this hassle: 7/10 6 Section B: Strategies to cope with stress How to cope with daily hassles Now that you have identified what your day-to-day problems try this next exercise to see if it is possible to reduce them. At the end of the day review your problem list, and then sort into three categories: Those problems that could be avoided.1 Those where although the event could not be avoided, the amount of2 stress it generated could be reduced. Completely unavoidable problems that you think you will have to live3 with. If you’re having trouble with this, take a look at some of the suggestions below to see if it helps you. Group 1: Could be avoided Some possible ways you could be able to avoid these problems: By negotiating a better arrangement If your stress is coming from pressure at work, it may be possible to speak to your manager about the level of pressure you are under. They may be in a position to take work off you or create more flexible deadlines for you. By planning your day differently to make better use of your time Being able to give a task the correct amount of time and then moving on to the next thing will help you keep on top of different stresses. The temptation is to stay and dwell on certain parts of your life (such as putting extra time in at work), which could mean other areas suffer (such as spending time with children). Planning may help to prevent this Group 2: Could not be avoided, but the stress could be reduced Some possible ways you can try to reduce your stress levels when dealing with these: Try using some quick relaxation techniques. In the final section of this manual are some suggestions and techniques for relaxation. When you have found which one work best for you, try putting it into practise closer to the time of when the stress is caused. Try thinking about whether this is really so important. It is possible that you have blown the problem out of proportion. If every thing else were going well in life, would this be as much of a problem? Will this matter in 3 months time? 7 Think about how important each task was to do. Under the heading ‘Code’, mark ‘A’ -the tasks which really needed to be done urgently and are a top priority; ‘B’ - tasks that needed to be done at some point soon but were not yet urgent; ‘C’ - the tasks that did not need to be done soon and were a low priority. It may have been possible for some tasks to have been delegated, or given to someone else; mark these with a ‘D’. Finally, for slots of time that you were wasting when you feel you should have been doing specific things, mark with a ‘W’. List everything you did today, from the moment you woke up, in the space below. Use a new line for each item. Add roughly how long you spent on each. Bracket together things you were doing at the same time. Now go through the list. Take one item at a time and ask yourself if doing it at that time was the best use of your time right then? Next to each item write: A - if it was a top priority for use of your time today. B - if it was a medium priority for use of your time today. C - if it was a low priority for use of your time today. D - if you could have delegated it to someone else. W - if you were wasting time when you had said you would be getting on with something else. What you did How long Code 10 Review your categories Do you think that too many of your A list items were there because they had reached a crisis point and this was the last day you had to tackle them? Are you spending time on things that really are a priority, or are you doing B and C group jobs but not finishing your A list. Time that I would have needed to finish all ‘A’ list jobs: ....................................... Jobs that I could have postponed to finish ‘A’ list jobs: ....................................... ........................................ ....................................... • • • • • • Items that were at crisis point A-list jobs Finished Not finished 11 Look at the things you now realise you could have delegated. What stopped you? Perhaps you like doing them and even if it is possible to delegate them, you prefer not to? If you hesitate to definitely commit to delegating them, ask yourself why you are hanging onto them. Are you worried about asking people to do things? Are you worried that if someone else does them they won’t get done properly? If you are choosing to do them, decide how much of a priority they are. You may want to reconsider delegation. Now look at your ‘W’ category. Are you accumulating too much guilt over this list? It is important to recognise when ‘wasting time’ is the result of feeling too anxious about what you are supposed to be tackling. Your anxiety pushes you into procrastination. However it is equally important to recognise that some things you have coded as ‘W’ ought really be on a priority list! Sometimes, wasting time is quite the best thing to do. You need short breaks, a quick breather, an energiser, a little relaxation or even a bit of ‘light relief’ to prevent the pressures of the day building up on you. They help you recover and should be valued and, indeed, planned into your day. Now that you have done this review you should find it easier to plan ahead by making A, B, C and D lists of all the things you need to do. Use these ‘things to do’ lists to plan daily and weekly timetables. Don’t forget to plan in time to negotiate delegating your D list. When planning your week consider whether there is a particular time when you are at your most productive. Are you a morning person or an afternoon person? If so then this would be the best time to do high-priority tasks D-list jobs Reason not delegated 12 Think of the last time you wanted someone to do a task for you but were unable or unsure how to ask him or her. Make a note of it here: .................................................................................................................................... .................................................................................................................................... .................................................................................................................................... .................................................................................................................................... Now try to create a clear statement or question for that person that you could have used. Try not to be unclear but avoid being aggressive, so rather than ‘Don’t you think the washing needs to be done?’ or ‘Why do you never do the washing?’ Try something like: ‘Could you do the washing? I’ve got a lot on my hands right now.’ .................................................................................................................................... .................................................................................................................................... The next time you need something done, or you are unable to do something you have been asked to, pause for a moment and try to create a clear but non- aggressive statement like you have done here. Balancing competing tasks We are very often performing balancing acts when we choose between different aspects of our lives and determining priorities. We have to balance one set of demands against another. This process in itself can be stressful. You may feel as though you cannot avoid letting someone down, or decide that the only way you can appease everyone is to let yourself down, which you may resent strongly 15 Some examples of balancing acts: Demand A Versus Demand B Paid work Work My job Too much to do Eating well Need to keep fit Need for change and excitement Need to get work done Fitting everything in Time for my family Unpaid domestic or voluntary work Home My partner’s job Too little to do Not enough time/money to eat well Not inclined towards exercise Need for stability Need to have fun Getting enough sleep Time for me v v v v v v v v v v If you have problems with conflicting demands you can: Renegotiate - set limits on what you are prepared to do• Manage your time better• Learn to live with them• Have a go at this activity that will enable you to identify which of your most important demands fall into these categories. Make notes about one demand being made on you that you would like to renegotiate. What is the demand?................................................................................................ What would you like to change?.............................................................................. What would make it more bearable?...................................................................... Who would you have to discuss it with?.................................................................. When will you begin to renegotiate?...................................................................... 16 Make notes about a demand that could be improved by careful time management. What is the demand?................................................................................................ When can you spend half an hour making some plans? Make a note of this time in your diary .................................................................................................................................... What demands can’t you change? Make notes about one that you will have to learn to live with. What positive things could you do to help make this demand more bearable? .................................................................................................................................... You have to take life as it happens, but you should try to make it happen, the way you want to take it (Old German saying)“ 17 Improving your social network Taking care of current relationships In a busy life it can be hard to find time for friends. One way to manage• this is to socialise and get something else done at the same time. Exercise together, carpool, form a reading group. It can be easy to forget about friends when you start a new romantic • relationship or go through a stressful period. Although you may want to scale back social commitments occasionally, maintain reasonably regular contact with your friends. Strive for regular contact with the people who mean the most to you.• Some people set up regular meetings, like a weekly squash game or a monthly lunch. Planning events is harder to do when feeling stressed so this can be helped by having social commitments already planned in your diary. Deepening current relationships Of the people you already know who would you like to know better?• What things do you have in common that might help to deepen the relationship? If deepening relationships are important to you, give those relationships• higher priority than you do daily tasks like washing up, or solitary activities like reading. When talking about topics like movies, work, or local events, get a bit• more personal about yourself. Briefly share your own feelings, opinions, or experiences. Then give the other person a chance to open up in turn. Reviving old friendships Do you have any friendships that have lapsed? Perhaps you could bring• those people back into your social circle, after all, you already know that you are compatible with your old friends. Perhaps your friendship has slipped because one of you has moved away.• Letters, phone calls, video-calling, texting and e-mails can be rewarding ways of interacting with people across a longer distance. Reconnecting with old friends can raise a lot of doubts about yourself. Do• they like you? Did they ever like you? Will you be imposing on them? These doubts are often misplaced. The only way you will really know the answer is by contacting them again. 20 Starting new friendships Your goal should be to talk with a new person, not to find a soul-mate.• Most of the people you meet will not become close friends, so avoid hoping for too much. Don’t always wait for others to introduce themselves or break the ice. • Mingle at parties or events. Have a few things in mind that you could talk about. You don’t have to hide your true nature or be unusually clever or • charming. Remind yourself that people respond better to warmth and genuineness than to attempts to impress. People who ask about the other person are often felt to be the best • conversationalists. It’s also much easier to ask questions than to carry out the conversation on your own. Once you have spoken to someone new, dwell on the fact that you have• accomplished something that is difficult for most people. Pat yourself on the back. Taking care of yourself The better you feel about yourself, the more you want to take care of your health. Being fit and healthy makes you feel good so that you see yourself and talk to yourself more positively. This improves your self-image. Handling stress well makes it easier for you to take care of your health: taking care of your health makes it easier to handle stress well. Accumulated tension can lead to stress related illness. Unwanted side effects of any unhelpful coping strategies can damage your health. Such unhelpful strategies include smoking, alcohol and caffeine. If you are fit you can handle stress better. A healthy diet gives you energy and maintains your body’s immune (defence) system so that it can repair any damage from stress. Exercise can lift your mood, help get rid of tension and improve your physical stamina. Getting enough sleep ensures that you are mentally alert and your body is well rested so that you are ready to handle what the new day brings. If you have a car, which do you care for most – your car or yourself? With any machine, such as a car, careful use and regular maintenance helps it to run well, safely and efficiently, avoiding unnecessary breakdowns. This way the machine will do the job for which it was designed and might even be a source of pleasure. We can think of taking care of our health in a similar way to taking care of a car. Regular maintenance is much better than waiting for a breakdown before giving it attention. 21 Careful motorists reduce wear and tear by checking the oil level and topping up when necessary, using the appropriate gears for the speed they are travelling. They do not race the engine or tear around corners on two wheels, spending most of the time in top gear. Nor do they keep pressing the accelerator when stuck at traffic lights. They notice new squeaks or noises as they arise and will attend to them early on, to avoid possible long term damage or costly major repairs. They keep a close eye on the road to be warned of dangers ahead and enable them to take avoiding action wherever possible. When travelling on unmade roads they drive slowly, avoiding potholes or taking them steadily. They arrange regular services and MOT tests and maintain the car’s insurance. If the handbook calls for 4-star petrol, they do not use 2-star as a false economy. They fill up with petrol before a long journey and arrange regular breaks when the journey is particularly long or arduous. In other words; careful motorists look after their car, gives it the right fuel, ensures regular maintenance and drives it carefully avoiding unnecessary risks. Some people take more care avoiding wear and tear on their cars than on themselves. Health When it comes to maintaining your own health do you know what’s right for you and how to do it? We all tend to have quite grand and unspecific intentions, for example, ‘I’ll take up swimming and go every day’. However the first steps might be getting answers to these questions -‘Is there a pool near me that’s open when I could go? Can I afford the admission fee? Can I find my swimming costume – and does it still fit me?’ Concentrate on making your health changes as enjoyable and as convenient as possible. Most of the things we can do to improve our health and generally maintain our bodies in the best working order can be enjoyable in themselves. Healthy eating and moderate exercise can be fun. Try to reduce any health- damaging strategies you use in the short term in an attempt to cope with stress. These unhelpful strategies include smoking, excessive use of alcohol and caffeine and excessive reliance on medication i.e. overuse of tranquillisers. Although these strategies can offer powerful short-term rewards, they also add to the stress and often make it harder for you to address the underlying problem. These strategies can become problems in themselves as they are often hard to give up and may need careful planning. Should you find you need support to do this there is a good deal of help available; the CPFT website or NHS Choices can guide you to find appropriate help. Good things that you may already be doing include avoiding caffeine before you go to bed or deciding in advance how many alcoholic drinks to have. And, of course, deciding to find out more is a positive step forward. 22 Below are descriptions of four different methods of relaxation. Why not give them a try and see which one works best for you? You may find that relaxation is difficult at first. You may not find it easy to relax your muscles, or you may have trouble concentrating on relaxing. This is why it is important to practice relaxation techniques – it takes time and practice to be able to relax effectively. If you practice twice a day you will start to notice that it becomes easier to relax, and that you can become more relaxed more quickly. When you feel ready, you can reduce the amount of time you spend practising and use your skills whenever you feel you need them Applied relaxation Applied relaxation is something to do be done when you are alone and when you are not expecting any interruptions. Sit or lie down in a comfortable place (e.g. a bed or the sofa). It will be helpful if the room is relaxing – warm and pleasantly lit. If you find a piece of favourite music soothing, use it as a soft background to your relaxation. If too much silence puts you on edge, leave the radio on at a low volume – preferably to a music station. Try to adopt a ‘passive attitude’, which means not worrying about your performance or whether you are successfully relaxing. Just ‘have a go’ and let it happen. Remove your shoes and loosen tight clothing. Start by taking a couple of deep breaths. Allow yourself to be still for a few minutes to help you get in the right frame of mind and allow yourself to start to unwind. Focus on your breathing, and let your muscles slowly start to relax. Focus your attention on your hands and arms. Tighten the muscles in this area; notice what it feels like when these muscles are tight and tense. Hold this for about 10 seconds. Then relax the muscles in your hands and arms – let the muscles become floppy and limp. Concentrate on the changes in sensation in your muscles from the tense state to the relaxed state. Focus on the feelings of relaxation in your hand and arm. Then move on to other muscles groups. Tighten and release each of these groups of muscles, one at a time: Feet, calves, thighs• Buttocks, stomach, back• Shoulder, neck• Jaw, eyes, scalp• 25 Once you have gone through each of the muscle groups, tensing and relaxing, turn your attention back to your breathing. Focus on filling your lungs and letting the air out through your mouth as slowly as you can. Continue to breathe slowly and regularly and notice the rhythm – like wavelets, running onto and receding from a beach. While you are lying quietly, focus again on your body. Go through the muscle groups and check to see if your muscles have remained relaxed. It is not unusual for some muscles to have tensed up while you have been relaxing others. If you notice any tension at all, focus on relaxing that area. Let the muscles go loose and limp. When you are satisfied that you are physically relaxed and that your breathing is deep and regular, let your feelings of relaxation continue to deepen. There is no hurry – just enjoy the comfort. Sometimes people can use this time to imagine an imaginary scene in their mind; one in which they are completely calm, content, and relaxed. Pay great attention to detail, using all of your senses focusing on what can you: see; hear; smell; feel; taste. When you are ready to stop practising, count backwards from 5 to 0, and then open your eyes. Take a deep breath, stretch, and get up very slowly. Take your time and notice how relaxed you feel. Relaxation response This simple method of relaxation was devised by an American doctor called Herbert Benson. It is based on research that examined the key factors in a variety of western and eastern forms of relaxation and meditation. The research identified four key factors that reduce the physiological response in the body. These are: Being in a quiet place• Using a word or short phrase which should be repeated over and over• again Adopting a passive attitude – just letting it happen rather than striving to• relax Being in a comfortable position• Guidelines for learning the relaxation response Prepare to relax Make sure that you will be warm enough. Sit quietly in a comfortable • position. Close your eyes.Think about letting go of the tension in all of your • muscles.. Keep the muscles loose.• 26 Focus on your breathing Breathe through your nose. As you breathe out say the word ‘one’ silently• to yourself (or another word, such as ‘calm’, ‘peace’, or easy). Breathe easily and naturally.• Don’t try too hard Do not worry about if you are not good at reaching a deep level of • relaxation. Keep a passive attitude and allow relaxation to happen at its own pace.• Deal with distractions Distracting thoughts will probably occur. Do not dwell on these. • If you start to feel a little dizzy or breathless this will be caused by • overbreathing because you are feeling anxious about doing it right. Just breathe out when your body naturally wants to and concentrate on saying your word. If you notice a slight tension in your ‘favourite spot’ – your jaws, neck or• scalp – this will be because you are trying too hard. Just let go – this type of relaxation comes when you are not thinking about it. Bring your relaxation to an end You may open your eyes to check the time but do not use an alarm, which• will make you tense up again. When you finish, sit quietly for several minutes, at first with your eyes• closed and later with your eyes open. Then stand up slowly. The relaxation response can be adapted to many everyday settings when it’s not convenient to sit down and close your eyes. All the variations involve natural breathing and repetition of a word or counting to still the mind and relax the body. Think of times in your life when you could put into practice adapted versions of this technique. For example: Waiting for trains buses and other people.• In a lift.• While waiting for the safety release on a washing machine• 27 breathing’ (your diaphragm moves down and pushes your stomach out as you take in a breath) rather than shallower higher lung breathing. If you find that it’s difficult to lengthen your breaths to a count of 7/11 then reduce the count to breathing in for 3/5, or whatever suits you best, as long as the out-breath is longer than the in-breath. Continue in this way for 5-10 minutes or longer if you have time – and enjoy the calming effect it will have on your mind and body Tip: Try all the different methods of relaxation and decide which one works best for you. It is possible that there are times of day or circumstances that lend themselves to one method over another. So try them all and discover which you are most com- fortable with. 30 Section C: Summary Hopefully by now you will have had the chance to practice some of the techniques in this manual. If you have not started to see results immediately don’t worry, remember it takes time and practice to deal with your stress. You are now aware of the life-style changes that can be made as well as having some methods of relaxation. Once you have had the chance to work on the techniques for a few weeks you should have a good idea of which one works best for you. Remember the more you practice the better you get. We looked at the reasons for being assertive and the benefits that can be gained from them. We identified how time management, through prioritising tasks and learning to delegate appropriately, can be used to reduce stress. Then the manual addressed your self-esteem in relation to your self-image and how this is important for building a network of friends. We hope this manual has been useful and that you have been able to apply these practical solutions to your every day life and combine them with the relaxation techniques. You can find out more information about stress and anxiety on other websites by searching the CPFT website www.cpft.nhs.uk or NHS Choices. 31 Recording day-to-day problems Date: Time: What happened? How did I ‘see’ it? How did I feel? What physical symptoms of the stress response did I have? Stress score out of 10 for this problem: Date: Time: What happened? How did I ‘see’ it? How did I feel? What physical symptoms of the stress response did I have? Stress score out of 10 for this problem: