|
Are we there yet? Most readers opening a book about stress management hope they will learn better ways to manage stress in their own lives. Learning about the psychophysiology of stress is a useful starting place, and you may have already seen examples in your own life. At this point, you understand the general nature of stress and the stress cycle. You know that the stress cycle involves sources of stress that can be real or imaginary as well as a stress response-a total body- mind event that includes thoughts, feelings, behavior, and physical preparation for fight or flight. You have seen how the nervous and endocrine systems orchestrate the fight-or-flight response, and you have studied the many physiological effects that occur as you gear up to deal with a potential threat. You have also seen how chronic stress can disrupt the psychophysiological processes that keep you healthy and how such stress can result in a variety of stress-related disorders. You know that stress and its symptoms are not "all in your mind."
Now it is time to look more closely at stress and your life. In this chapter you will examine your stress cycle from several different angles. You will assess the ways in which you are currently dealing well with stress and the ways in which you would like to improve your coping abilities and stress resistance. You will also set some preliminary goals for improving your ability to manage stress.
SOURCES OF STRESS: LIFE EVENTS
Most of us would agree that there is a relationship between feelings of stress and the events in our lives. Selye's concept of the General Adaptation Syndrome, introduced in Chapter 2, explained Selye's theory that any sort of change required adaptation, which required energy (Selye, 1976). For example, if a professor asks you to meet with her after class, you adapt by rearranging your after-class plans and mentally preparing for the meeting. Such adaptation hopefully takes only a little energy (unless you are preparing for a hostile encounter), but even small adaptations add up. Larger events such as moving to a new city, starting college, and ending a relationship take quite a bit of energy. In the 1960s, stress researchers Thomas Holmes and Richard Rahe proposed a questionnaire, the Life Events Scale, also known as the Social Readjustment Rating Scale, as a tool for measuring stress (Holmes & Rahe, 1967). This scale measures stress in terms of Life Change Units (LCUs). The original research of Holmes and Rahe tested the hypothesis that people who reported more stress as measured by this scale would experience more illness. On the average, this was true. Of people reporting' 150 to 199 LCUs in one year, 37 percent became ill during the following year. Subjects who scored 200 to 299 LCUs had a 51 percent illness rate, while 79 percent of those scoring over 300 LCUs got sick. So, more change meant more stress, which meant more illness.
STRESS AND YOU |
SELF-ASSESSMENT SURVEY You are the best expert on the role stress plays in your life. You probably have a fairly good idea about what sorts of things bother you most and whether your stress response is sometimes harmful to your health. You may also realize that you have acquired many stress management skills over the course of your life, though you may not have called them that. The following survey is de signed to begin your stress management self-assessment. Begin by closing your eyes and taking a few minutes to be quiet. Become aware of your body, your breathing, sounds reaching your ears. Observe thoughts coming and going without judgment or control. After a few minutes, open your eyes and answer the following questions. Remember: there are no right or wrong answers, only your true feelings. Stress Management Self-Assessment Survey
--Interferes substantially with daily activities --Interferes somewhat with daily activities --Bothers me but does not interfere with activities --A high level but not bothersome --A good balance between stimulation and relaxation --Not aware of any stress |
Subsequent research has not always found a strong relationship between scores on the Social Readjustment Rating Scale and illness. This is not surprising, since a given source of stress may vary in stress "content" from person to person. For example, starting college may be a welcome event requiring only a minimum amount of adjustment for one person, while another young person, not really wanting to attend college, might approach this change full of resentment, loneliness, and fear. Who is to say exactly how many points that event is worth? Nevertheless, calculating your score on such scales can be useful. We are generally well aware of the major stressors in our lives, but we often underestimate how many potentially stressful minor changes occur on a regular basis and require some adjustment. Understanding how much stress you have experienced during the last year can help you understand your current stress level. Two scales are included here. The first is a life events questionnaire adapted from the Social Readjustment Rating Scale; the second is a special version for college students (Anderson, 1972). Use whichever seems more applicable to you.
STRESS AND YOU | |||
SOCIAL READJUSTMENT RATING SCALE
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Life Event | Number of Occurrences | Scale Value | Your Score |
Death of spouse | ____ | 100 | ____ |
Divorce | ____ | 73 | ____ |
Marital separation from mate | ____ | 65 | ____ |
Detention in jail or other institution | ____ | 63 | ____ |
Death of a close family member | ____ | 63 | ____ |
Major personal injury or illness | ____ | 53 | ____ |
Marriage | ____ | 50 | ____ |
Being fired at work | ____ | 47 | ____ |
Marital reconciliation with mate | ____ | 45 | ____ |
Retirement from work | ____ | 45 | ____ |
Major change in the health or behavior of a family member | ____ | 44 | ____ |
Pregnancy | ____ | 40 | ____ |
Sexual difficulties | ____ | 39 | ____ |
Gaining a new family member (e.g., through birth, adoption, oldster moving in, etc.) | ____ | 39 | ____ |
Major business readjustment (e.g., merger, reorganization, bankruptcy, etc.) | ____ | 39 | ____ |
Major change in financial state (e.g., a lot worse off or a lot better off than usual) | ____ | 38 | ____ |
Death of a close friend | ____ | 37 | ____ |
Changing to a different line of work | ____ | 36 | ____ |
Major change in the number of arguments with spouse (e.g., either a lot more or a lot less than usual regarding child-rearing, personal habits, etc.) | ____ | 35 | ____ |
Taking on a mortgage greater than $10,000 (e.g., purchasing a home, business, etc.) | ____ | 31 | ____ |
Foreclosure on a mortgage or loan | ____ | 30 | ____ |
Major change in responsibilities at work (e.g., promotion, demotion, lateral transfer) | ____ | 29 | ____ |
Son or daughter leaving home (e.g., marriage, attending college, etc.) | ____ | 29 | ____ |
Trouble with in-laws | ____ | 29 | ____ |
Outstanding personal achievement | ____ | 28 | ____ |
Wife begining or ceasing work outside the home | ____ | 26 | ____ |
Beginning or ceasing formal schooling | ____ | 26 | ____ |
Major change in living conditions (e.g., building a new home, remodeling, deterioration of home or neighborhood) | ____ | 25 | ____ |
Revision of personal habits (dress, manners, associations, etc.) | ____ | 24 | ____ |
Troubles with the boss | ____ | 23 | ____ |
Major change in working hours or conditions | ____ | 20 | ____ |
Change in residence | ____ | 20 | ____ |
Changing to a new school | ____ | 20 | ____ |
Major change in usual type and/or amount of recreation | ____ | 19 | ____ |
Major change church activities (e.g., a lot more or a lot less than ususal) | ____ | 19 | ____ |
Major change in social activities (e.g., clubs, dancing, movies, visiting, etc.) | ____ | 18 | ____ |
Taking on a mortgate or loan less than $10,000 (e.g., purchasing a car, TV, freezer, etc.) | ____ | 17 | ____ |
Major change in sleeping habits (a lot more or lot less sleep, or change in part of day when asleep) | ____ | 16 | ____ |
Major change in number of family get-togethers (e.g., a lot more or a lot less than usual) | ____ | 15 | ____ |
Major change in eating habits (a lot more or a lot less food intake, or very different meal hours or surroundings) | ____ | 15 | ____ |
Vacation | ____ | 13 | ____ |
Christmas | ____ | 12 | ____ |
Minor violations of the law (e.g., traffic tickets, jaywalking, disturbing the peace, etc.) | ____ | 11 | ____ |
This is your total life change score for the past year | ____ | ||
Source: Reprinted with permission frorn Journal of Psychosomatic Research, Vol 11, TH Holmes and RH Rahe, Social Readjustment Rating Scale, 1967, Elsevier Science Ltd, Pergamon Imprint, Oxford, England. |
STRESS AND YOU | |||
COLLEGE SCHEDULE OF RECENT EXPERIENCE
On the following scale, indicate the number of times during the last 12 months that each of the following life change events has happened to you. Score your questionnaire by adding up the points for each item checked. Predictive value for point totals are similar to the scales for the previous questionnaire. First, for the number corresponding to each of the life evets .... indicate the number of times (1, 2, 3, etc.) that the particular event has occurred in your life during the past 12 months, then multiply each item by the indicated weight and total the scores. |
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Life Event | Number of Occurrences | Scale Value | Your Score |
1. Entered college. | _____ | 50 | _____ |
2. Married. | _____ | 77 | _____ |
3. Had either a lot more or a lot less troubles with your boss. | _____ | 38 | _____ |
4. Held a job while attending school. | _____ | 43 | _____ |
5. Experienced the death of a spouse. | _____ | 87 | _____ |
6. Experienced a major change in sleeping habits (sleeping a lot more or a lot less, or a change in part of the day when asleep). | _____ | 34 | _____ |
7. Experienced the death of a close family member. | _____ | 77 | _____ |
8. Experienced a major change in eating habits (a lot more or a lot less food intake, or very different meal hours or surroundings). | _____ | 30 | _____ |
9. Made a change in or choice of a major field or study. | _____ | 41 | _____ |
10. Had a revision of your personal habits (friends, dress, manners, associations). | _____ | 45 | _____ |
11. Experienced the death of a close friend. | _____ | 68 | _____ |
12. Have been found guilty of minor violations of the law (traffic tickets, jay walking, etc.) | _____ | 22 | _____ |
13. Have had an outstanding personal achievement. | _____ | 40 | _____ |
14. Experienced pregnancy, or fathered a pregnancy. | _____ | 68 | _____ |
15. Had a major change in the health or behavior of a family member. | _____ | 56 | _____ |
16. Had sexual difficulties. | _____ | 58 | _____ |
17. Had trouble with in-laws. | _____ | 42 | _____ |
18. Had a major change in the number of family get- togethers (a lot more or a lot less). | _____ | 26 | _____ |
19. Had a major change in financial state (a lot worse off or a lot better off than usual). | _____ | 53 | _____ |
20. Gained a new family member (through birth, adoption, older person moving in, etc.) | _____ | 50 | _____ |
21. Changed your residence or living conditions. | _____ | 42 | _____ |
22. Had a major conflict in or change in values. | _____ | 50 | _____ |
23. Had a major change in church activities (a lot more or a lot less than usual). | _____ | 36 | _____ |
24. Had a marital reconciliation with your mate. | _____ | 58 | _____ |
25. Were fired from work. | _____ | 62 | _____ |
26. Were divorced. | _____ | 76 | _____ |
27. Changed to a different line of work | _____ | 50 | _____ |
28. Had a major change in the number of arguments with spouse (either a lot more or a lot less than usual). | _____ | 50 | _____ |
29. Had a major change in responsibilities at work (promotion, demotion, lateral transfer). | _____ | 47 | _____ |
30. Had your spouse begin or cease work outside the home. | _____ | 41 | _____ |
31. Had a marital separation from your mate. | _____ | 74 | _____ |
32. Had a major change in usual type and/or amount of recreation. | _____ | 37 | _____ |
33. Had a major change in the use of drugs (a lot more or a lot less). | _____ | 52 | _____ |
34. Took a mortgage or loan less than $10,000 (purchase of a car, TV, school loan, etc.). | _____ | 52 | _____ |
35. Had a major personal injury or illness. | _____ | 65 | _____ |
36. Had a major change in the use of alcohol (a lot more or a lot less). | _____ | 46 | _____ |
37. Had a major change in social activities. | _____ | 43 | _____ |
38. Had a major change in the amount of participation in school activities. | _____ | 38 | _____ |
39. Had a major change in the amount of independence and responsibility (for example: for budgeting time) | _____ | 49 | _____ |
40. Took a trip or a vacation. | _____ | 33 | _____ |
41. Were engaged to be married. | _____ | 54 | _____ |
42. Changed to a new school. | _____ | 56 | _____ |
43. Changed dating habits. | _____ | 41 | _____ |
44. Had trouble with school administration (instructors, advisors, class scheduling, etc.). | _____ | 44 | _____ |
45. Broke or had broken a marital engagement or a steady relationship. | _____ | 60 | _____ |
46. Had a major change in self-concept or self- awareness. | _____ | 57 | _____ |
Total life change score | _____ | ||
Source: From GE Anderson, "College Schedule of Recent Experience." Unpublished Master's Thesis, 1972. Reprinted with permission of the School of Education, North Dakota State University. |
A given situation, such as a family gathering, may vary in stress content from person to person.
THINKING ABOUT YOUR LIFE EVENTS
It is important not to regard your questionnaire scores as an indication of a future over which you have no control. Remember that college students tend to score high on these questionnaires, but much of the change associated with being in college is positive for most students and thus less likely to lead to stress-related illness. Nevertheless, adaptation does take energy, and that's the main message here. Pace yourself! Recognize all the change that has taken place in your life during the past year, appreciate all the opportunities that are part of this change, and take it from there. Exert what control you do have. Schedule optional events for slower times. When possible, try not to push too much change into a small time frame. Plan ahead and do what you can to make those small changes as nonintrusive as possible. Recognize times when your LCUs are high and remember that you may be more vulnerable to stress-related illness then, so pay special attention to the habits that keep you healthy, like eating well, exercising, and getting enough sleep (Nespor, 1985). Also remember that many people with high scores do not get sick any more frequently than people with lower scores. The next section looks at the characteristics of people who tend to be resistant to stress, and helps you assess your stress resistance.
HARDINESSIn the 1970s, a group of researchers looked at the relationship between LCUs and illness from a new angle (Kobasa, 1979; Kobasa et al., 1982). Why, they asked, did some people who score high on the rating scale not get sick? As you remember, research had suggested that almost 80 percent of people scoring over 300 LCUs became ill during the following year. What about the other 20 percent? How were they different? Were there some common traits among people who consistently operated under high levels of stress without suffering from stress-related illness? This research group found that several traits discriminated between people who were stress resistant and those who were more vulnerable to the negative effects of stress. People with these traits were described as having "hardy" personalities. According to this research group, hardy people are characterized by high levels of conunitment, control, and challenge. They feel a sense of commitment to themselves, their work, families, and other important values. We've already seen that a sense of control has come up in many studies as an important stress buffer. Hardy people see the changes in life as challenges to master rather than obstacles to be overcome (Kobasa, 1984). We'll talk more about the concept of hardiness in Chapter 14 -- indeed throughout this book. The Hardiness Self-Assessment on the previous page will help give you some idea of how hardy you are.
STRESS AND YOU |
HARDINESS SELF-ASSESSMENT
Write down how much you agree or disagree with the statements below, using the following scale: 0 = strongly disagree 1 = mildly disagree 2 = mildly agree 3 = strongly agree
___ A. Trying my best at work and school makes a difference. ___ B. Trusting to fate is sometimes all I can do in a relationship. ___ C. I often wake up eager to start on the day's projects. ___ D. Thinking of myself as a free person leads to great frustration and difficulty. ___ E. I would be willing to sacrifice financial security in my work if something really challenging came along. ___ F. It bothers me when I have to deviate from the routine or schedule I've set for myself. ___ G. An average citizen can have an impact on politics. ___ H. Without the right breaks, it is hard to be successful in my field. ___ I. I know why I am doing what I'm doing at work or school. ___ J. Getting close to people puts me at risk of being obligated to them. ___ K. Encountering new situations is an important priority in my life. ___ L. I really don't mind when I have nothing to do. To get your scores for control, commitment, and challenge, write the number of your answer, from 0 to 3, above the letter of each question on the questionnaire. Then add and subtract as shown below. ____ + ____ = ____ ____ + ____ = ____ ____ + ____ = ____ A G C I E K
____ + ____ = ____ ____ + ____ = ____ ____ + ____ = ____ B H D J F L Control ____ Commitment ____ Challenge ___
_____ _____ _____ _______ Control + Commitment + Challenge = Total Hardiness Score
Score Interpretation 10-18 Hardy personality 0-9 Moderate hardiness Below 0 Low hardiness Reprinted with permission of American Health. Copyright 1984 by Suzanne Ouellette Kobasa, Ph.D |
STRESS AND WELLNESS
Don Ardell is one of the original writers who helped shape the wellness concept in the 1970s. He devised the next questionnaire, which offers a wellness approach to stress assessment, and evaluates your stress/wellness level from your perceptions of possible stressors rather than their occurrence in your life. This test is more applicable to older students since it asks about situations that have yet to become a reality for many younger ones, such as career choice and satisfaction with the decision of whether to have children. It is included here to broaden your understanding of stress as a component of wellness and to give you a useful evaluation of how things are going in various arenas of your life so far.
With risk comes excitement, and
with acceptance of the challenge
comes engagement in life. Then,
like a surfer, one can actually be
held aloft by the waves and
currents that sweep others away.
It all depends on how they are
perceived.
JEAN HARRIGAN |
RELAXATION AND ADAPTIVE COPING
Most people already have a coping and relaxation repertoire, things they enjoy doing that help them unwind and feel good. In Chapter I we referred to such activities as palliative coping strategies. Take a closer look at yours by completing the Twenty Pleasures exercise on page 78.
USING PLEASURABLE EXPERIENCES TO COPE
It's important to note that the relaxation value of a given activity can vary greatly depending on
your mind-set. For example, a hot bath can be very soothing if you focus on relaxing, but it won't
be if you spend your time in the tub worrying about how much work you have to do. Watching
television can be either relaxing or stressful. Some items on your list, such as having a drink, may
be associated with relaxation but actually be causing stress. Evaluate carefully the relaxation
activities you wish to promote as adaptive coping measures.
STRESS AND YOU |
THE ARDELL WELLNESS STRESS TEST
Rate your satisfaction with each of the following life areas using the following scale: +3 Ecstatic; +2 Very happy; +1Mildly happy; 0 Noncommital; -1 Mildly disapproving; -2 Very disapproving; -3 Completely dismayed ___ 1. Choice of career ___ 2. Present job/business ___ 3. Marital status ___ 4. Primary relationships ___ 5. Capacity to have fun ___ 6. Amount of fun experienced in the last month ___ 7. Financial prospects ___ 8. Current income level ___ 9. Spirituality ___ 10. Level of self-esteem ___ 11. Prospects for having a positive impact on those who know you and possiby others ___ 12. Sex life ___ 13. Body-how it looks and performs ___ 14. Home life ___ 15. Life skills and knowledge of issues and facts unrelated to your job or profession ___ 16. Learned stress management capacities ___ 17. Nutritional knowledge, attitudes and choices ___ 18. Ability to recover from disappointments, hurts, setbacks and tragedies ___ 19. Confidence that you are now at or will in the future come reasonably close to your highest potentials ___ 20. Achievement of a rounded or balanced quality in your life ___ 21. Sense that life for you is on an upward curve, getting better and fuller all the time ___ 22. Level of participation in issues and concerns beyond your immediate, interests ___ 23. Choice whether to parent or not and with the consequences or results of that choice ___ 24. Role in some kind of "network" of friends, relatives and/or others about whom you care deeply, and who reciprocate that commitment to you ___ 25. Emotional acceptance of the inescapable reality of aging Score Interpretation +51 to +75 This is a self-actualized person, nearly immune from the ravages of stress. There are few if any challenges likely to untrack him or her from a sense of near total well-being. +25 to +50 This person has mastered the wellness approach to life and has the capacity to deal creatively and efficiently with events and circumstances. +1 to +24 This is a wellness-oriented person, with an ability to prosper as a whole person, but he or she should give a bit more attention to optimal health concepts and skill building. 0 to -24 This is a candidate for additional train ing in how to deal with stress. In this case, the Holmes Index does apply, since a sudden increase in potentially negative events and circumstances could cause a severe emotional setback. -25 to -50 This person is a candidate for counseling. He or she is either too pessimistic or has severe problems in dealing with stress. -51 to -75 This is a candidate for major psychological care with virtually no capacity for coping with life's problems. Source: Reprinted with permission from the Ardell Wellness Report. For a sample copy, send a stamped self-addressed envelope to the publisher/editor Don B. Ardell at 9901 Lake Georgia Drive, Orlando, FL 32817. |
The notion that all stress makes
you sick ... assumes we're all
vulnerable and passive in the
face of adversity. But what
about human resilience,
initiative and creativity? Many
come through periods of stress
with more physical and mental
vigor than they had before.
SUZANNE OUELLETTE KOBASA |
STRESS AND YOU |
TWENTY
PLEASURES
Make a list of twenty things you love to do. They can be big or little things. Ten of them should be things you can do on a daily or weekly basis. Examples: listening to music, talking to a friend, taking a walk.
When your list is complete, mark with an X those things you already use for relaxation. Mark with an * those things you would like to use more often for relaxation and managing stress. |
DEVELOPING A DEEPER UNDERSTANDING OF YOUR PERSONAL STRESS CYCLE WITH A STRESS LOG
Awareness is the first step to improving your stress resistance. Keeping a stress log is one of the best ways to increase your understanding of your personal stress cycle: what types of stressors cause you to overreact, how you respond to various stressors, how your stress response affects your health and stress level, how effective your coping strategies are, and how your health behavior and lifestyle contribute to your current level of stress.
There are many ways to keep a stress log. You may wish to make copies of the sample stress log page in this chapter, or you may wish to devise a notebook of your own. Notice times when you feel stressed, and take notes as soon as possible on what is causing the stress and how you are responding and coping. It is important to include observations on all components of the stress cycle and to record your observations for at least a week-longer if possible. The components of the stress cycle to observe include the following:
Stressors: Describe the sources of stress.
Physical response. What did your body feel while you felt stressed? Examples: tense jaw, pounding heart, upset stomach.
Psychological response: What thoughts and feelings flashed through your mind as you evaluated and responded to the stressor? Examples: I can't do this. Why am I so stupid? She's impossible.
Coping. Include actions taken, decisions made, palliative strategies used.
Coping evaluation: You may wish to evaluate coping strategies after the stressor and stressful feelings have passed-maybe even a few days later when you can look back on your stress log notes more objectively. Were you satisfied with your coping response? What worked? How could you cope better next time?
Health behaviors that may have influenced the day's stress level: Examples include not enough sleep, too much coffee, and good feelings and improved coping following exercise.
STRESS AND YOU |
STRESS LOG Date: ______________ 1. Stressors:
2. Physical response:
3. Thoughts and feelings:
4. Coping strategies:
5. Evaluation of coping:
6. Related health behaviors: |
ON YOUR MARK, GET SET ...
DESIGNING A STRESS MANAGEMENT ACTION PLAN
Stress management is about intervening in your stress cycle. It is about changing sources of stress and coping with problems more effectively, changing the way you respond to stressors, and improving your stress resistance by building a meaningful, healthful lifestyle. Where do you go from here? Awareness alone often brings change. Over time, simply observing yourself and your stress cycle as objectively as possible will lead to new ways of coping with and evaluating stressors, and to an improvement in your physical and psychological stress response. For example, you may observe that you habitually react to minor hassles by holding your breath and tensing your neck and shoulder muscles. Once you become aware of this response you may be able to intervene before you develop major aches and pains.
STRESS AND YOU |
EVALUATING YOUR STRESS LOG We tend to take our stress cycles for granted. When we record our observations in a stress log and then review what we have written, we often see some surprising patterns. Sometimes it's almost like reading about someone else. Having your stress cycle written down in front of you improves your objectivity. After you have kept your log for several days, reread what you have written and answer the following questions.
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Observation can also lead to the formulation of stress management goals. Goals help you set your stress management course. Knowing where you want to go makes it more likely that you will get there. It makes you better able to take advantage of opportunities that present themselves. It improves your ability to make decisions, which in turn improves your stress resistance. Now that you have completed the self-assessment exercises and stress log presented in this chapter, it is time to formulate your stress management goals. Goals work best when they have the following characteristics (Gillespie & Bechtel, 1986):
Goals must be as clear and specific as possible. It is frustrating to work toward goals that are vague; you feel like you never get there. Instead of writing "I want to be a better student" try something more specific, such as "I want to organize my time and use my study time more effectively."
Goals must feel reasonable to you. You should feel as though you can make significant progress toward your goals over the next few weeks. Goals that are too lofty or focus on areas you are not yet ready to address encourage procrastination.
Goals should represent something you really want for yourself, not something someone has told you to change. If your housemates have complained about your slovenly lifestyle, you must first decide that orderlinesis something you want for yourself, something that will bring benefits to you, before making it one of your stress management goals.
The process of working toward your goal must seem worthwhile to you. Change takes time and commitment. See this process as educational. Change will occur more readily if you value the learning experience rather than feel frustration at what you perceive as failure to accomplish your goal.
ACTION PLAN |
STRESS MANAGEMENT ACTION PLAN Step 1: Write your goals. Take a moment to think about what you have read and observed. Review the material and self-assessments from this chapter and the previous chapters, and then write two or three goals that you would like to work toward during your study of stress management. You may wish to use the form on the facing page. Step 2: Define several action steps for each goal. Action steps are specific activities that will help you accomplish your goal. They should be something you can and will do right away or in the near future. Let's say you wish to write action steps for the goal, "I want to organize my time and use my study time more effectively." Here are some possible action steps:
Step 3: Anticipate roadblocks and mobilize your resources. Behavior change is more likely to be successful if you anticipate the future. What things might keep you from sticking to your plan? By thinking about potential problems ahead of time, you will be prepared to deal with them creatively and continue your progress toward your goals. Here are some potential roadblocks for the action steps outlined above:
Now, think about how you will deal with the roadblocks and get help accomplishing your goals. What kinds of things will help you stick to your plan? Getting support from family and friends is essential. Maybe there are resources on campus or at work that can help you. Some people promise themselves incentives for sticking to their plan. Possible reinforcements for the action steps outlined above might be the following:
The counseling center offers a time management workshop. Maybe I'll sign up for that. Maybe someone there can help me with my study schedule. I'll talk to some of my professors and friends who have taken the courses I'm in and get their advice on the best way to prepare for exams and use my study time in these classes. Stress Management Action Plan Stress management goals: 1. 2. 3. Possible action steps that will help me move toward these goals: Action steps Roadblocks Reinforcements ______________________________________________________ Goal 1: 1. 2. 3. Goal 2: 1. 2. 3. Goal 3: 1. 2. 3. |
STUDENT STRESS |
STEVE'S STRESS MANAGEMENT ACTION PLAN
Steve was trying to write his Stress Management Action Plan. He thought over all he had read, and he reviewed all the questionnaires he had completed. All along, however, he knew what his first goal would be: to do something about his frequent feelings of anger. The section on hostility and artery disease had really hit home for Steve. His father was a perfect example of a Type A person. "They must have used him for a model when they invented Type A behavior pattern," Steve thought when he read the description in the text. His father had suffered a heart attack in his late 50s, five years ago. The cardiac rehabilitation program his father had attended had emphasized stress management along with other lifestyle changes. Steve's father had changed careers and worked hard to develop a more relaxed approach to life. "I don't want to wait until I have a heart attack to manage my stress," Steve decided. "And the stress that's hurting me the worst is these angry feelings." Steve had observed that his anger tended to rise when he felt frustrated, when things didn't go the way they were supposed to go and people didn't behave the way they were supposed to behave. When he kept his stress log, he noticed that even things that would seem unimportant later could set him off when they happened. He had blown up at the new student worker at the library who had taken a long time to locate the book Steve had asked for in the reserve section. He stewed his way through every class period in his math course because he had difficulty understanding his professor, who spoke English with a foreign accent. The junior varsity soccer coach seemed to change Steve's playing position every week, and Steve had decided the coach was an idiot. But Steve was beginning to see that even though all this anger felt "normal" because he was so used to feeling this way, it was not good. In fact, it was probably doing him harm. "Some days I can feel my blood pressure stuck on high," he had noted in his stress log. And so Steve wrote Goal 1: Reduce feelings of anger. The action steps were more of a problem. Steve knew he couldn't simply will his anger away. Since he had a good relationship with his father and he knew his father had been dealing with his own anger problems, Steve decided to talk to his dad to see what had helped him. That would be action step 1. What else might help? Steve decided to continue the stress logs for another week, paying special attention to one anger- producing incident each day to try to figure out the thoughts that were setting off the anger. Maybe if he could analyze his thinking, he could short-circuit his habitual angry response. For his third action step, Steve went back to his list of Twenty Pleasures. He had come up with only 12, but he liked the idea of using something fun for relaxation. He had put several sports on his list, but competitive sports sometimes just got him more riled up. "I always feel terrific after I've ridden my bike for 20 miles or so," he noted. He felt himself relax just remembering that happily tired sense of relaxation that seemed to stay with him for several hours after a good ride. Once he had listed his action steps, Steve had no trouble completing the rest of the action plan. Here's what it looked like; Goal 1: Reduce feelings of anger. Possible action steps that will help me move toward these goals: Action steps Roadblocks Reinforcements ________________________________________________________________ Goal 1: 1. Talk to dad Finding a good time Good connection with dad Hard to talk about Hear his good advice our feelings
2. Continue stress log It's a bother Get in touch with for 7 more days No time thoughts that -- Resistance to this anger stuff Feel better with less anger
3. Ride bike 3-4 Weather? Feels great! X a week No time
|
We should treat our anxiety, our
pain, our hatred, and passion
gently, respectfully, not
resisting it, but living with it,
Making peace with it,
penetrating into its nature.
THICH NHAT HANH |
CREATING A SUCCESSFUL ACTION PLAN
Successful behavior change occurs when you move slowly. Too much change is stressful because you accumulate more LCUs, right? Slow and steady wins the behavior change race. In the Stress Management Action Plan form, you have room to outline action steps for three goals. This is to give you practice with the Action Step process that is used throughout this book. In real life, you might be more comfortable working on one goal at a time, especially if it is a large and complex one, such as the study schedule example given previously.
Most behavior is learned; therefore, it can be unlearned and replaced with more desirable habits. This is the premise of the wellness model for a self-responsible lifestyle. Stress management is a lifelong journey toward self-actualization and optimal well-being. We are continually formulating and reformulating our goals, observing ourselves, dreaming up action plans for change, and then assessing our progress. It's a never-ending cycle of assessment, intervention, and reassessment. If we look on this as an onerous chore, we are doomed. If we can remember that wellness is not a destination but a way of traveling, we can create a joyful journey.
SUMMARY
To some extent, stress is related to life events. The Social Readjustment Rating Scale measures stress in terms of Life Change Units (LCUs). In general, the higher your LCUs, the greater your likelihood of developing stress-related illness.
When experiencing a period of time that requires a great deal of adaptation on your part, exert what control you do have to schedule flexible events at less hectic times.
Health behaviors such as eating well, exercising, and getting enough sleep are especially important during high-stress times.
Research by Suzanne Kobasa and her colleagues found that of people experiencing a great deal of stress (as measured by LCUs), those with hardiness characteristics became ill less frequently than people without these characteristics. These characteristics include a feeling of commitment, a sense of control, and the ability to perceive a stressor as a challenge.
Wellness writers such as Don Ardell emphasize that your perceptions of potential stressors have as much impact on your sense of feeling stressed as the stressors themselves.
Most people already have many effective ways of reducing feelings of stress, including pleasurable experiences such as talking to friends, going for a walk, or spending time on a favorite hobby or recreational activity.
Keeping a stress log for a week or more can increase your understanding of your personal stress cycle.
Stress management is about intervening in your stress cycle.
Effective goals are clear and specific, feel reasonable to you, represent something you really want for yourself, and seem worth working for.
An action plan for behavior change includes action steps (concrete activities you can do) that will help you achieve your goals.
Anticipating roadblocks helps to ensure the success of a behavior change program.
REFERENCES
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Ardell, DB. A wellness alternative to managing stress. Optimal Health, May/June 1985, 22-25.
Gillespie, PR, and L Bechtel. Less Stress in 30 Days. New York: New American Library, 1986.
Holmes, TH, and RH Rahe. The social readjustment rating scale. Journal of Psychosomatic Research 11:213-218, 1967.
Kobasa, SC. Hardiness and health: A prospective study. Journal of Personality and Social Psychology 337: 1-11, 1979.
Kobasa, SC, SR Maddi, and S Kahn. Hardiness and health: A prospective study. Journal of
Personality and Social Psychology 42: 168-177, 1982.
Kobasa,
SO. How much stress can you survive? American Health, Sept 1984, 64-71.
Nespor, K. Stressful life events: A preventive approach. International Journal of Psychosomatics 32:28- 32,1985.
Selye, H. The Stress of Life. New York: McGraw-Hill, 1976.