The following was part of a little research project I did as part of my homework in psychology, and because I thought it was interesting, I wanted to post it.
Psychological and physiological methods of stress management
Stress is a universal phenomenon, experienced by most people
at some point during their lives. It can be brief and passing, or more chronic.
People who experience chronic stress often suffer from specific medical
complaints. This means that stress can be quantified, defined and measured.
The proper definition of stress is that of the transactional
model of stress which is:
The perceived lack of fit between the demands of the
situation and the person’s ability to cope
Stress is harmful for numerous reasons. When somebody
undergoes a stress response it is because they perceive something as a threat
to their safety. This was an evolutionary advantage when we hunted or were
hunted as it allowed one of two actions to take place more effectively – that
is, we were able to fight or run away. This is called the fight or flight
stress response. However, nowadays, one
cannot simply fight or run away from whatever we perceive to be a threat
because it could be something as simple as job insecurity or ambiguity, or other
such stressors.
The end result is that the stress response which would once
have been a short lived and temporary solution now does not work, but because
you continue to be stressed, you continue to undergo the physiological changes
which are attributed to flight or fight. These carry serious complications if
they continue for too long, like an increased risk of coronary heart disease
(CHD), and a lowered immune defence (Kiecolt-Glaser 1984)
Psychological methods of stress management
The psychological methods for dealing with stress include
but are not limited to Meichenbaum’s stress inoculation training and Kobasa’s
hardiness training.
Cognitive-behavioural therapy
This technique was devised to help individuals prepare for
instances in the future where they may experience stress, and promotes
resilience in patients. There are three main phases within this therapy. They
are:
·
Conceptualisation
·
Skills training and practice
·
Real life application
Conceptualisation: This is where the patient is encouraged
to remember and thoroughly recreate any previous events where they may have
experienced stress. They are then asked to analyse it – what was their
reaction? Was it successful? Why? This helps patients reach a more realistic
understanding of the demands of the situation. That is, their perceived demands
are reduced, and this reduces the stress of the situation.
Skills training and practice: this where, having identified
the stressful aspects of the situation, the patient is expected to develop
strategies to combat them. For instance, if they find job interviews stressful,
they could practice job interviews and learn techniques to make themselves come
across as a more viable candidate.
Real life application: this is where the training is put
into effect without the therapist. Meetings are still arranged with the
therapist to follow up, but the idea is that from here on, they should be able
to go their own way.
Evaluation of the stress inoculation technique
Pros:
·
It works
·
It targets both sources of stress and symptoms
Cons:
·
It is expensive
·
It takes a long time
·
It is a difficult process
Kobasa’s hardiness training
Kobasa believed that hardiness was a measure of how well
people could cope with stress and was a reason for the differences in peoples
responses to stress and their potential physiological or psychological changes
when they experienced prolonged stress.
Hardiness training is based around three key concepts of:
·
Focusing
·
Reliving stressful encounters
·
Self improvement
Focusing: this is where a patient is asked to pay attention
to their body signals – sweating, raised heart beat, anxiety etc – so that they
can identify stressful situations and can therefore deduce the source of the
stress
Reliving stressful encounters: this is when they are
encouraged to remember what the stressful event was and what they did about it;
They are asked to imagine how it could have gone worse, to make them realise
that their coping resources are not as bad as they could have been, and how
they could have gone better, to improve their current coping strategies.
Self improvement: this is where the patient is encouraged to
make reasonable and achievable goals. There will be problems within life which
someone cannot cope with. By aiming for achievable goals the patient confirms
to themselves that they do have control over their lives and lack of control
can be a key cause of stress.
Evaluation of Kobasa’s hardiness training
Pros:
·
It
appears to have a positive effect
Cons:
·
Takes time
·
Is expensive
·
The concept of “hardiness” is in dispute
·
Kobasa’s studies cannot be generalised – they
only happened on white, middle class businessmen
·
Not many studies as to how effective it is
Physiological methods of treating stress
There are two methods of treating the physiological, both
involving drugs. Because of the nature of the stress response which is a
physiological one (meaning your body emits chemicals and changes how it works) the
physiological response can be altered by introducing synthesised drugs into the
equation. These can reverse the effect of the naturally produced hormones or
block them, and act as inhibitors.
Benzodiazepines (BZ’s)
These are anti anxiety agents. They include, but are not
limited to, drugs like Valium or Librium. They act directly on the brain and
have a calming influence, reducing brain activity. They work by increasing the
effect of an inhibitor, gamma amino butyric acid or GABA for short. GABA
influences the brain on a neuronal level by making it calmer, or less
excitable. BZ’s enhance gaba’s effectiveness, by acting as a pump for the
chloride ions into the neurotransmitters. This means that other neuronal
impulses are less effective. BZ’s work on about 40% of the brains neurones and
can cause the body to relax. Impulses to or from the pituitary gland, for
example, to release ACTH, could be inhibited. ACTH is one of the main hormones
involved in the physiological stress response, and by inhibiting it you can
calm the user down for a period of time.
Beta Blockers (BBs)
Beta blockers are another stress relieving drug. They do not
work in the brain on a neuronal level like BZ’s, but in and around the body.
They inhibit the hormones adrenaline and noradrenaline in the blood stream by
competing for the same receptor sites. Adrenaline and noradrenaline are
activated in the body’s physiological stress response. They stimulate
beta-adrenergic receptors around the body, particularly in the heart, brain and
blood vessels. When a body undergoes the stress response to a perceived threat
they release the hormones adrenaline and noradrenaline. This causes the
activation of the sympathetic ganglia (a process known as sympathetic arousal),
part of the autonomic nervous system, which reduces blood flow to the stomach
and other digestive organs, and increases blood pressure and heart rate, and
allows the release of energy in the form of fats and sugars from the muscles
where it is stored as glycogen. By taking BB’s they reduce the effect of
adrenaline and noradrenaline and as a result the body does not experience
sympathetic arousal. By competing for the same receptor sites the BBs stop
adrenaline from increasing heart rate and blood pressure. This reduces the
strain on the heart. BBs can also be taken by musicians and snooker players
where “nerves” might make them jittery and reduce performance.
Evaluation of a drug based approach to treating stress
Pros
·
Instant effects
·
Clear and noticeable effects
·
Easily available
Cons
·
Dependency/addiction to the instant fix
·
Tolerance – the drugs have less effect the
longer they are used. Higher doses are needed
·
Symptoms – drugs target the symptoms of the
problem, not the source
·
Side effects – most anti anxiety drugs have side
effects. BBs can be dangerous for individuals with serious asthma, and can
contribute to type 2 diabetes
Alternative stress management techniques
These include physiological approaches which are not drugs
and psychological ones which are alternatives to the ones stated above.
Progressive muscle relaxation technique (PMR)
Relaxing is often thought to be a natural process but it is
in fact an art. A patient undergoing PMR would be encouraged to find a
comfortable position and consciously contract and relax every muscle in their
body, starting low down at the feet and working their way up. Eventually the
patient is used to the sensations enough that they can recreate the feelings
themselves and use it on an everyday basis. This allows the activation of the
parasympathetic ganglia, a nervous pathway which enables digestion to take
place, lowers blood pressure and heart rate. This is an alternative
psychological stress management technique.
Evaluation of muscle relaxation technique
Pros
·
It can be very effective in reducing stress
Cons
·
It requires practise
·
It often is not practical (traffic jams can be
stressful, using this technique would be difficult and inconvenient)
·
It’s time consuming
·
It targets the symptoms and not the problems
Biofeedback
This is a physiological technique used to treat stress. It
involves someone being hooked up to a device which measures and reports blood
pressure and heart rate, from information gathered from electrodes placed on
the body. They are then encouraged to experiment themselves, and see which
techniques they can use to lower either their blood pressure or their heart
rate or both. Once they have proven to be able to consistently use a specific
technique or combination of techniques they are then encouraged to try and
utilise these in everyday life.
Evaluation of biofeedback
Pros
·
It can be very effective for particular
individuals, especially children
Cons
·
It is expensive – it takes time to practise and
the equipment needed is sophisticated
·
Some scientists have stated that it is no more
effective than the other techniques like PMR without biofeedback, and that the
addition of the machines do not help
In conclusion, the best approach would be to utilise one of
the psychological methods of stress management which targets the source of the
stress. Physiological methods can and should be used in certain circumstances
(the build up to important life events causing severe stress) but should be a
temporary measure, and dependant on the patient also attending and using the
other methods.
Resources used
Psychology for AS (AQA) fourth edition published 2008 ISBN
978-0-00-725503-0
http://www.bcnc.org.uk/howtheywork.htm
