Programs for Coping with Stress and Promoting Health

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Promoting Healthy Behavior
2. Contemplation. A problem behavior has been identified and the person is
seriously thinking about changing it.
3. Preparation. The person has a strong intention to change and has made specific
plans to do so.
4. Action. The person is engaging successfully in behavior change.
5. Maintenance. The healthy behavior has continued for at least six months, and
the person is using newly learned skills to prevent relapse, or “backsliding.”
The road from precontemplation through maintenance can be a bumpy one
(Prochaska, 1994). Usually, people relapse and go through the stages repeatedly until
they finally achieve stability in the healthy behavior they desire (Polivy & Herman,
2002). Smokers, for example, typically require three to four cycles through the stages
over several years before they finally reach the maintenance stage (Piasecki, 2006).
Programs for Coping with Stress and
Promoting Health
TAKING TIME OUT The workplace is
the number one source of stress for many
people. On January 1, 2000, Raymond
Fowler, who was then chief executive officer of the American Psychological Association, joined the ranks of those whose
elevated blood pressure, heart problems,
and other physical stress responses required a leave of absence from stressful
jobs (Fowler, 2000). The National Institute
for Occupational Safety and Health (1999)
suggests a wide range of other behavioral coping options for stressed employees who cannot afford to take time off.
You can view this advice online at
http://www.cdc.gov/niosh/stresswk.html.
LINKAGES
How can people manage
stress? (a link to Treatment of
Psychology Disorders)
An important part of health psychologists’ health promotion work has been to improve
people’s stress-coping skills (e.g., Keogh, Bond, & Flaxman, 2006). Let’s consider a few
specific procedures and programs associated with this effort.
Just as people with extra money in the bank have a better chance
of weathering a financial crisis, those with effective coping skills have a better chance of
escaping some of the more harmful effects of intense stress. Like family money, the ability to handle stress appears to come naturally to some people, but coping strategies can
also be learned. Programs for teaching these strategies include several stages, which are
summarized in Table 10.4.
Bear in mind, though, that no single method of coping with stressors is right for
everyone or every stressor. For example, denying the existence of an uncontrollable
stressor may be fine in the short run but may lead to problems if no other coping
method is used. Similarly, people who rely entirely on active, problem-focused coping
might handle controllable stressors well but find themselves nearly helpless in the face
of uncontrollable ones (Murray & Terry, 1999). The most successful stress managers
may be those who can adjust their coping methods to the demands of changing situations and differing stressors (Taylor, 2002).
Planning to Cope
Developing Coping Strategies Strategies for coping with stress can be cognitive, emotional, behavioral, or physical. Cognitive coping strategies involve changing the
way we think. These changes include thinking more calmly, rationally, and constructively in the face of stressors and may lead to a more hopeful emotional outlook. For
example, students with heavy course loads may experience anxiety, confusion, discouragement, lack of motivation, and the desire to run away from it all. Frightening,
catastrophizing thoughts (such as “What if I fail?”) magnify these stress responses.
Cognitive coping strategies replace catastrophic thinking with thoughts in which
stressors are seen as challenges, not threats. This substitution process is called cognitive
restructuring (Lazarus, 1971; Meichenbaum, 1977). It involves first identifying
upsetting thoughts (such as “I’ll never figure this out!”) and then developing and practicing more constructive thoughts to use when under stress (such as “All I can do is
the best I can”). Cognitive coping doesn’t eliminate stressors, of course, but it can help
us to perceive them as less threatening and therefore less disruptive (Antoni et al.,
2000; Chesney et al., 2003).
Seeking and finding social support are effective emotional coping strategies. As
mentioned earlier, feeling that you are cared about and valued by others can be an
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Chapter 10 Health, Stress, and Coping
effective buffer against the ill effects of stressors, leading to enhanced immune
functioning (Kiecolt-Glaser & Newton, 2001) and quicker recovery from illness
(Taylor, 2002).
Behavioral coping strategies involve changing behavior in order to minimize the negative impact of stressors. Time management is one example. If it seems that
learn you are always pressed for time, consider developing a time management
by
doing plan. The first step is to use a calendar or day planner to record how you
spend each hour of each day in a typical week. Next, analyze the information to locate
when and how you might be wasting time and how you might use your time more efficiently. Then set out a schedule for the coming week and stick to it. Make adjustments
in subsequent weeks as you learn more realistic ways to manage your time. Time management can’t create more time, but it can help control catastrophizing thoughts by
providing reassurance that there is enough time for everything and a plan for handling
everything you have to do.
Physical coping strategies can be used to alter the undesirable physical responses that
occur before, during, or after the appearance of stressors. The most common physical
coping strategy is some form of drug use. Prescription medications are sometimes an
appropriate coping aid, especially when stressors are severe and acute, such as the sudden death of one’s child. However, people who rely on prescribed or nonprescription
drugs, including alcohol, to help them face stressors may come to believe that their coping success is due to the drug, not to their own skill. This belief can make people more
and more psychologically dependent on the drug. Furthermore, the drug effects that
blunt stress responses may also interfere with the ability to apply coping strategies. The
resulting loss of perceived control over stressors may make those stressors even more
threatening and disruptive.
Nonchemical methods of reducing physical stress reactions and improving stress
coping include progressive relaxation training (Bernstein, Borkovec, & Hazlette-Stevens,
2000; Scheufele, 2000), physical exercise (Anshel, 1996), biofeedback (Sarafino &
Goehring, 2000), and meditation and tai chi (Carlson et al., 2003; Davidson et al., 2003;
Li et al., 2001), among others (Taylor, 2002).
“In Review: Methods for Coping with Stress” summarizes our discussion of stresscoping methods.
2
DEALING WITH CHEMOTHERAPY
in review
Progressive relaxation training involves
briefly tensing groups of muscles
throughout the body, one at a time, then
releasing the tension and focusing on the
resulting feelings of relaxation. It can be
used to ease a variety of health-related
problems, including the anxiety, physiological arousal, and nausea associated
with cancer chemotherapy (Bernstein,
Borkovec, & Hazlette-Stevens, 2000).
METHODS FOR COPING WITH STRESS
Type of Coping
Method
Examples
Cognitive
Thinking of stressors as challenges rather than as threats;
avoiding perfectionism
Emotional
Seeking social support; getting advice
Behavioral
Implementing a time-management plan; where possible,
making life changes to eliminate stressors
Physical
Progressive relaxation training; exercise; meditation
?
1. Catastrophizing thoughts are best overcome through
coping strategies.
2. The first step in coping with stress is to
the sources and effects of your
stressors.
3. True or false: It is best to rely on only one good coping strategy.