stress

stress is defined as any circumstance that poses a threat to one’s wellbeing or is perceived as such, leading to a strain on coping abilities. folkman and lazarus (1984) conducted research suggesting that stress can accumulate over time. they found that minor stressors, such as moving or changing jobs, can collectively amount to the stress level caused by major traumatic events like the death of a loved one or divorce. the perception of stress varies among individuals, influenced by their unique cognitive processes. for instance, what may be an exciting experience for one person, like going on a date, might be perceived as terrifying by another.

stress can be understood in three parts:

  1. stress as a stimulus

this refers to external events or circumstances that trigger stress reactions in individuals. examples include catastrophic events like floods and plane crashes.

  1. stress as a result of cognitive appraisal

stress isn’t solely determined by the nature of the event, but also by how individuals perceive and interpret these events. this cognitive appraisal influences their emotional and psychological responses.

  1. stress as a response

this component involves the physiological, emotional, and behavioural reactions that individuals exhibit in response to stressors

stressful stimuli can be catastrophic events, major life events (measured in life change units: LCU), and daily hassles and uplifts. uplifts are enjoyable things that counteract stress.

holmes and rahe (1967) developed a scale to measure the impact of stressful life events. scores range from 11 to 600, with higher scores indicating a greater likelihood of experiencing illness shortly.

  • 11-150: individuals in this range have a low to moderate chance of becoming ill.

  • 150-299: this range indicates a moderate to high chance of illness.

  • 300-600: individuals scoring in this range have a high or very high risk of becoming ill

the transactional model of stress and coping proposes that stress is experienced as an appraisal (evaluation) of the situation we find ourselves in.

  • Primary Appraisal Processes:

    • individuals evaluate the significance and implications of a stressor.

    • they categorise stressors into three types: those that threaten harm or loss, those that present a challenge, and those that are benign.

  • Secondary Appraisal Processes:

    • after primary appraisal, individuals assess their resources and capabilities to cope with the stressor.

    • this includes both internal resources (such as strength and determination) and external resources (such as social support or financial resources).

    • examples:

      • feeling overwhelmed with the belief of inevitable failure indicates a primary appraisal of threat and a perception of limited resources, resulting in stress.

      • recognising the difficulty of exams but feeling confident in one's ability to overcome them with effort suggests a primary appraisal of challenge and adequate resources, leading to reduced stress.

      • considering the situation benign due to confidence in abilities implies no stress as there is no perceived threat or challenge.

  • Factors Influencing Appraisal:

    • various factors influence how individuals appraise stressful events, including their context and characteristics:

      • events that are imminent, unexpected, unpredictable, ambiguous, risky, undesirable, associated with low control, or involve significant life changes tend to be more stressful.

there are also many different types of stress that we may experience.

— acute (short-term) stress is characterised by a sudden intense reaction to an immediate threat or challenge, triggering the body’s fight-flight-fawn response which is a primal survival mechanism aimed to increase survival chances. there is a rapid onset of physiological changes, like increased heart rate, heightened senses, and the release of stress hormones like adrenaline and cortisol. this is typically short-lived and dissipates once the threat or stressor is removed. examples are startling events like unexpected news or sudden loud noises.

— intermittent stress refers to stressors that occur sporadically and vary in duration and intensity. they are not constantly present but can arise from recurring situations. while intermittent stressors can be challenging, they may also contribute to increased resilience over time as the body learns to adapt and cope. examples include academic pressure during exam periods and interpersonal conflicts that come up periodically.

— chronic (long-term) stress is persistent over an extended period due to ongoing life circumstances and environmental factors. they can result from many sources, such as financial difficulty, chronic health conditions, and demanding work environments. chronic stressors can have detrimental effects on physical and mental health and overall quality of life. it increases the risk of developing health problems such as hypertension, cardiovascular disease, anxiety disorders, and depression. examples are persistent. financial worries, ongoing conflicts in relationships, enduring work-related stress, or the constant demands of caring for a sick family member.

cognitive appraisals involve the interpretation and evaluation of stressors and one's ability to cope with them. different appraisals can lead to a variety of emotional responses. for example, if an individual perceives a stressor as controllable, they may feel more empowered, whereas a perception of helplessness can lead to feelings of despair.

contrary to common belief, stress is not always associated with negative emotions. positive emotions such as joy, gratitude, and humour can co-occur with stress and serve adaptive functions. they can enhance resilience, promote problem-solving abilities, and foster social connections, all of which aid in coping with stress. positive emotions also have physiological benefits, such as reducing inflammation and improving cardiovascular health. example: finding humour in a stressful situation, feeling grateful for support during difficult times, or experiencing moments of joy despite ongoing challenges.

emotional states can significantly impact cognitive functioning and task performance, particularly under stress. high emotional arousal can impair performance on complex tasks by interfering with attention, memory, and decision-making processes. however, for relatively simple tasks, moderate levels of arousal may enhance performance by increasing motivation and focus. the relationship between emotion and task performance is complex and influenced by factors such as task complexity, individual differences, and coping strategies.

yerkes-dodson law is an empirical relationship between arousal and performance. the law dictates that performance increases with physiological or mental arousal, but only up to a point. overall, an optimal level of stress results in optimal performance.

stress has physiological effects. it elicits a cascade of bodily responses orchestrated by our autonomic nervous system, because it regulates involuntary bodily functions. effects include increased heart rate, elevated blood pressure, heightened respiration, and cortisol and adrenaline release. additionally, stress can impact digestion, immunity, and cognition.

the fight-flight-freeze-fawning response is also called the 4 F’s of the hypothalamus. the hypothalamus plays a central role in initiating stress responses.

— fight involves physiological readiness to confront of combat a threat directly

— flight is the instinctual reaction to escape or flee from a perceived threat

— freeze represents a state of immobility in response to threat, where bodily function may shut down temporarily

— fawning involves attempting to appease or please the source of the threat using submissive behaviour to avoid harm, as a survival strategy

modern stressors often persist over extended periods as opposed to acute threats in ancestral environments. this leads to chronic activation of stress responses which affects wellbeing poorly.

hans selye, a pioneer in stress physiology, conducted extensive research on the effects of chronic stress. he proposed general adaptation syndrome (GAS) as a framework for understanding the body’s response to stress. it consists of 3 stages…

  1. alarm stage

initial recognition of a stressor triggers physiological arousal and mobilisation of resources to cope with the threat

  1. resistance stage

if the stressor persists, the body enters a stage of prolonged physiological arousal. while the body attempts to adapt and cope, physiological functions remain elevated above baseline levels

  1. exhaustion stage

with continued exposure to stressors, the body's resources become depleted, leading to a breakdown of physiological functioning and increased susceptibility to illness or injury

individuals employ a variety of behavioral strategies to cope with stress and manage its effects on their well-being. these responses may be adaptive or maladaptive depending on the situation and the individual's coping mechanisms. responses may involve:

  • learned helplessness — when people perceive stressors as uncontrollable and unavoidable, they may adopt a passive attitude characterised by giving up and blaming themselves for their inability to change the situation

  • aggression — frustration and anger resulting from stressors can sometimes lead individuals to lash out at others aggressively as a means of venting their emotions or asserting control over their environment

  • self-indulgence — in an attempt to find comfort or distraction from stress, individuals may engage in self-indulgent behaviours such as overeating, excessive consumption of alcohol or drugs, or other forms of escapism

  • defence mechanisms — these are psychological strategies used to protect oneself from unpleasant emotions or realities. examples include denial, repression, rationalisation, and projection. may be conscious or unconscious

  • constructive coping / self-care — some individuals adopt healthier coping mechanisms, such as realistically appraising stressful situations, seeking social support, practicing relaxation techniques, and engaging in self-care activities like exercise, meditation, or hobbies. these strategies aim to address stressors directly and build resilience over time

stress has numerous effects. personality factors previously labeled as Type A, such as strong competitiveness, impatience, time urgency, anger, and hostility, are linked to an increased risk of coronary heart disease (CHD). among these traits, anger and hostility are particularly associated with coronary events. in patients with stable CHD, emotional reactions can trigger cardiac symptoms. stress decreases the immune response by reducing lymphocytes, increasing susceptibility to infections. it contributes to the development and exacerbation of psychosomatic diseases from hypertension to eczema. it may influence tumour cell mutation by interfering with the cell repair process. it exacerbates symptoms of bowel diseases, such as in irritable bowel syndrome where stressful episodes increase gut reactivity to cause bloat and pain. chronic stress is associated with various psychological issues as well, from sleep problems to depression to PTSD to burnout. compassion fatigue refers to stress experienced by caregivers like psychologists during times of crisis (occupational stress).

compassion fatigue and burnout are related but distinct phenomena. compassion fatigue typically has a rapid onset, while burnout develops over a prolonged period in response to chronic job-related stressors. they both manifest in various ways — decreased concentration, preoccupation with trauma, withdrawal, loss of purpose, substance use, and chronic fatigue are some. if left untreated, prolonged burnout lasting 3-6 months can lead to depression.

positive psychology suggests that stress can lead to personal growth and self-empowerment. stressful experiences can compel people to develop new skills, acquire strengths, and gain insights. overcoming stress enhances self-esteem and coping abilities.

social support, optimism, conscientiousness, age, and gender have all been shown to moderate impacts of stress.

  • the presence or quantity of social relationships is strongly positively correlated with the perceived availability of assistance and increased immune functioning

  • optimism is associated with psychological and physical well-being, as well as more adaptive coping strategies

  • conscientiousness involves having an increased internal locus of control and high self-efficacy, which are strongly related to fostering better health habits. these habits can be protective during times of increased stress

  • maturity plays a role in the use of effective coping mechanisms. strong correlation between age and generativity, which relates to having a sense of purpose and employing emotion-focused coping strategies for uncontrollable stressors. mccrae's growth hypothesis suggests that individuals between 40-70 years old use immature coping mechanisms like hostile reactions and escapist fantasies less frequently than younger individuals.

  • gender norms play a significant role in the types of stressors individuals face and the coping strategies they employ. men are more likely to face stressors related to perceived control, such as financial worries and major life changes, and may rely on escapism. women are more likely to face stressors related to family-work balance and may rely on social support strategies. the gender minority stress model highlights the complex gender-related stress faced by transgender and gender non-conforming/diverse individuals. this stress includes the strain of educating cisgender individuals, concerns about physical safety, and experiences of prejudice and discrimination. these individuals may use strategic avoidance to manage gender-related stress, prioritising safety.

coping styles can be emotion-focused or problem-focused. emotion-focused coping mechanisms involve thoughts or actions that aim to alleviate the emotional distress caused by stressors without necessarily addressing the root cause directly. this can include seeking emotional support from others, engaging in activities that provide comfort or distraction, or using relaxation techniques to calm oneself. problem-focused coping strategies, on the other hand, involve efforts to directly address the source of stress by taking action to change or improve the situation. this may include problem-solving techniques such as seeking information about the stressor, planning and implementing solutions, or confronting the individuals or circumstances responsible for the stress.

stress management techniques in psychotherapy include:

  • assertiveness training — teaching people how to express needs, thoughts, and feelings directly and respectfully. by learning these skills, people can effectively communicate which reduces interpersonal stress

  • thought stopping — a CBT technique used to interrupt and replace negative or distressing thoughts with more positive or neutral ones. by interrupting the cycle of negative thinking, emotional distress can be reduced

  • refuting irrational ideas — challenging and changing irrational beliefs that contribute to stress. another CBT technique, this can reduce vulnerability to stress and improve coping abilities

  • modifying type A behaviour — type A refers to a personality pattern characterised by competitiveness, time urgency, and hostility, which has been linked to increased stress and health problems. modifying "type A" behaviour involves adopting healthier and more balanced ways of approaching work and life

  • cognitive reappraisal (ellis’ ABC model) — ellis's ABC model (also known as rational emotive behaviour therapy) proposes that events themselves do not directly cause emotional distress; rather, it is the individual's interpretation of events (their beliefs and thoughts) that lead to emotional reactions. according to this model, when faced with a stressor (the activating event, A), individuals have beliefs or thoughts about the event (beliefs, B) that influence their emotional and behavioural responses (consequences, C). by identifying and challenging irrational beliefs, individuals can restructure their thinking and develop more adaptive coping strategies

outside of this, effective ways to manage stress include:

  • time management

  • proper nutrition

  • regular exercise

  • finding alternatives to frustrated goals — when faced with obstacles or setbacks, it is important to identify alternative pathways or goals that can provide a sense of purpose and fulfilment. this may involve reevaluating priorities, adjusting expectations, or exploring new opportunities

  • stopping bad habits

stress inoculation training is a form of CBT aimed at equipping individuals with the tools to effectively manage stress. it begins with education, providing them with a framework for understanding their stress response. this includes learning about the physiological, cognitive, and behavioural aspects of stress as well as coping strategies. in the rehearsal stage, individuals learn and practice coping skills. they develop proficiency applying these skills to situations. the application stage involves use of the information and skills learned in real-life stressful experiences. individuals gradually expose themselves to increasingly challenging situations.

research suggests that humour can serve as a valuable coping mechanism, helping individuals to alleviate stress and promote psychological well-being. good sense of humour has been associated with various positive outcomes, including reduced levels of stress, increased resilience, and enhanced social support. 4 hypothesised explanations for the link between humour and wellness include:

  • psychological distancing — humour allows individuals to mentally distance themselves from stressful situations, providing a temporary escape

  • cognitive reappraisal — humour involves reframing or reappraising stressful events in a more positive or lighthearted manner, which can alter perceptions of the situation and diminish its impact on emotions

  • social support — humour fosters social connections and camaraderie, enabling individuals to bond with others and receive emotional support during times of stress

  • physiological effects — humour triggers physiological changes in the body, such as the release of endorphins and reduction in cortisol levels, which can promote relaxation and alleviate stress

breathing exercises are a simple yet effective technique for reducing stress and promoting relaxation. deep breathing techniques, such as diaphragmatic breathing or paced breathing, can help calm the body's physiological response to stress by activating the parasympathetic nervous system and lowering heart rate and blood pressure. biofeedback is a therapeutic technique that involves using electronic monitoring devices to measure and provide feedback on physiological processes such as heart rate, muscle tension, and skin temperature. by learning to control these bodily functions through relaxation techniques and mental focus, individuals can reduce stress.

managing occupational stress:

  • building a supportive team

  • regular supervision

  • professional development

  • broadening knowledge

  • practice self-care

  • setting boundaries

  • organisational responsibility