Practical Stress Management: A Comprehensive Workbook

By John A. Romas and Manoj Sharma

Practical Stress Management, Eighth Edition emphasizes a positive approach to stress management, covering topics such as relaxation techniques, coping with anxiety, managing anger, communication skills, exercise and nutrition. In this edition, the authors cover the latest advances in stress management, as well as stress related to the use of technology in education. The context of disasters, such as the COVID-19 pandemic, is also incorporated throughout. The workbook describes some of the surreptitious meditation techniques from India not described before in any text. Worksheets and Thoughts for Reflection boxes help users determine their own level of stress to apply effective stress management techniques.

• Presents techniques for managing personal distress
• Covers a range of topics to help manage stress, from meditation to nutrition
• Includes a companion website with audio guided relaxation techniques, learning modules and a sample syllabus

• Language: English
• Publisher: Academic Press
• Release date: Feb 9, 2022
• ISBN: 9780323986335

John A. Romas

Dr. John A. Romas, MPH, Ph.D., a University of Michigan Graduate, is professor emeriti within the Department of Health Science, Minnesota State University-Mankato. Before retiring in 2010, he was the former department chair administrator of the Health Science Department. In addition to his background and experience in health education and promotion, Dr. Romas has training in counseling psychology and career development. He has worked as a public school teacher/administrator, public health administrator/educator, state health consultant, and small business owner/manager. He has been a well-known speaker, presenter, and health consultant for health care, business, educational organizations, government, and industry in the areas of personal performance, stress reduction, managing change, and health promotion. His Licensure as a Professional Counselor was earned with the State of Minnesota Board of Behavioral Health.

Book preview

Chapter 1

Understanding stress

Abstract

The purpose of this chapter on understanding stress is to explain the concept of stress as it has originated in the West and the East. The origin of response-based concepts of stress, followed by event-based concepts of stress, and then the contemporary interactional (transactional) model of stress, adaptive calibration model, and generalized unsafety theory of stress in the West are described in the chapter. Also included is a discussion on types of stressors: life events, chronic stressors, and nonevents. Ancient concepts of stress in India are also discussed. Stress in special and diverse groups is also described. The chapter concludes with a discussion on effects of stress on the body. Included are Thoughts for Reflection on why stress exists. The chapter has six worksheets on (1) knowledge about stress, (2) coping skills, (3) attitudes about stress, (4) Social Readjustment Rating Scale, (5) personality-type identification, and (6) advantages of stress management. The chapter also has a list of five websites to explore with interactive activities.

Keywords

Understanding stress; fight or flight; changing life events; acute and chronic stress; definitions of stress; type A personality; physiology of stress; stress and disease and stress management

1.1 Stress management principle

It is not the stressor but your perception of the stress that is important.

Please complete the precourse assessment in the Personal Assessment Log at the beginning of the workbook or online at https://www.elsevier.com/books-and-journals/book-companion/9780128112953.

1.2 What is stress?

If asked whether we have experienced stress in our lives, it is quite likely most of us would respond affirmatively. However, if asked to define stress, we may not be able to find appropriate words to express ourselves. Our responses might include words such as:

• Pressure

• Being down

• Anger

• Anxiety

• Nervousness

• Having butterflies in the stomach

• Strain

• Negative stimulation

• Being uptight

• Depressed

• Being under the weather

• Tension

• Being upset

It is certainly true that these terms convey a meaning of stress. However, to comprehend stress completely, we need to explore the meaning of stress in depth. Before we proceed any further, review your knowledge, attitudes, and coping skills pertaining to stress with the help of Worksheets 1.1, 1.2, and 1.3.

Worksheet 1.1

Worksheet 1.2

Worksheet 1.3

1.3 Contemporary concepts of stress in the West

According to Webster’s New World Dictionary of American English (2000, 4th ed.), the word stress is derived from the Latin word strictus, meaning hardship, adversity, or affliction. It later evolved as estresse in Old French and stresse in Middle English. This word has been used in the physical sciences, medical sciences, psychology, and behavioral sciences. Stress has been defined from three perspectives—namely, as environmental or external to the body, as a mental or internal state of tension, and as the body’s own physical reaction (Rice, 1999). We present the concept of stress as it has evolved in the West from response based to event based, and then to the interactional model. These models help explain the complex phenomenology of stress.

1.4 Response-based concept of stress

In the Western world, the first attempts at defining stress in a psychological and behavioral context originated with the work of physiologist Walter Cannon, who defined stress as a fight or flight syndrome; that is, when an organism is stressed, it responds either by fighting with the stressor or by running away from it (Cannon, 1932). This concept gained further understanding with the work of Hans Selye on the general adaptation syndrome (GAS; Selye, 1936, 1974a, 1974b; Selye, Goldberger, Breznitz, Goldberger, & Breznitz, 1982). While attempting to isolate a new sex hormone in rats, he observed that when injected with ovarian extracts, their adrenal glands (endocrine glands located over the kidneys that pour their secretions directly into the bloodstream) secreted corticoid hormones (a steroid), their thymus and lymph nodes became smaller in size, and they developed stomach ulcers. Later, he found that disparate events like cold, heat, infection, injury, loss of blood, and pain also produced similar responses. He labeled this gamut of responses as the GAS, composed of the following three stages (Fig. 1.1):

Stage 1: Alarm reaction: In the alarm reaction phase, the organism’s homeostasis, or balance, is disrupted. The endocrine glands become active—particularly the adrenal glands that secrete corticosteroid, which supply a ready source of energy to the body. This is accompanied by a shrinkage of lymphatic structures, a decrease in blood volume, and ulcers in the stomach.

Stage 2: Stage of resistance: The stage of resistance occurs with continued exposure to the agent that elicited the response. In this stage, alarm reaction changes cease and opposite changes occur, such as an increase in blood volume. The adaptation energy continues to deplete.

Stage 3: Exhaustion: Exhaustion causes permanent damage to the system. If the agent is not removed, the organism’s energy depletes and death may ensue.

Figure 1.1 Stages of Selye’s general adaptation syndrome.

On this basis, Selye defined stress as a nonspecific response of the body to any demand made upon it (Selye et al., 1982; Selye, 1936, 1974a, 1974b). Selye, in his later work, found that the same arousal response can be evoked by different situations. Situations that are productive to the organism were labeled as eustress; others that are harmful were labeled as distress (Selye et al., 1982). This model of stress was response-based and physiological in its orientation. Many Russian scientists (such as Boris Aleshin, Igor Eskin, and Vassily Komissarenko) also tested the model and found it to be useful (Viru, 2002). This model has also been applied to sports training and found to be beneficial (Cunanan et al., 2018). However, the main criticism leveled at this conceptualization has been its neglect of the situational and individual contexts in which stress occurs (Genest & Genest, 1987).

1.5 Event-based concept of stress

The early work of Holmes and Rahe (1967) focused on stressful events and constructed a Social Readjustment Rating Scale (SRRS) to assess the amount of stress to which an individual is exposed. The scale Holmes and Rahe developed assesses stress by applying weighted life change units to events in a person’s life. These weights are based upon the estimated amount of change or readjustment required for each event on the part of the individual experiencing it. Estimates of this scale have been derived from ratings obtained from a sample of primarily white, middle-class adults. The total life stress experienced during a period of time is assessed by summing the weights, or life change units, of the 43 events represented on the SRRS. Before you proceed any further, complete Worksheet 1.4, keeping in mind the events that you have experienced during the past year.

Worksheet 1.4

During the 1970s, the life event concept was very popular. (Holmes et al., 1979) estimated that as many as 1000 publications appeared based on SRRS during the 1970s. Some other scales were also developed based on this concept—including the Recent Life Changes Questionnaire (Rahe et al., 1974) and the PERI Life Events Scale (Dohrenwend, Krasnoff, Askenasy, & Dohrenwend, 1978). Based upon this concept, stressors have been defined as life events or changes that produce or have the potential to produce changes within the individual, his or her family, and his or her surroundings. However, later work has challenged this viewpoint. It has been found that stress reactions differ as a function of (1) neurophysiological levels of response, (2) qualities of the stressor, and (3) differences among individuals (Genest & Genest, 1987). In recent years, the SRRS has been used for measuring patient stress (Edwards & Shaw, 2021), stress in older adults (Zorigt, Enkh-Amgalan, & Yu, 2019), as a quality of life assessment tool (Ortega et al., 2020), and in Alcoholic Anonymous 12-step program (Puente et al., 2019) among others (see Thoughts for Reflection 1.1).

Thoughts for Reflection 1.1

Murphy’s laws

Murphy’s laws are popular maxims in Western culture. There are several versions of these laws available. Accounts differ as to the precise origin of these laws. It is claimed that these laws were born at Edwards Air Force Base, California, in 1949, and were named after Edward Murphy, an engineer working on Air Force Project MX981. The project was designed to see how much sudden deceleration a person can withstand in a crash (Spark, 2006). The beauty of these laws is that they provide an interesting perspective on whatever stressful situation we are experiencing. To experience a new perspective to your stressors, reflect on this list of a few of Murphy’s laws.

• Nothing is as easy as it looks.

• Everything takes longer than you think.

• If anything can go wrong, it will.

• A day without a crisis is a total loss.

• Inside every large problem is a series of small problems struggling to get out.

• The other line always moves faster.

• Whatever hits the fan will not be evenly distributed.

• No matter how long or hard you shop for an item, after you have bought it, it will be on sale somewhere cheaper.

• Any tool dropped while repairing a car will roll underneath to the exact center.

• You will remember that you forgot to take out the trash when the garbage truck is two doors away.

• Friends come and go, but enemies accumulate.

• The light at the end of the tunnel is the headlamp of an oncoming train.

• The chance of the bread falling with the peanut-butter-and-jelly side down is directly proportional to the cost of the