There are two main approaches to stress management these are the physical approach and the psychological approach The physical approach One way of coping with stress is the use of drugs. Drugs are related to the bodily processes involved in the stress response. They interfere with the activity of the ANS. Barbiturates depress the activity in the central nervous system and reduce anxiety. For a long time these were used in stress management but have been known to cause undesirable side effects, such as slurred speech, and can be addictive. Valium and Librium are the most commonly used.
They act on synapses and neurotransmitters, especially by promoting GABA, which is the body’s natural form of anxiety relief. GABA reduces serotonin levels, a neurotransmitter related to arousal and aggression. The common side-effects of benzodiazepines include sleeplessness and dependence. Buspirone enhances the effects of serotonin, thus reducing anxiety, but also has side effects such as depression. Drugs can be effective in reducing stress but only in the short term. Drugs only deal with the symptoms and don’t tackle with the real problem.
In the long term drugs often have unpleasant side-effects and problems with dependence Biofeedback is a technique to learn voluntary control of involuntary muscles or voluntary muscles that can’t normally be controlled, such as blood pressure and heart rate. There are two possible explanations for biofeedback. Operant conditioning occurs when certain behaviours are reinforced because they result in a desirable response. An example might be a patient connected to various monitoring devices and a light or tone signals when the correct alteration occurs.
Miller and DiCara (1967) demonstrated this by paralysing rats with curare. This way they could ensure the rats had no voluntary control. Half of the rats were rewarded whenever their heart rates slowed down by stimulating the pleasure-centre of the brain. The other half was rewarded when their heart rates speeded up. In both groups there were significant changes in heart beats after repeated reinforcement. Learning can also occur through relaxation. In order to reduce blood pressure the patient is told to relax, and this leads to changes in muscle tone and ANS activity.
Relaxation leads to restoration of homeostasis, the body’s normal state of balance. Selye’s GAS model suggested that stress disrupts the body’s normal state, so relaxation helps the body to regulate the various physiological activities that are out of control, such as blood pressure. Empirical support for biofeedback comes from Dworkin and Dworkin (1988) who successfully used biofeedback to teach sufferers of scoliosis (curvature of the spine) to control their back muscles and alter their posture.
There are also reports of its usefulness with asthma, incontinence, anxiety, hypertension, migraine circulatory problems, irritable bowl syndrome, pain control, and bed wetting (Underhill 1999) Biofeedback certainly works with voluntary responses. However, apparent changes in involuntary control may be due to relaxation and control of unused voluntary muscles. Attempts to replicate the work of DiCara and miller have never been as successful (Dworkin and Miller 1986). This kind of treatment is costly time consuming and requires effort and commitment, if these cant be given it will not work.
On the other hand biofeedback is non-invasive, has virtually no side-effects, and can be effective over the long term. Other physical methods of stress control include exercise as this improves circulation which strengthens the heart. Goldwater and collis (1985) found that exercise was positively related to decreased anxiety. Emotional discharge, expressing emotion through crying, anger or humour is also thought to help stress management. The psychological approach Stress inoculation therapy was proposed by Meichenbaum (1985).
He proposed a form of therapy to protect an individual before dealing with stress rather than dealing with it afterwards. This is a form of cognitive therapy because it aims to change the way the individual thinks about their problem rather than changing the problem itself. There are three main phases to this therapy. These are: * Assessment, the therapist and patient discuss potential problem areas. * Stress reduction techniques are taught such as relaxation using self-coping statements such as ‘stop worrying, because it’s pointless’.
* Application and follow-through, here a patient practices stress reduction techniques in role play, and then uses them in real life. Meichenbaum (1977) compared stress inoculation with desensitisation (a form of learning therapy where patients learn to relax with their feared object). Patients had both snake and rat phobias, one of which was treated with one of the methods. Meichenbaum found that both methods were effective but stress inoculation also greatly reduced the non-treated phobia, showing that the patient had learned general strategies for coping with anxiety.
Stress inoculation therapy is good for coping with moderate stress but not as effective for severe stress. Not all individuals are able to use this method effectively Kobassa (1986) suggested that people who were psychologically hardy find it easier to cope with stress. Hardiness training consists of three techniques:. Focusing: people are often unaware they are stressed, so they should become more aware of the signs of stress, such as tight muscles.
Reconstructing stress situations: think of a stressful situation and write down how it could have turned out better or worse. Compensating through self-improvement: find tasks that can be mastered. This reassures you that you can cope. Sarifino (1990) claimed that people following such a program report feeling less stressed, and having lower blood-pressure than before. Some people find this sort of strategy doesn’t work. It requires considerable effort and determination which are the characteristics of a hardy person.