V Now read the article closely answering the margin questions to help you understand the text better and fill in the following table.
Physical / psychological /
How it works
When it should be used
3. Cognitive-behavioural approaches:
4. Physical exercise
5. Mediation and relaxation
How to combat stress
In this article, Simon Green shows how evaluating methods of stress management can be straightforward, particularly if you remember some of the basic features of stress and its effects on the individual. The critical issue isstress management,in particular the physical and psychological methods of stress management, along with their strengths and weaknesses.
Using a conventional definition of stress, we can say that it exists when we feel that the demands being made upon us are greater than our ability to cope with them. Stress can be short-lasting (acute) or long-lasting (chronic). Immediate physical effect can include physiological arousal in the form of increased heart rate and blood pressure, and the release of 'stress' hormones from the adrenal gland which help maintain arousal and increase blood levels of fatty acids for use in muscular activity. Activity of the immune system may be reduced, and if the stressful condition persists, the long-lasting arousal is thought to lead to 'stress-related' illnesses such as cardiovascular disorders (heart and circulation problems). The suppression of the immune system may leave the person vulnerable to other illnesses and infections. Although the emphasis is usually on physical illness, it is important to remember that anxiety and depression are common psychological problems associated with stress.
Two features of this simple outline are that stress is linked to a feeling that life events are out of our control, and that some of the negative effects of stress are linked to the high and sustained levels of physiological arousal. The most effective methods of stress management try to modify both of these fundamental features.
Treating the symptoms of stress
Apart from the major approaches listed in textbooks, there are many other techniques which are supposedly effective in stress management, especially in the general area of alternative medicine (a recent review listed 50 or more). Although the specification gives examples of methods you might revise, you are free to choose whichever you want. But try to follow some simple rules. For instance, is there evidence that the method works? Are there clear procedures? Even general approaches such as meditation and relaxation have specific and detailed routines to be followed. Can you link the method to the features of stress outlined above? Drugs, biofeedback and physical exercise directly influence physiological arousal, while cognitive-behavioural approaches try to alter the sense of being in control of your life.
If you choose techniques more commonly associated with areas other than stress, such as Freudian psychotherapy or antidepressant drugs, try to bring out their direct relevance.
Psychotherapy is usually used for psychological problems such as depression, anxiety or general unhappiness. Part of the process can be to identify current areas of concern or stress in your life, and this may help in coping with them. With the use ofantidepressant drugs, the simple link is that depression can be caused by chronic (long-lasting) stress, so the use of these agents could be seen as helping to cope with stressful situations. It is far simpler, though, to choose a clearly-developed method as a means of stress management.
Physical or psychological?
This specification refers to physical and psychological approaches, and questions may require you to deal with one or the other. This division can be hard to spot, as many methods are neither one nor the other, but represent a mixture of approaches. Drugs would be the clearest example of a physical method, as there is no necessary psychological element in the technique.
Biofeedback also concentrates on physiological responses, but an important element is the conscious psychological effort to control these responses through relaxation, meditation and imagery. So biofeedback could count as either physical or psychological. Similarly, muscle relaxation, meditation and yoga all help to reduce physiological arousal, and could be seen as both physical and psychological methods. Physical exercise does not sound very psychological, but the effects are often on mood and self-esteem, so it could also qualify as being either physical or psychological. Although examiners will read answers as sympathetically as possible, and know that many methods are a mixture of physical and psychological, it helps if you can briefly justify your choice of approach.
Despite some clear drawbacks, drugs are the commonest treatment for stress-related conditions. Specific antianxiety agents (anxiolytics) include the benzodiazepines such as diazepam (valium) and chlordiazepoxide (librium); this group are the most prescribed of all drugs used for psychological disorders. An advantage is that they directly target brain pathways thought to produce the increased anxiety associated with stressful situations, and they can also work quite quickly. Disadvantages include the fact that up to 40% of people do not respond to them and, more importantly, they usually have a range of undesirable side effects which can lead to patients simply not taking them. They can also lead to physical and psychological dependence if over used. Critically, they do not treat the conditions leading to the high levels of stress and anxiety, so there is a strong likelihood that when treatment stops, the individual's situation is basically unchanged.
An important evaluative point is that, as we become more aware of the need to treat causes rather than symptoms, there is an increasing trend for drugs to be used to improve the situation in the short term, but to combine them with psychological approaches which aim to produce longer-term change.
Other drugs used to treat stress-related symptoms include beta-blockers and, more recently, ACE-inhibitors. These agents target bodily-arousal systems rather than the brain itself, and can be crucial in rapidly controlling life-threatening conditions such as high blood pressure. They are less prone to producing physical or psychological dependence, but are only treating symptoms rather than the causes, so are increasingly combined with other non-drug therapies aimed at the underlying causes. As a general evaluative point, remember that conditions such as high blood pressure can be produced by inherited factors — diet, general lifestyle (e.g. being overweight), as well as stress. Ideally, all of these would be addressed by a comprehensive therapy program.
Biofeedback involves the use of recording electrodes and monitors to measure physiological responses such as blood pressure or muscle tension in the head and neck, which can lead to stress headaches. The individual is trained to reduce levels of blood pressure or muscle tension using a mixture of techniques such as progressive muscle relaxation, meditation and imagery. An advantage of biofeedback is that the use of the monitors helps the person learn effective techniques to reduce arousal, and they can then use them independently of the technology. Disadvantages include the cost of the technology and the time needed by the trainer and client to learn how to reduce arousal.
Although biofeedback has been shown to be effective in controlling blood pressure and stress-related headaches, there is some doubt as to whether the feedback is actually necessary. One or two studies comparing biofeedback with relaxation methods seem to show that the technology does not significantly add to the benefits of relaxation training.
Biofeedback does not directly focus on the causes of the stress-related problems. However, training the client in how to manage the condition does improve their sense of being 'in control' (also called self-efficacy) and can help make their attitudes to stressful life events more positive.
The major advantage of these approaches, such as Meichenbaum's stress inoculation therapy and Kobasa's Hardiness training, is that they focus directly on the causes of stress in the individual's life. The first stage is always to discuss with the therapist situations which the person has found stressful and hard to deal with. Their previous methods of coping are analysed in terms of their success or failure. Specific problems, such as poor time management in relation to examinations and weak social skills in finding personal relationships, are discussed. With the therapist, coping strategies and skills are improved, which in turn can lead to increased confidence and self-efficacy. New strategies are tried out in the real world, with further training and practice as necessary.
Many studies have demonstrated the effectiveness of cognitive-behavioural stress management techniques, with long-term improvement an important outcome. The key disadvantage is that to identify the causes of stress, learn new coping strategies and how to apply them in the real world, takes time and money. The client has to have considerable motivation and application to persevere with the training, besides being willing and able to analyse their own lives and the sources of stress within it. The technique does not suit everyone, and because of the need for a trained therapist, is not widely available.
Over the last few years membership of fitness clubs has multiplied, as exercise has become an important part of a stress-resistant lifestyle. However, it has been difficult to identify the precise contributions that it can make. It has been shown that regular exercise acts as a 'buffer' against the psychological effects of stress, as exercisers have lower levels of anxiety and depression compared with non-exercisers. They also report higher levels of self-esteem and self-efficacy, perhaps because the act of organising an exercise program and maintaining it increases the sense of being in control and acting positively to improve health.
The immediate physical effects of exercise are to increase heart rate, blood pressure and other measures of physiological arousal. It is therefore important that people with cardiovascular problems related to stress, lifestyle or inherited tendencies take great care and medical advice before beginning exercise programs. Although exercise can contribute to weight control by burning up excess calories, the physical stress of over-exercising in the unfit can have damaging consequences on the cardiovascular system, besides possible mechanical damage to joints, muscles and ligaments.
It is generally accepted that an exercise regime designed for your particular level of health and fitness has positive effects on mood and in toning up the arousal systems, in particular heart and circulation. Like many stress management techniques it has to be practised regularly to have any significant benefit; this is time consuming and, if done through a fitness gym, expensive.
Meditation and relaxation
There are many techniques involving meditation and relaxation. They involve a conscious attempt to reduce measures of physiological arousal through muscle relaxation and imagery, and can be very effective in the short term. Although some progressive muscle relaxation programmes are quite complicated, most can be learnt quickly and can be applied pretty well anywhere; they are especially useful for controlling the arousal associated with the immediate impact of stressful situations, e.g. traffic jams and intense personal encounters.
Longer-term effects are difficult to assess. They do not target the causes of stress, but if used regularly, help with the perception that you are in control of your body's reactions to stressors; this increase in self-esteem and self-efficacy is seen by many as fundamental to stress management, as it closes the gap between perceived demands and perceived coping responses.
Which method is best?
I have discussed a few of the many techniques of stress management. All have plus and minus points, and it is also important to remember that combined approaches are often the most effective. Relaxation and meditation are part of cognitive-behavioural techniques, and drugs are often given in combination with psychological therapies, simultaneously tackling physical symptoms and psychological causes.
Stress management techniques can also operate at an organisational rather than an individual level, focusing on work practices and the physical environment. If you wish to discuss these, remember that the basic principles still apply; work practices (e.g. machine-paced work, over- or under-load) and physical conditions (e.g. temperature and noise) increase the perceived demands on people. Managing organisational stress involves a reduction in these demands by reorganising work practices and improving physical conditions.
Simon Green is Head of the School of Psychology at Birkbeck College, University of London, and a Principal Examiner for AQA (A) psychology. Simon's books include Principles of Biopsychology (Psychology Press).
1. What does ‘straightforward’ (line 2) mean here? a) honest to do) difficult to do c) easy to so
2. What does ‘in particular’ (line 6) signal here? a) emphasis b) contrast c) example
3. What does ‘conventional’ (line 10) mean here? a) new b) traditional c) original
4. What is immediate (12) here?
a) instant b) urgent c) next
5. What are cardiovascular disorders (17)? Can you find the explanation of this expression in the text?
6. What does this simple outline (21) refer to?
7. What does sustained (23) mean here? a) continuing for a short time b) continuing for a long time c) low
8. What does outlined (31) mean here? a) describe b) description c) described
9. What does bring out (36) mean here? a) to make sth appear b) to make sth easy to see or understand c) to to publish sth
10. What does this specification (41) refer to?
11. What does this division refer (42) to?
12. What does neither … nor (43) mean?
13. What do one and the other (43) refer to?
14. What does similarly (48) signal here? a) contrast ideas b) additional ideas c) almost the same ideas
15. What does despite (55) signal here?
16. What are drawbacks (55)? a) advantages b) disadvantages
17. What are antianxiety agents (56)? Hint: prefix; context
18. What does target (59) mean here? a) attack b) effect c) ruin
19. What does over used mean (63) here? a) used enough b) used too much c) used too little
20. What is self-efficacy(93)? Can you find the explanation of this word in the context?
21. What does outcome (103) mean here? a) effect c) cause c) advantage
22. What does stress-resistant (110) mean here?
23. What does the unfit (118) refer to? a) unsuitable people b) people who aren’t in good physical condition c) healthy people
24. What does e.g. (131) stand for? a) that is b) and so on c) for example
w In the article “Under Pressure” find the following information:
- two types of stress determined by the time it develops in a person;
- examples of stress-related illnesses;
- techniques that help to reduce physiological arousal;
- disadvantages of using drugs as a method of stress management;
- examples of inherited factors that can add to stress level;
❹ Paraphrase the following statements describing stress managements methods. Instead of the bold-faced words use words and word combinations given in the article “Under Stress”:
- Risky jobs can cause acute stress in people.
- Long-lasting stress symptoms are most difficult to handle.
- People who are on drug medication can experience psychological addiction.
- Such jobs as firefighters or policemen often involve conditions that put the professionals’ lives under risk or high danger.
- In recent years membership of fitness clubs has raised greatly.
- Practicing some meditation and relaxation techniques can take a lot of time.
- The long-term effects of stress methods applied sometimes are difficult to evaluate.
u Fill in the vocabulary map using the words from the box:
be vulnerable to
a sign of stress
a source of stress
stress management techniques stress factors
be susceptible to
a symptom of stress