Stress Management Series

[John P.]

STRESS MANAGEMENT SERIES

The following is a series of newsletter articles on the subject of
stress management. The objective of the series is to help the reader
develop a toolbox of stress management techniques that could be used
in varying types of stressful situations that come up as a normal part
of living one's life. More parts of this series will be added in
coming months.


--Stress Can Be Beneficial--Newsweek cover story, part #1


The general public has been under a lot of stress for the past six
months because of the financial news, or because they have felt the
direct impact of the economic downturn.

Most people with schizophrenia have felt much stress for years or
decades because of the symptoms of the illness. Or because of the
destruction of interpersonal relations that usually happens along with
this. Or because of the regular experience or threat of poverty
that usually happens with this brain disorder.

Stress is a harsh thing to deal with, under any of these
circumstances.

Yet, there may be another way to look at it: Stress can be helpful.
Or at least sometimes. This topic is the featured cover story of a
recent edition of Newsweek.

One psychology textbook is quoted in the article this way--”Some
stress is healthy and necessary to keep us alert and occupied.”

Janet DiPietro, a psychologist at Johns Hopkins University is quoted
as saying: “The public has gotten such a uniform message that stress
is always harmful. And that is too bad, because most people do their
best under mild to moderate stress.”

UCLA psychiatrist Judith Orloff says that stress helps by “revving up
our systems to handle what we have to handle.”

Other quotes from the Newsweek article:

-Stress can energize us.

-Stress can motivate us to do a better at jobs we care about.

-Stress can make us hardy people, when we use it as something to
transcend.


Although not directly mentioned in the Newsweek article, there can be
other senses in which stress can be worthwhile.

Stress may be the necessary cost of doing a lot of good things and
doing acts of kindness under difficult circumstances. And stress may
be a necessary cost of doing one’s duty and performing essential
things that are part of one’s station in life. In these senses too,
stress is not always a bad thing. And stress can make one a better
person, when it is handled in a good way.

Next issue we’ll talk about the pioneering stress researcher Hans
Selye, and what he said about all this. And also talk about the
helpful idea of stress management techniques.

SOURCE: Newsweek magazine (Feb. 23, 2009), cover story entitled:
“Stress Could Save Your Life (Or at Least It’s Better for You than You
Think)” by Mary Carmichael.
==============================================

--Stress Can Be Beneficial--Newsweek cover story, part #2

The Newsweek story on the benefits of stress cites many modern
researchers on the subject. But is also cites the two pioneering
scientific researchers on the subject of stress, both of them
physiologists: Hans Selye of the University of Montreal and Walter
Cannon of the Harvard Medical School.

Hans Selye’s experiments on animals in the 1930s led him to become
the father of stress research. He actually came up with the
application of the word stress. Selye recognized that living beings
experience distress and have an internal biological response when
confronted with stressors. This he called the general adaptive
syndrome, as we try to cope with the difficult things around us. His
point was that people could live for a while--even a long while--under
stressful conditions, but eventually exhaustion and the inability to
cope sets in. Selye became interested in methods for managing stress
and its impacts on our physical health. He noticed something early
on. Often stress was helpful and had beneficial aspects. Selye
invented a word for this--he called it eustress.

Walter Cannon at Harvard in the 1940s added the concept of the “fight
or flight response” when confronted with threatening stressors. When
the brain perceives danger, it sets off bodily chemicals that result
in us having the physical capacities to be better at fighting or
quickly retreating from the threat. Our hearts, lungs, muscles,
blood vessels, digestive, and immune systems all become highly
activated to enable us to deal with the danger. This is helpful a lot
of time when we are dealing with actual threats. The problem becomes
if we begin to see danger everywhere we go, especially things that
really aren’t that particularly threatening. Our bodies go through
the same fight or flight response whether the threat is imagined or
not. This can cause all sorts of physiological health problems down
road, plus an incredible amount of emotional misery and unhappiness.
Thus the really important thing to learn here is how to turn off the
mental danger switch when threats are not actually happening. This is
where problem-solving ability and stress management techniques come
into the picture.

Newsweek doesn’t really go into the problem-solving ability side of
things, but does talk about stress management techniques. One Harvard
Medical School professor says simply: “The facts are that stress can
worsen the symptoms of any disease and stress management can offer
relief.” Studies cited in Newsweek show that meditation and exercise
can help people cope with stress. And in many cases something like
meditation can “repair or compensate for damage already done to the
brain.” (An important point in the article is that chronic stress can
shrivel neurons of brain cells and result in brain tissue shrinkage in
key parts like the prefrontal cortex.) The good news is the recent
discovery that brain tissue can grow back when we do healthful
things.

The article makes an important point about stress management
techniques. They usually don’t work when people don’t want to do
them, or when people don’t “throw themselves” into the technique with
enough regularity for the technique to become a habit and take hold.
The stress management technique can actually have an adverse affect if
unwilling people are forced to do them, lose a sense of control in the
process, and then get internally angry and frustrated about the
situation. One stress researcher said that if he was forced to do
mediation for 30 minutes a day, he’d probably have a stroke. So folks
might benefit from knowing how stress management techniques have
helped others--but to be helpful, people need to choose which
techniques they want to try and apply themselves to.

Here’s a list I’ve come up with of ten stress management techniques
that people often choose to help them cope. In a future edition we
can talk for about these. Some of these aren’t mentioned in the
Newsweek article.

TEN STRESS MANAGEMENT TECHNIQUES

1. Meditation (or relaxation techniques)

2. Exercise

3. Prayer

4. Shifting Focus (attention away from the stressor)

5. Friendly Chats (with supportive people)

6. Comic Relief (that produces healthy laughter and merriment)

7. Helping Someone Else (who may be suffering more than you do)

8. Cognitive Adjustments (changing the way you look at negative
things)

9. Seeking Help (from reliable and wise people)

10. Massage Therapy (can be self-administered)

In the next edition, we’ll talk about what the Newsweek article
reports about stress hardy and resilient people, as well as other
topics on the subject of stress.

SOURCE: Newsweek magazine (Feb. 23, 2009), cover story entitled:
“Stress Could Save Your Life (Or at Least It’s Better for You than You
Think)” by Mary Carmichael.
==============================================

--Stress Can Be Beneficial--Newsweek cover story, part #3

People respond differently to stress. Some folks get harried and
frazzled really easily. Others are able to, in the words of one stress
expert, quell the anxiety that stress tends to spark and then go on to
exercise immediate impulse control. This second group of people are
called “stress hardy” by researchers, in that they seem to be
resilient in all sorts of situations.

How do these stress hardy people get that way? Can we learn their
resiliency traits?

The recent Newsweek article on stress talks some about this. The
researchers say that stress hardy people often model one of their
parents who had the same skill. Or the resilient ones had a period of
exploratory freedom when they were young that enabled them to build
confidence in their ability to solve problems. Women turn to their
social networks during stressful periods, which results in the release
in the brain chemical oxytocin (which in turn calms down the stress
system in the body).

Genes may be an important factor in stress hardiness, say the
researchers. For instance, scientists have identified a gene that is
important in the production of seratonin--one of the “feel good” brain
chemicals. Variations on this gene can protect people from emotional
difficulties. Says Stanford University scientist Robert Sapolsky:
“I’m willing to bet the farm that that’s going to begin to explain who
gets depressed after disastrous unrequited love and who just feels
lousy for two weeks.”

Another surprising finding was that egocentric and self-focused people
tend to be less resilient. The problem with being self-focused is
that these folks often take things very personally and get slighted
very easily. They can fall into the trap of thinking that their
problems are directly targeted at them, or that they almost attract
problems. People who are not self-focused bounce back more quickly
when problem come.

Dr. Andy Morgan, a researcher for the Yale Medical School, has been
studying resiliency of military men at Fort Bragg’s Army Special
Forces units in North Carolina, as well as the Navy’s elite diving
training center in Panama City, Florida.

Morgan has found that those military men who are particularly stress
hardy naturally release huge amounts of anti-stress chemicals in their
brains. One brain chemical is called neuropeptide Y (or NPY), which
works like “fire hoses that your brain uses to extinguish your alarm
and fear responses by keeping the frontal-lobe parts or your brain
working longer under stress.” The other brain chemical is a natural
steroid called DHEA, which mutes the stress hormone cortisol. With
more ample supplies of these two brain chemicals, these soldiers and
sailors are able to keep cool under pressure and pain, and more able
to “stay focused and clearheaded despite uncontrollable fear.” Often
these guys keep bouncing back and refuse to give up.

Anger, hostility, and depression are toxic responses to stress.
According to the Newsweek article: “Some people respond to chronic
stresssors with remarkable equanimity. Others spend a substantial
fraction of their day experiencing one or more of the toxic
reactions. This is influence partly by our genes, but is also
controllable with stress-management techniques.”

My bet is that those of us who are frazzled won’t become stress hardy
hummingbirds over night. But the looks of it are that we can learn to
manage a big chunk of our stress-related difficulties. We’ll talk
about some more specific stress management techniques next issue.

SOURCE: Newsweek magazine (Feb. 23, 2009), cover story entitled:
“Stress Could Save Your Life (Or at Least It’s Better for You than You
Think)” by Mary Carmichael.
-------------------------------------
--Stress Can Be Beneficial--Newsweek cover story, part #4
Robert Sapolsky of Stanford University studies alpha males in social
settings. Sapolsky has observed a difference between angry alpha males
and cool-headed alpha males. The angry alpha males are "son of a bitch
types who respond to stress by lashing out." On the other hand, the
cool-headed alpha males are sort of like the=2 0nice guys who finish
first. Per the Newsweek article, these alpha males don't get into many
fights. Sapolsky calls these his Zen master alphas. It should be
mentioned that Sapolsky's research subjects are baboons studied in the
wild. But he feels that there are counterparts in human society:
Dominant people who are calm enough to resist provocation.

Sapolsky believes that we can change how we handle stress in such a
way that we will be more cool-headed and less frazzled. To paraphrase
his words in Newsweek: "Even if we're not born well-equipped to deal
with stress, we can change because as humans we ought to be wise
enough to keep stuff in perspective."

The Williams Lifeskill program, based on research from Duke
University, has a cognitive mini-makeover which involves a formula for
assessing conflicts. In a way, it teaches one to pick the right
battles when necessary. When a situation arises that could result in
conflict, ask--How important is this to me? Should I really be mad?
Can I do something about the problem? Would conflict be worth the
trouble? Most of the time when things are working right in our heads,
the answers to these questions lead us to the conclusion that a
conflict isn't the way to go.

This is one stress management technique mentioned in the Newsweek
article. In the coming months we'll examine many stress management
techniques from numerous sources.

Meditation and exercise were mention ed prominently in Newsweek,
because studies show that both can relieve stress and lead to the
renewal of brain tissue in stricken areas of the brain. Also it is
mentioned that we cope better when we feel in control of our
situation. But even when that control slips away, creative thinking
can help our way out of the stress.

Diet can impact on stress management, per quotes from Dr. Michael
Miller (editor of the Harvard Mental Health Letter). Healthy well-
balanced meals enable the brain to work well in helping us deal with
difficult situations. Dr. Miller also talks about time management
principles as a way of dealing with stress. Check out his quote from
Newsweek:

"I try to be realistic about what I can achieve. I try to say no
sometimes, so I can focus on my top priorities. Sometimes it's hardest
to keep the commitments we make to ourselves; I certainly find that
difficult. For example, I try to follow my my own advice to do one
thing at a time, though I can rarely keep the to-do list completely at
bay. I try to accept 'good enough' from myself and, since mistakes are
unavoidable, live with the possibility that I will be criticized when
I make one."

Stress management involves methods for helping us cope with stress.
This should be a useful topic in the months ahead--as the economy puts
more stress upon us.

SOURCE: Newsweek magazine (Feb. 23, 2009), cover story entitled:
"Stress Could Save Your Life (Or at Least It’s Better for You than You
Think)" by Mary Carmichael.

========================

--Stress Management, part #5

Herbert Benson, M.D., of the Harvard Medical School, wrote a book
called The Wellness Book that tells how to manage stress and reduce
the impacts on stress-related illnesses. In the book, Benson has a
neat section on developing stress management. According to Benson,
stress-hardiness is the ability to experience stressors without the
accompanying mental or physical stress response.

When stressful things begin to happen, our response can make a big
difference. Often when stress comes we begin to have awfulizing
thoughts and worse-case scenario images about where the stressful
situation will take us. Our body then develops a physical response,
full of muscle tension and other stress cycle responses. Benson has a
section in his book about a Four-Step Approach for dealing with stress
situations. These four steps are: Stop, Breathe, Reflect, and Choose.
When stressful things happen:

Stop--silently say Stop to yourself before your thoughts escalate into
awfulizing scenarios. This can help break the pattern of your body's
usual cycle of stress response.

Breathe--after the Stop, breathe deeply to release tension. This will
again interrupt your body's stress response. Focus on breathing calmly
to relax.

Reflect--once the awfulizing thoughts have settled down, appraise your
situation objectively, without highly-charged emotional thoughts
scaring you out of your wits. Come up with rational alternatives for
dealing with the stressful situation.

Choose--when you feel your mind is not clouded with scary thoughts,
and your body is not all wound up from tension, choose one of your
rational alternatives for dealing with the stressful situation.

Benson believes that practicing these four steps regularly can make
help one develop a pattern of behavior that has more stress hardiness.

SOURCE: Herbert Benson, M.D. and Eileen Stuart, The Wellness Book.
(New York: Fireside Book, 1992)

------------------------------------------------


--Stress Management, part #6

Herbert Benson in his Wellness Book references the work of Robert
Yerkes and John Dodson of Harvard University, who showed that
increases in stress and anxiety produce increases in performance and
efficiency, but not indefinitely. And if the increases in stress and
anxiety are hiked more and more past a certain point, performance and
efficiency decline or are even diminished significantly.

The idea is to develop positive approaches to stress in order to
increase the chances to adapt better to it. Susanne Kobasa, a
psychologist at the University of Chicago, has shown that some persons
are less vulnerable to stress--they have stress-hardy characteristics.
Benson lists four of these stress hardy traits--what he called the
Four C's: control, challenge, commitment, and closeness. Here are
elements of stress-hardy people:

Control--the ability to make lasting personal choices and influence
personal environment

Challenge--to see stressors as an opportunity to advance something
good or for personal growth
Commitment--to feel deeply and personally involved despite the stress-
producing activity, enough to keep interested and curious about the
activities and the people
Closeness--to have warm relationships and social support

Benson also references the work of Dr Barrie Grieff, who was a
psychiatrist at the Harvard Business School. Grieff came up with the
Five L's of Success, which incidentally also help in managing stress.
The Five L's are: Learn, Labor, Love, Laugh, and Let go. Here they
are--

Learn--be open to new experiences, and absorb new information every
day

Labor--work at something that brings meaning to life and satisfaction

Love--be able to give, recognize others, and receive

Laugh--chuckle with yourself and others

Let Go--don't become too absorbed with things that are outside of your
control

Grieff believes that these five things will enable one to be better at
managing stress. Maybe they are worth a try. In short--the Four C's
and the Five L's.


SOURCE: Herbert Benson M.D. and Eileen Stuart, The Wellness Book. (New
York: Fireside Book, 1992)

-------------------------------------------------

--Stress Management--part #7

Almost any list of stress management techniques includes exercise as
one of the key methods. We can't here recommend a program of exercise
for readers, for that would depend on the health and physical
capacities of each individual. A person planning to begin a program of
regular exercise should consult with his or her physician first, and
then seek the advice of a trained expert on how to set such an
exercise regimen up. Or your doctor may just recommend that you do
some walking or a simple exercise method like that.

Myself, I'm not much into exercise. But the evidence supporting its
health benefits are very strong. And exercise often works effectively
as a stress management tool, for very specific reasons.

One factor here is that exercise is a natural outlet for your body
when it is in a "fight or flight" state of stress arousal. During
this state there is a sudden surge of adrenalin in your system, which
puts your body in full alert and high gear. The exercise works to
quickly metabolize the adrenalin in the bloodstream. This
metabolizing then slows the arousal and state of vigilance. After the
exercise you come to calm.

Also with exercise there is reduced skeletal muscle tension, the kind
tension that results in you feeling uptight. Exercise tends to
diminish the experience of anticipatory anxiety. So maybe if we are
stuck ruminating in worries, we should try a bit of exercise to shake
it off.

Exercise can also work as a way to discharge pent-up frustrations.
Some experts say that if discharging aggression is an important thing,
then the person might consider participating in competitive sports.
Check with your doctor first.

At the other end of this spectrum, exercise produces endorphins in the
brain--these natural brain chemicals that make you feel good and give
you a sense of well being.

Putting this list together sort of makes me want to start exercising.
If I did, I'd be following the advice of about every physician
around. Some kind of exercise is recommended for everyone, even if it
a very simple type.

SOURCE: Edmund J. Bourne, PhD, The Anxiety and Phobia Workbook.
(Oakland, CA: New Harbinger Publications, 1990.) Note: The title of
the previous article in this series was mistakenly given as #5, when
in fact it was the sixth article in the series.

-----------------------------------------------------------

--Stress Management--part #8

Visualizations. One stress management technique that works for
some people involves visualizations, or guided imagery that uses your
imagination to bring your mind to peace and quiet. Folks may want to
try to see if to see if this works on an individual basis. Perhaps
visualizations could become one of the twenty or thirty tools we'll
talk about that a person would easily have available to regain
calmness when stress comes. No one of these tools would probably work
all the time, but hopefully one of the twenty tools would work in each
of the different situations we get into. Perhaps we would find that
different stress management tools are regularly effective in different
types of stressful circumstances.

Psychologist Edmund J. Bourne has written about visualizations and has
given some guidelines, some of which are below. Some common
visualizations involve imagining yourself in a very safe, beautiful,
and peaceful place--and then letting this visual trip in your
imagination bring you to an internal physiological state of peaceful
calmness. Often these visualized places can be a secluded summer
beach, a meadow in the sunlight, or a cabin in the forest.

The visualization process has three parts: preliminary relaxation, the
visualization itself, and the return to the alert state of mind. Like
meditation, it's best to be in a quiet place in your home or elsewhere
when visualizing, and be in a comfortable position with head
support. It's often best to prerecord the visualization from a
script written to produce calm images that touch you. There are tapes
and CDs available of nature sounds related to beaches, meadows, and
forests. One that I experienced once in a therapeutic setting was a
cabin in a forest, with the coming of a gentle rain. It was really
effective for me in producing calm. Below are three place
visualization discussed here:

* A Meadow in the Sunlight. Picture yourself in a beautiful meadow
in the country on a sunny summer day. There are rolling hills full of
wildflowers. The sound of songbirds fill the air. A gentle breeze
blowing over you. A radiant blue sky above with white clouds.
Sunshine reaches you throughout.

* Beach in the Summer. A secluded beach stretches on each side of
you into the distance. The water is a beautiful shade of blue, as is
the sky. Warm sand surrounds you. The ebb and flow of the waves
reaching shore make for a rhythm of peacefulness. Seagulls are flying
out into the sea. Perhaps a sailboat or merchant ship sails in the
distance. You feel safe and secure in this natural setting.

* A Cabin in the Forest. You walk a path in the forest. All around
you are trees--pine, fir, maples, oak. The sun enters the canopy of
the treetops. It's like a great primeval cathedral. The sounds of
forest birds and woodpeckers echoing in the forest. You reach a
clearing in the forest. There a cabin of wood stands, which will be
your safe and secure home for the night. In the distance you can hear
the sound of rushing water--there is a stream down in a gully near the
cabin. You can explore that stream later in the day.


In all three of the visualization settings above, the prerecorded
script would use the imagery to encourage you to relax all muscle
groups in your body and letting you know that there is a safe and
secure place in your head where you can be calm. Bourne talks about
bringing relaxation to every muscle, tendon, and nerve in your body
through visualizations.

There is another visualization type that does not involve nature
settings, but rather imagining yourself in stressful situations, and
then imagining yourself handling things well. We'll discuss this
visualization type next edition.


SOURCE: Edmund J. Bourne, PhD, The Anxiety and Phobia Workbook.
(Oakland, CA: New Harbinger Publications, 1990.)

--------------------------------------------------

--Stress Management--part #9

More on Visualizations. Last issue we discussed visualizations
as a means to reduce tension and increase relaxation, by way of
bringing to mind the imagery of peaceful and secure settings in
nature. This edition speaks about using visualizations as a means of
reducing stress by imagining yourself handling things well in
difficult situations.

This visualization method I’m talking about here has to do with mental
practice and preparation exercises used before specific stressful
situations take place. I’m not talking about any “visualize,
actualize, realize” method found in recent law of attraction or
creative visualization materials. I’m interested in using mental
imagery as a sort of simulation beforehand that will help one better
deal with tense situations.

According to Edmund J. Bourne, PhD: “Visualizing that you can
successfully negotiate a phobic situation you’ve been avoiding will
also help you to confront and master that situation.”

Bourne’s method takes about 20 minutes. Below is an broad adaptation
of his method. There are three parts to the visualization method--1)
preliminary relaxation, 2) the visualization itself, and 3) returning
to an alert state of mind.

To begin, get in a comfortable position, with your head supported. A
quiet environment that is free of distractions is best. Use a
relaxation technique--one by Herbert Benson, MD. Bring your mind to
quiet.

Have a specific stressful situation that you want to do better in. In
your mental imagery, place yourself in that situation. Same place,
same people, same events. Throughout the visualization, picture
yourself remaining calm in the situation, or as calm as possible.
Practice in your mind remaining at enough ease to be able to handle
the situation well. Try in this mental simulation to use quickie
relaxation methods to remain as calm as possible.

As you are able to remain more at ease in this mental image of the
stressful situation, try taking simple actions and saying simple
things that would help you handle the situation well. It may take
more than one visualization session to get this part down. You may
want to get advice from a therapist or another wise person in how to
best handle yourself in this practice visualization. You can learn
new behaviors to model yourself after this way. During the
visualization be aware of how you think, act, and feel.

Keep trying these visualizations and getting feedback from your wise
advisor on how to handle the specific situation. Keep working on it
until you can see yourself in the visualization handling yourself
calmly in the stress, and working things out well in the mental
simulation. At the end of each visualization session, give yourself a
couple minutes to slowly return to an alert state of mind.

When you try the method in the actual real-life situation, be open to
making mistakes and then getting more feedback on how to solve them
from your wise advisor. And too, be aware that some problems in life
are just too difficult to solve, and don’t beat yourself up over these
kinds of situations.

Hopefully, through a method like this you will learn more helpful
behaviors to using in adapting, as well as staying calmer in stressful
situations.

A more complex method of this sort by the behavioral scientist Joseph
Wolpe will be discussed further down the road in this stress
management series. Wople’s method is called systematic
desensitization.

SOURCEL Many of the ideas for this article came from Edmund J.
Bourne, PhD, The Anxiety and Phobia Workbook. (Oakland CA.: New
Harbinger Publications, 1990.)


-------------------------

--Stress Management--part #10

Cognitive Restructuring. Your thoughts affect your stress level.
This seems so obvious, but it is also an important realization for
reducing stress. Key researchers at the University of Pennsylvania
(like Aaron Beck, Martin Seligman, and David Burns) have developed a
stress reduction method that involves eliminating unnecessary
emotional difficulties that arise simply from one’s thoughts, beliefs,
and attitudes. It is called cognitive restructuring. This is a
constructive reworking of one’s negative, unrealistic, and distorted
ideas.

One of the important notions in this method is that we have “automatic
thoughts.” That is, when something happens, our mind is immediately
filled with a lot of ideas, almost automatically and without any
premeditation or effort on our part. These automatic thoughts are
often knee-jerk reactions that in themselves can cause negative moods
and emotions. The automatic thoughts can be a never-ending tape of
personal myths.

A big part of cognitive restructuring involves getting a handle on
these automatic thoughts, and giving them an appropriate evaluation.

Many of the automatic thoughts can lead to a self-talk or inner
dialogue that has many self-defeating attitudes. The researchers at
the University of Pennsylvania have developed methods for working on
these automatic thoughts so that unnecessary stress and disruptions
to well-being occur less often. We will discuss these cognitive
restructuring methods in coming editions. From our standpoint, it is
probably best if we experience the method with the help of a qualified
mental health professional.

A couple important points are made by Harvard researcher Herbert
Benson in his presentation of the helpful aspects of cognitive
restructuring. First, it isn’t intended to remove all difficult
emotional situations. Things happen regardless of how we think of
them. Often emotions like fear and irritation can be constructive and
lead us to find constructive resolutions to the real-life problems
that brought on the emotions. The goal of the method at hand is to
reduce the unnecessary suffering that comes from irrational or
unreasonable ideas.

Benson also points out that the flow of thoughts and mood can go in
both directions. In this method we usually work with the idea that
negative thoughts lead to our moods. But also, if we have a headache--
that can affect our mood, which can lead to negative thoughts. And
sometimes, our constant stewing in negative thoughts can lead to a
headache, which then further affects our moods. This is all by way of
saying that the flow of mental activity is not always in one
direction.

Also, Benson states that cognitive restructuring is a part of the more
general cognitive therapy method developed at the University of
Pennsylvania.

SOURCE: Much of ideas and some of the direct wording comes from
Herbert Benson MD et al, The Wellness Book. (New York, NY: Fireside
Books: 1992.)

--------------------------------------------

--Stress Management--part #11

More on Cognitive Restructuring. As discussed in the last
edition, Harvard professor Herbert Benson makes the point that much of
our stress can come from “automatic thoughts” that pop into our heads
during stressful situations. Benson makes an important point about
these automatic thoughts when they put us into a negative mood. From
his book cited below, Benson says this:

“We are always talking to ourselves, and the content of that self-
dialogue is usually negative. We are engaged in a constant stream of
self-chatter, coaching, advising, wishing, criticizing--and after
saying something often enough, we begin to believe it....We rarely
stop to question our thoughts....[and] Your body doesn’t know the
difference between things you imagine and the things you actually
experience. If you recall a scary movie you have seen, you may notice
that your heart beats faster. Or if you imagine yourself on a favorite
beach, you may feel your body begin to relax and your breath slowing
down.”

A whole lot of time we can get a cascade of automatic thoughts, even
to the point of turning us into a ball of neurotic entanglements.
Sometimes we need to seek a professional intervention, and a
psychiatrist or a therapist steps in to sort things out after asking
the question--what happened here?

Often times our automatic thoughts spring out of our core set of
beliefs, attitudes, and assumptions. The act of cognitivive
restructuring seeks to challenge these ideas that cause hurtful
emotions by demanding adequete evidence to support the ideas. If one
cannot provide adequate evidence, one might easily wonder if the
belief is a misperception.

When running across a personally-held idea that causes misery, the
person might ask himself--do I really know if this idea is true? and
how do I know this? If the answers to these two questions are weak,
then maybe its time to re-examine the idea that causes misery. The
approach would be evidence-based.

The next edition will have a discussion the on stress caused by
irrational ideas and how to approach them using cognitive
restructuring.


SOURCE: Much of ideas and some of the direct wording comes from
Herbert Benson MD et al, The Wellness Book. (New York, NY: Fireside
Books: 1992.)

-----------------------------------------

--Stress Management--part #12

3 Point “Stay Cool” When Angry List from Reader’s Digest

This past month’s Reader’s Digest had a short article on three tips
for coping with one’s anger, and at the same time avoiding a heart-
related episode. When angry, here are the three tips as stated:

1. Recognize that anger is universal.
2. Ask yourself if whatever made you angry is important.
3. Talk yourself down.

Now each of these points could deserve a book of its own to describe
how to apply the tips in daily situations. Yet the Reader’s Digest
article did give short sentences on how to work these three tips.
Here are some of the ideas, as paraphrased:

1. Recognize that anger is universal.

Anger is part of us. Wisdom guides when to express it and when to let
it go. Problems occur when we only have one way to react to things--
anger always or anger never.

2. Ask yourself if whatever made you angry is important.

Consider the objective facts of the situation. Ask yourself if your
thinking and feelings are appropriate to these objective facts. Then,
ask yourself can you change the situation? Then, is it worth taking
action to change it?

3. Talk yourself down.

When replaying the offense in your mind, yell “Stop” silently to
yourself in your head. Take a deep breath, clench your fist, release
your fist. Begin distracting yourself (day-dream or some benign
activity that will absorb you).

The Reader’s Digest article with the above information was written by
anger-management consultant Virginia Williams, PhD, co-author of book
Anger Kills. The book was co-authored with her husband, Redford
Williams, MD.

Of course, anger management could easily be a part of any stress
management course of study. Next month we will try to continue with
the set of articles on cognitive restructuring and its role in stress
management.

SOURCE: Reader’s Digest (Aug. 2009)


-----------------------------------------

--Stress Management--part #13

Added Comments on Cognitive Restructuring. Herbert Benson makes the
point that we often have a “confirmatory bias” when we interpret the
negative things that happen to us. And that our erroneous downbeat
theories about ourselves seem confirmed by our biases when we choose
how to view the information on bits of bad luck. Likewise we can
develop “self-fulfilling prophecies” in which we really do fail as we
suspected, but the real culprit was that we didn’t try hard enough or
we quit too soon because we said “what’s the use.”

Psychologist Albert Ellis came up with something called the ABC’s of
emotions. It goes like this:

A--Activating event
B--Belief system
C--Consequential emotions
D--Disputation of beliefs
E--Emotional stability

The idea above is that our emotions are not necessarily affected by
the stressful event itself, but by the filtering mechanism of how the
event is viewed in our mind via our belief system. And if we wish to
be more stable during stressful situations, we can accomplish this by
challenging some of the negative aspects of our belief system. Albert
Ellis went on to identify what he thought were a grouping of common
Irrational Ideas that make us miserable.

Meanwhile Aaron Beck and David Burns at the University of Pennsylvania
developed a listing of ten common Cognitive Distortions. One
cognitive distortion is called “All or Nothing Thinking” where we
mistakenly think that if something is not perfect, that it is
worthless. Another cognitive distortion is called “Personalization,”
in which we assume we are personally responsible for something when
we are in fact barely even connected with the outcome in question.
More is given about cognitive distortions in David Burns book “Feeling
Good.”



SOURCE: Much of ideas and some of the direct wording comes from
Herbert Benson MD et al, The Wellness Book. (New York, NY: Fireside
Books: 1992.)

--------------------------------------

--Stress Management, Part #14

Thought Stopping. This is a behavioral technique started in the
1920s, but really developed in a big way in the late 1950s by Joseph
Wolpe and other behavior therapists. It’s used mainly to counter
against intrusive trains of thought, or to extinguish a line of
thinking that is bothering you. These bothersome thoughts can be
excessive worrying, resentful notions, a preoccupation with negative
ideas, or any train of thought that is not healthy or is
counterproductive.
The Thought Stopping approach involves thinking for a short
period about the intrusive train of thought, and then saying a command
like “stop” to interrupt the unpleasant thoughts. Then you empty your
mind completely. This is followed by a set of thought substitutions
that replaces the unpleasant train of thought.
Behavioral therapists have developed this techniques into a
systematic set of instructions that will be discussed in the next
couple of editions. It often takes from three days to a week of
applying the technique again and again in order to extinguish the
intrusive train the thought or neutralize its power.
But the results are said to be encouraging. According to the
source text, Thought Stopping is more than 70 percent effective
against things like phobias. It appears that Thought Stopping is
particularly effective when the problem is cognitive in nature, Thus
it is much more helpful against obsessive thinking rather than some
compulsive behaviors, as in repetitive ritual actions.

SOURCE: Martha Davis, PhD et al, The Relaxation & Stress Reduction
Workbook. (Oakland, CA: New Harbinger Publications: 1988.)

---------------------------------------

--Stress Management, Part #15

More on Thought Stopping. The Thought Stopping technique has five
parts, as follows:

1. Explore and list your stressful thoughts.


2. Imagine a stressful thought.

3. Systematically interrupt the thought.

4. Unaided thought interruption

5. Thought substitution.

The stress reduction handbook cited further below gives details on how
to do these steps. Here are some the of ways.

1. Explore and list your stressful thoughts. Make a list of the
thoughts that make for the most discomfort and are the most
intrusive. Next edition we’ll help in giving examples of what some of
these common stressful thoughts can be.

2. Imagine a stressful thought. With eyes close, imagine a
situation where the stressful event in the thought could occur.
Permit normal thoughts to happen too.

3. Systematic thought interruption. Set a cooking timer for
three minutes. Close your eyes and ruminate on your stressful
thought. When the timer rings, shout “stop!” If you need to remain
quiet, just stand up quickly, and yell “stop” silently in your
imagination. For the next 30 seconds, try to make your mind
completely blank. If the upsetting thought returns during that time,
say “stop” to yourself.

Firmly say “stop” into a tape recorder at intervals (say every three
minutes) for a period of 15 minutes. Now play the tape recorder
back. Close your eyes and think. When the word “stop” is heard, snap
your fingers and try to clear your mind completely out for 30 seconds.

Do this once or twice every day for three days or up to a week. See
if you are able to reduce the incidence of the troublesome thought
this way.

4. Unaided thought interruption. Extinguish the thought without
using an egg timer or a tape recorder. When ruminating on an unwanted
thought, say “stop!” If your situation permits this, use a succession
voice strengths to stop the thought. First, yell “stop.” Once this
command stops thoughts, simply say “stop” in a firm voice. Once this
command works to stop thoughts, say “stop” in a normal speaking voice.
Once this works, whisper “stop.” Finally, once this works, silently
say “stop” in your imagination. At this point, you can use this
techniques in public places.

5. Thought substitution. Come up with some positive and assertive
statements that you can use to replace the troublesome thoughts.
Maybe some positive slogans or affirmations that are based on
reality. Learn to think about these positive thoughts when the threat
of the troublesome thoughts might come back.

The manual stresses that this technique requires practice and that
sometimes it is best to first try the method with a medium stressful
thought, get it to work, and then go after the really stressful
thoughts.

SOURCE: Martha Davis, Ph.D. et al, The Relaxation & Stress Reduction
Workbook. (Oakland, CA: New Harbinger Publications: 1988.)


---------------------------

--Stress Management, Part #16

Additional Materiel on Thought Stopping. It looks like it is best
to apply the thought stopping technique on one troublesome thought at
a time. Then maybe over a period of months or a year, you can opt to
apply thought stopping to a series of thoughts that have been
bothering you?

Which kinds of thoughts should be extinguished using this technique?
Best to use this with those thoughts that are most painful,
unproductive, and intrusive. Ask yourself:

Do I imagine awful things happening to me, even after wise people
have told me not to worry about these things anymore?

Do I imagine awful things happening to me, so much so that I am unable
to engage in problem-solving efforts?

The source book for this info on thought stopping (Davis et al cited
below) has listed more than 40 questions along these lines that would
help you identify areas where you could usefully apply thought
stopping. Eight of those question are quoted below verbatim:

Are you a person who often has a guilty conscience over quite ordinary
things?

Do unpleasant or frightening thoughts or words ever keep going over
and over in your mind?

Do you become preoccupied with angry or irritable thoughts when people
don’t do things carefully or correctly?

Do you ruminate about details?

Do you have recurring feelings of jealousy, or fear of being left?

Are you at times preoccupied with desire for things you cannot have?

Does a negative feature of your appearance or makeup preoccupy you at
times?

Do you think again and again about your failures?


For more examples consult the book below.



SOURCE: Martha Davis, Ph.D. et al, The Relaxation & Stress Reduction
Workbook. (Oakland, CA: New Harbinger Publications: 1988.)