Reducing Stress
In addition to the very real and significant ways in which social support can moderate
stress, there are thousands of ways to reduce stress available to people, either free-of-
charge or by paying individuals or organisations for either knowledge or equipment to
facilitate relaxation. Some of these are more unusual and 'wacky' than others, but most
can be classified into how they affect their stress relief.
Exercise is one way to relieve stress. Studies have shown a relationship between the
ability of the body to cope with stress and indulgence in exercise, especially aerobic
exercise. Sinyor et al (1983) compared people who exercise regularly with those who do
not in their hormonal reactions to an artificial stressor. They found that the exercisers had
better rates of recovery from the stress.
Relaxation is another path to reducing stress, achieved commonly through things such as
meditation. In Japanese offices, workers are often encouraged to exercise at work, and
calming sounds such as that of rain are played through the company public address system.
Reducing stress, therefore, is not just a private, individual thing: it can be a public or group
activity. In China, early morning tai chi sessions are to be seen in open-air, public squares.
Scientific involvement in relaxation-based stress reduction has, at times, centred around the
issue of biofeedback. Biofeedback concerns the process of wiring up a person to measure
their vital signs such as heart rate and blood pressure, and enabling them to monitor them
with a view to changing them consciously, at will. The idea is that by learning to lower blood
pressure or heart rate, the individual can relax more effectively and take control over bodily
functions which have a central role in health. The problem is that reducing stress signs during
periods of non-stress does not necessarily generalise to times when stressors are present
(Holmes, 1984).
Time management is a common technique aimed at reducing stress indirectly, by
eliminating the feelings of being under time-pressures. Companies realise that an
employee who manages their time well is one who not only gets more work done in the
time available, but who is also less stressed. Less stress equates directly to better health,
and this means fewer days off work. Stress is estimated to result in millions of lost days of
work per year in most developed countries. Aside from the official statistics on this, there
are also the unofficial cases. When some people pretend to be physically ill because they
cannot face going in to work, it is likely to be stress which is putting them into that
position.
Social support enhancement is a key factor in cutting down on the damaging effects of
stress. It is not always easy to do, simply because it is often painfully difficult for people
to make friends. However, by joining clubs and 'getting out more' people who are lonely
may find ways to generate more social support, which as we have seen can have a
significant impact on their health, even their likely age of death. Additionally, TV
campaigns such as those in the United Kingdom, asking people to check on their
neighbours regularly, especially if they are old and live alone, may assist in this. The
purpose of such a request goes beyond personal safety, and can easily contribute to
psychological health.
Control enhancement is another issue which is achieved by a range of techniques. We
have already identified that stress is something that can be moderated by perceived
control over situations. By effectively tampering with perceived control, we can make a
difference to perceived stress. How can we achieve this? Firstly, control can be increased
in real terms, by people's employers, for instance, changing the nature of work to allow
for employees to make decisions and to control their working practices within reason.
Secondly, cognitive-behavioural techniques are a good way, involving changing people's
perceptions of themselves and their sense of control. By a range of methods, usually
involving some kind of more or less sophisticated conditioning, people learn to think
differently.
Stress inoculation training (Meichenbaum and Deffenbacher, 1988) is a specific form of stress
management. It involves training people in new skills, through three phases: conceptualization,
skills acquisition and rehearsal, and application. In the conceptualization phase, people are taught
what the body does as a reaction to stress, and what the common psychological consequences are.
They are made to analyse their own reactions to stress. In the skills acquisition and rehearsal
phase, people are asked to try out alternative reactions. So instead of waiting in a queue provoking
the usual thoughts of 'Come on, come on, hurry up, come on, I haven't got all day ...', the person is
encouraged to think something like 'Keep calm ... the queue will go down in time ... my
anxiousness will not make a difference to the queue.' They are taught techniques of stress
reduction such as relaxation, and positive coping styles are emphasised. In the application phase,
people have to really try these things out in their lives, keeping records to see the differences they
make to them. This is, in essence, an extended form of cognitive-behavioural therapy, which has
been shown to have a moderate degree of success in helping stressed individuals
Stress in Health Professionals
The health professions, like many others, are high-stress occupations. Doctors and nurses
commonly work long hours, and have some particularly difficult problems to deal with. In
careers of this type, people often report that they are unable to 'switch off from work at
the end of a shift. Their work remains on their minds, especially when during the day they
have been witness to deaths and to the aftermath of horrific accidents. Chronic stress in
those professions which have a high level of contact with clients (teaching, law, policing,
medicine and the like) can have some particularly strange effects on the person, the
constellation of which has been termed burnout.
Burnout is quite separate from stress, and is really best seen as a result of stress rather than a form
of it. The term was coined by Freudenberger (1974), and has since been used extensively to describe
the physical and emotional changes which can occur when job stress forces an individual to adapt to
their environment (Maslach, 1982). Long-term work stress can create a situation where people turn
to alcohol or other drugs in order to cope, develop many physical symptoms of stress, and begin to
lose interest in things around them. They also, typically, start to lack sympathy for people in their
environment. Losing a sense of caring for one's clients is, of course, particularly damaging when
one is working in a so-called caring profession. No-one would wish to be treated by a nurse who
simply does not care. In many ways emotional flatness which occurs in burnout can be considered
to be a biological, protective reaction which has become exaggerated. It can be seen as a way of
turning off from the outside world to protect the individual. However, it is usually also damaging to
them, and can be considerably disturbing: for example, they are usually distressed when they realise
that they seem to have stopped caring about people and what happens to them.
The three main characteristics of burnout, according to Maslach (1982) are
depersonalisation, as described above, emotional exhaustion (where the person feels
simply tired of things, and unable to muster up the resources to be an emotional being)
and perceived inadequacy (where the person feels that they are losing their ability to do
their job properly).
It is not difficult to imagine how a doctor experiencing burnout will treat their patients.
Lacking energy, lacking empathy or sympathy, and lacking self- confidence, they will
neither care much about what happens to them, nor believe that they are likely to be able
to make a difference to them. In the best case, the patient receives no help, in the worst
the patient is harmed (by, for example, a doctor who takes less care in administering an
injection and so damages tissue, or does not doublecheck a drug dosage and ends up
poisoning the patient).
