Stress and its related illnesses are of major public health concern. Chronic stress is described as the experience of repeated, uncontrollable/unpredictable, moderate-level life-stressors whose cumulative effect involve distress and difficulty coping (think of these as “mini-traumas” that exhaust the body and mind over time). Repeated oxidative stress leads to inflammatory states in the body, which can have both physical and psychological consequences. Research has linked this chronic stress to heart disease, diabetes, cancer, dementia, major depression, chronic pain and musculoskeletal injury, and shorter lifespan.
Learning problem-solving skills on how to reduce the demands in life may offer some stress relief, especially for those who have access to external resources. However, in many cases, the problem is bigger then the stressors themselves. When health effects begin to accompany the experience of stress, such as sleep disturbance, depressed mood, relationship problems, feelings hopeless or worthless, anxiety, “burnout,” muscle tension, and substance abuse, this may signal the need for additional intervention.
Keeping a good self-care routine, exercising regularly, and having contact with supportive others is key to stress management (in addition to problem solving). Here, we describe a few of the evidence-based stress management techniques that one can learn in the context of psychotherapy or on their own from published manuals and self-help books.
Mindfulness-Based Stress Reduction (MBSR) was developed by Jon Kabat-Zinn at the University of Massachusetts in an attempt to integrate mindfulness practice in people’s lives as a way to alleviate chronic stress and related problems (e.g., sleep difficulty, anxiety, adjustment disorders). This approach combines meditation, yoga, and education about the human stress response in a weekly group setting lasting 8-10 weeks. The group format provides social support through the shared stress experience.
Participants are expected to meditate for at least 45 minutes per day following audio recordings. Additionally, the formal program includes an intensive full day of mindfulness after about 75 percent of the treatment has been completed.
In relaxation-based treatments, patients are taught exercises to alter their patterns of breathing and holding tension. Frequent sessions (e.g., bi-weekly) are typically required to adequately teach relaxation skills. Practice at home also ensures that patients gain mastery of the relaxation techniques. Although relaxation therapy is demonstrably effective, there is little evidence suggesting differential effectiveness across the range of relaxation modalities.
Progressive muscle relaxation involves the flexing and subsequent releasing of different muscle groups in the body so that, by the end of the exercise, the patient is relieved of somatic tension. By bringing about an awareness of what it feels like to be “tense,” this exercise also helps patients notice their personal patterns of holding tension, such as in the shoulders or arms.
Breathing retraining may involve several components, depending on the patient’s problem pattern. Patients who often hold in their breath when stressed or hyperventilate (which serve to raise the heart rate), may be taught to notice these patterns and exhale more air. Patients who breathe shallow and/or hold their breath when they are stressed may be taught slow deep-breathing exercise. Mindfulness techniques, such as yoga, also involve control and meditation on breath as a reliable tool for self-regulation of one’s physical and emotional state.
Resources for Building a Mindful Foundation
- Free Guided Meditation from the UCLA Mindfulness Research Center
- Mindfulness Solution by Ronald D. Siegel, PsyD
- Mindfulness: Finding Peace in a Frantic World
- Self-Compassion by Dr. Kristin Neff
- Mindful Self-Compassion by Christopher Germer, PhD
- Mindfulness-Based Stress Reduction
- Self-Guided Online Mindfulness-Based Stress Reduction