Stress and distress
In recent years the topic of stress has become one of increasing public awareness and concern. Although often considered in a negative light as something to be avoided, stress is actually beneficial to us. That is, a certain amount of stress motivates us to act. Excessive stress, however, is debilitating and results in distress.
Research indicates that distress is a key casual factor in a variety of diseases and conditions including heart disease, stroke, respiratory disease, sleep disturbances, migraine and tension headaches, accident proneness and a series of complaints.
It should be noted that distress is also subjective and unique to each person. In other words, an experience (potential distressor) that may produce a distress response in one person may be stressful but not excessively so to another. This is because people respond to events based on their perceptions of events. Values, beliefs, attitudes, and expectations, as well as genetics, determine their ability to adapt. Consequently, effective stress management requires that individuals be able to distinguish between those stressors that produce distress and those that do not. Moreover, individuals must experiment to discover those practices and procedures which can most effectively reduce and/or prevent distress for themselves.
Potential Distressors Among the factors often identified as contributors to distress are the following:
Change
Clinical researchers have shown that changes (both positive and negative) requiring adaptation in a person's routines can produce distress. When a substantial number of changes (marriage, injury, outstanding personal achievement, death in the family, vacation, end of school, change in eating habits, troubles with one's boss, etc.) are accumulated in a short time span the results can be the development of symptoms.
Attitudes
Negative, critical, fearful, and/or pessimistic attitudes about oneself others and the world frequently result in behaviors and feelings which can become manifest in symptoms.
Nutrition
It is evident that we must be properly fueled in order to function at our best. Hence, a diet which provides for one's basic nutritional needs is essential to well-being. In the chronic absence of a balanced, nutritionally sound diet, the body becomes distressed and is encouraged to respond by developing symptoms.
Physical fitness
Recent research has shown that many of the stress-related diseases are related to a sedentary and affluent life-style which contributes to poor physical fitness. The body's systems need regular, vigorous exercise in order to keep them vital and fit. Without such exercise, we diminish lung capacity, decrease blood flow, decrease muscle mass, resiliency and elasticity, and increase body fat. All such developments can lead to symptoms.
Relationships
Just as certain foods are nourishing to your body, while certain others are toxic, so it is with human relationships. We all realistically expect and accept that relationships are characterized by occasional conflict and disagreement. As a result, we experience minimal distress from such events. However, when the frequency of conflict and disagreement increases so that it is the norm rather than the exception, then symptoms reflecting that distress can emerge.
High quality relationships characterized by good communication, mutual caring, and respect enhance living. Indeed, they are necessary if one is to reach one's fullest human potential. Toxic relationships need to be avoided or changed so that they become meaningful and positive.
Meaningless activity
Much has been stated in recent years about the boredom and meaninglessness experienced by large numbers of our labor force. Such worker feelings are often cited as being casually related to alcoholism, drug abuse, absenteeism, and accident proneness - all being practices which compound distress. The worker, for example, who drinks to avoid feelings of boredom and becomes alcoholic now has the distress of alcoholism to contend with in addition to the distress of boredom.Other factors
Additional factors having the potential to cause distress are: noise, toxic chemicals in the air, congested travel and living conditions, anxiety over national and international policies, inhumane and impersonal situations, excessive competition, career pressures, and economic uncertainties. In many instances, we can learn to exercise control over our responses to these and other potential distressors. Techniques for learning such control and management follow.
Stress management methods
Goal setting and conscious planning
A clearly stated, positive goal with a specific sequence of steps identified to reach the goal is an important method for coping with stress. With realizable goals and concrete plans for their achievement, one can focus energy, see progress as it is occurring and enjoy a sense of accomplishment as one moves toward the goal. Since change has the potential for producing distress, planning for change can keep the stress within manageable limits.
The relaxation response
A major component of distress is muscle tension. Consequently, learning to deeply relax one's muscles can be an important stress reduction and management technique. This can be accomplished by systematically tensing specific muscle groups, and then contrasting the tension with relaxation. Regular practice of this procedure will produce deepening levels of relaxation in the muscles. Deep, slow and rhythmic breathing will also add to the "relaxation response."
A typical relaxation training model
This exercise will help you practice deep muscle relaxation – this is not a cure-all, but it can be very useful in reducing tension. It is important that you practice these exercises daily. If you are having sleep difficulties, try this before going to bed at night. Create an environment that is void of as many distracting stimuli as possible, i.e., lower lights and noise levels, loosen fight clothing, close your eyes.
Each of the following muscle groups should be tensed and then relaxed twice before moving to the next group. The tension phase of the cycle should last about seven to 10 seconds. Make mental contact with the muscle – try to visualize it in your mind's eye. Tense the muscle group gradually tighter and tighter, concentrating on where the tension is and what the tension feels like. After five seconds or so, relax the muscle group – let it go completely limp. The relaxation phase should last about 20 seconds. Go gently with areas of your body that are sore or stiff. The purpose of the exercise is increased awareness – not strength. Tension to perhaps 3/4 of the muscle's potential is adequate.
Following are the muscle groups and the exercises for the tension/ relaxation cycles:
Muscle group exercise
1. Right hand and arm: Clench right fist tightly.
2. Left hand and arm: Clench left fist tightly.
3. Upper back and shoulders: Shrug your shoulders up high and try to touch your ears.
4. Neck: Bring your head forward and press chin against chest.
5. Forehead: Wrinkle your forehead tightly.
6. Eyes: Close eyes tight enough to feel the muscles tense up.
7. Jaws and lower face: Clench jaws and bite slightly, just enough to feel the tension; in relaxing, let your lips part slightly as lower jaw hangs limp.
8. Mouth: Purse your lips.
9. Back: Arch back and bring shoulder blades together.
10. Chest: Breathe in normally, then let chest walls go loose and push the air out. Hold for two to three seconds, then fill the lungs naturally and blow out, hold ... etc. Continue relaxing and breathe freely and gently for 30 seconds – repeat.
11. Abdominal muscles: Slowly draw in stomach and hold.
12. Right leg: Tense all muscles of right leg.
13. Left leg: Tense all muscles of left leg.
Continue relaxing by focusing on your breathing, taking deep breaths and exhaling slowly. Let yourself relax completely. Keep out all distracting thoughts. When your attention wanders, bring it back to the sensations in your muscles (or follow your inhalations or exhalations with your mind's eye). When you are ready to stop, silently count forward from one to 10 along with your exhalations. Stretch your muscles and slowly open your eyes. You should feel refreshed, relaxed and very calm.
Aerobic exercise
Regular, vigorous exercise which exercises the whole body (so it involves especially the cardiovascular and pulmonary systems) for a duration of 20-30 minutes every other day can be effective stress management practice. When launching such a program, one should be careful to begin with an activity that is at least somewhat enjoyable. It should also be at a pace that is comfortable. Increasing one's pace and duration should be gradual. Walking is excellent, as jogging or running can be hard on the knees and joints.
Flexibility exercise
In order to keep the body elastic and supple, it is important to practice an exercise regime that stretches the muscles and limbers the joints. Hatha yoga is one approach to body flexibility which meets this criterion, but simple stretching exercises can do the trick.
Meditation
Since much of one's stress/distress results from how one thinks and what one thinks about, it follows that meditation techniques which temporarily set aside "thinking"are useful for reducing stress. Studies have confirmed the value of meditation for this purpose. How to Meditate by LeShan is a useful book for the novice.
Imaging and visualization
The incredible influence of one's inner images and visual thoughts on one's ability to cope with stressors is beginning to be understood. We now know that people can learn to change their thought processes and imagery so that distress is significantly reduced. By viewing in the mind's eye scenes that are specific, relaxing and serene, the individual can produce a generalized relaxation state throughout the body and mind, thus relieving distress.
Imaging exercise
Imagery exercises can be helpful tools for relaxing in any situation. One only needs a few, uninterrupted minutes.
Settle yourself in a comfortable position. (Sitting down may be helpful as you learn and practice this exercise.)
Think of a scene that is very pleasant to you. Imagine the sounds, sights and smells that comprise your restful scene. You are part of this pleasant place. Picture yourself enjoying a relaxing, quiet, peaceful time at the beach, in the mountains, the woods, etc. – whatever is most pleasant for you.
Take a few minutes to observe the scenery around you. Listen to the sounds that are special in your place. Notice any smells that belong there also.
You are very relaxed and comfortable. All your troubles and tensions are gone. Continue to relax and enjoy these feelings until you are ready to return to the present situation, feeling very relaxed, but very alert.
Know that you can help yourself relax at any time, in any place, just by using this imagery exercise to take you to your peaceful place.
Nutrition
Certainly food intake influences physical and emotional functioning. In addition to a balanced diet, persons who are anticipating stressful events (exams, etc.) are well advised to supplement their regular diet with an increase in protein since stress is known to increase the speed with which protein is used in the body. For an excellent discussion on diet, see Ballentine's Diet & Nutrition.
Positive affixed cultivation
Positive attitudes about self and others when cultivated perform a stress reducing function. Primary among these attitudes are:
- unconditional respect for self and others;
- forgiveness of self and others;
- empathy and understanding;
- love of truth;
- an active, participating approach to life;
- humor and joyfulness.
Play and recreation
In our competitively oriented culture it is not uncommon for people to "play" with the same sense of seriousness, time urgency and desire to win that characterizes the rest of their lives. To reduce stress, it is desirable to play for fun and recreation without getting caught up in competing and striving to win. Striving creates pressure, pressure produces tension, and tension can lead to distress. Play should reduce pressure, diminish tension and counter distress.
Final comment
Numerous other methods and suggestions for reducing and managing stress/distress could be outlined. Certainly by creating meaning and satisfaction in one's work or school situation and one's relationships with others, one moves in positive directions. Similarly, getting sufficient and regular rest enhances one's potential to function without debilitating distress. In short, becoming intimately acquainted with oneself opens the opportunity to develop methods for reducing and managing stress that are personal, fitting and tailored to oneself. Get to know yourself. Be regular in practicing distress-reducing methods and you can become your own "doctor/therapist/best friend" – at least sometimes. On those occasions, however, when your stress level exceeds your skills in management, you will likely be served best by seeking the help of a professional doctor or therapist.