A Practical Approach to Stress Management

By Nuala Cadwell, FTNI, R.T.Cert., MIACT

Our bodies, minds and spirits thrive on a well balanced diet of stimulation and relaxation but can respond negatively when under or over extended. Some people gravitate towards one of these polar extremities while others swing to and fro trying to find homeostasis. As this balancing act is an ongoing life challenge, the secret to happiness may lie in the enjoyment of achieving this balance through continual practice.

By learning and using some skills to combat dysfunctional stress we can enhance the likelihood of maintaining a more effectively balanced lifestyle. To do this we need to:-

  1. 1.      Understand the Nature of Stress.
  2. 2.      Increase Awareness of Causative Factors.
  3. 3.      Compile a Practical Skills Inventory.
  4. 4.      Set Realistic Goal Objectives.


The distinction between “stress” and “strain”, defined by Thompson in his book, “Stress & How to Live With It”, was a catalyst that broadened my own perceptual field, giving me a useful insight into the role stress plays in our lives. Thompson defines “stress” as an acceptable pressure in our lives and “strain” as the response we experience to untenable “stressors” that cause damage and even destruction to our system. From this perspective “stress” connotes an essential component of a healthy lifestyle and “strain” the dysfunctional state that can develop from over or under arousal.


Learning to recognise the signals of distress that we use to alert us to “strain” is an important step in developing the skills to maintain stress to a manageable level. Situations causing severe strain can be tolerated and ignored for long periods of time because of a lack of sensitivity to what our systems – physical, mental and emotional, need to stay healthy. Insensitivity to our needs, a lack of knowledge or misinformation as to how to meet these needs all contribute to the escalation of “strain” on a cumulative scale.

Fear of the unknown consequences of changes in behaviour can even interfere with a willingness to identify causative strain factors. Even when people recognise their behaviour as unhealthy and damaging, they often choose to stay with “the devil they know” rather then risk change. Change is a constant in life so in order to maintain the same direction, we expend a lot of energy. This energy could be better utilised sometimes by moving in a different direction.

The three “A’s”, Attitude, Awareness & Acceptance are initial steps on the journey towards effective stress management.

Attitudinal change towards risk taking, even on a small scale can be the initial directional shift that frees people towards attempting behavioural change that can lessen overall strain.

Awareness of causes can help identify what stressors can be eliminated or altered and lead to an acceptance and tolerance for what cannot be changed. Identifying the causes of strain and assessing what can be alleviated and what has to be accepted – at least for now – can be a freeing experience in itself. We can learn to live with problems in a different way. A change in attitude can greatly alleviate the weight of a burden and allow different possible solutions to emerge.

Society pressures

Although people are extremely adaptable the speed of change required to continually readjust today needs serious consideration when examining the relationship between stress and strain for the individual as well as the collec­tive whole.

Demands put on social structures and the economy to meet rapidly expanding needs, i.e. housing, education and health care, from rapid population growth in urban areas and decrease of youth population in rural communities.

Large numbers of people forced to move from their geographical, social and economic roots, because of rehousing or job mobility demands, resulting in the breaking up of previous powerful support structures into small isolated units generating great loneliness particularly among the most vulnerable members of society.

Lack of employment and job security due to restructuring of existing organ­isations because of the need to modernise equipment or due to economic pressures.

Widening of the gap between knowledge and experience between one generation and the next has occurred because of scientific development in many occupations and with the ease and speed of universal media com­munication. The status and knowledge that traditionally resided in age and experience now belongs to the younger generation. Even today’s technological skills become rapidly outdated, exerting pressure on young people to keep pace with changing technological advances.

Traditional values and beliefs that governed behaviour in settled communi­ties are being opposed and challenged on a wider scale than ever before (eg. religion, gender). This adds to the lack of stability in the fabric of people’s lives. Where previously there were answers, there are now more and more questions which can lead to insecurity. Young people in particular need some predictability to develop a sense of their individuality.

Conditioned patterns of behaviour required to live within society

Conditioned learned behaviour includes:-

1. Rules of behaviour that are learned early in life to fulfil societal expecta­tions around gender, class, race and creed.

2. Accommodations demanded to fit into societal mode at all of life’s transi­tional phases.

3. Cultural imperatives (expectations of behaviour, eg. work)

4. Competitive compulsions towards a success identity or the counter trans­ference of maintaining an opposing stance.

Personality and behavioural choices

Temperamentally we are all different. Some people thrive on challenge and others avoid it. Many of the values, beliefs and attitudes that influence our choice of behaviour are absorbed from early life experiences. Trust and con­fidence engendered early in life lead to a resilient attitude and optimistic pre-disposition which is a good preparation for developing effective stress coping strategies in later life.

Lack of stimulation

Overworking is easily identified in today’s society as a major cause of “strain”. Today consideration must be also given to the danger zone of “under-arousal”. Some situations particularly vulnerable to this occurrence are:-


Unemployment and the predictability of working until retirement is no longer a certainty. Urbanisation has eroded the network of community support that previously existed for many people leading to intense isolation. Efforts are being made by groups in society to counteract this trend, but individually people need to shoulder the responsibility to improve their own situations by learning the skills needed to alleviate the stress of modern living and personal dilemmas.

Chronic disability

Coping with chronic illness and physical disability is another situation where people can be exposed to strain by lack of stimulation. This is an example of a time when change to the fundamental problem seems beyond control. Here a change in attitude and beliefs can be explored and an increase in stress tolerance levels reached by finding ways to create stimula­tion and challenge that encourage the alleviation of emotional and mental strain, thus lessening the overall accumulation of stress in the system.


It is important to realise that our threshold tolerance to stress is not a given constant. Developing coping strategies that help desensitise our personal “trigger” points can extend stress tolerance. Sport psychology is based on this principle. More and more athletes are attaining feats not thought possible before, by practice, perseverance and a positive belief in their ability to do better. However, it is important to develop an awareness of what is right for us and not force the pace of change beyond what is functional for ourselves. Pain and strain can function as the “brakes” of nature and caution must be taken to work within realistic limitations while also realising that these limitations can be stretched and extended with patience, time and practice.

Some skills that can help to combat stress effectively include:


Mostly our awareness is directed to the outside world. However, the body registers stress long before the conscious mind does, so increased body aware­ness is an important step towards stress reduction.

It can be used as an indicator to stress tolerance and as the key to unlock the door to stress reduction.

Our physical, mental and emotional functions are inter-related. Relaxation can help access these on both conscious and unconscious levels. How tension on a physical level can influence our view of the world is a common experi­ence to which most people can easily relate. The accumulation of chronic muscular tension resulting from dysfunctional beliefs and attitudes held over time is often a more sub-conscious process. Because of the inter-relation­ship of our total behavioural system, relaxation on a physical level can help alleviate tension in our emotional and mental processes and vice versa.

Relaxation signifies the absence of tension in the body. When functioning at optimum level, it is the body’s automatic response to restore equilibrium after periods of expending effort. Deep muscle relaxation reduces physiolog­ical tension. It lowers blood pressure and slows heart rate, while respiration functions become deeper and more rhythmic, increasing oxygen intake by the blood and expelling toxic gases, feelings of warmth and well being suffuse the body and a sense of peace and harmony prevails. This state is incompatible with the anxious or depressive states of strain. Learning to relax at will increases voluntary control over physical and emotional func­tions so it is a useful resource in effective stress management.

Progressive relaxation techniques can help people learn to distinguish the difference between the feeling of body tension and that of relaxation. It can also increase conscious awareness of areas where tension is stored in the body so people become familiar with their own areas of susceptibility and can concentrate on relaxing in these areas when translating practice into action in situations likely to induce stress and tension. An example of this could be consciously breathing more deeply and relaxing shoulders when driving in heavy traffic. Translating knowledge into action by practice is an essential ingredient when developing relaxation skills. The more the skills learned are put into practice, the easier it becomes to integrate them into life situations and reap their benefits. For skills to work, competence has to be developed and put to use.

Relaxation is a rewarding and invigorating experience that can pay dividends with minimal effort: it joins easily with and underpins many other stress combating skills. It can be learned individually or in a group setting. It is often practised to restful background music or directions on tape that takes responsibility for guidance of a session out of the hands of the partici­pants, leaving them free to concentrate on giving themselves permission to relax. This permission from the participant to themselves is an essential ingredient that nobody else can supply. When people realise that they con­trol this permission, even subconsciously, it can help them to relax more completely.

Breathing is essential to life. Stressed respiration becomes shallow and rapid, this can be functional in emergency situations but can exacerbate stress symptoms in the long term.

Learning to regulate respiration rhythm enhances the capacity to manage stressful situations effectively. Again, the profound effects of increased lung capacity and breath control are cumulative and benefits are proportional to the patience and persistence invested.

Creative visualisation

Imagination is a powerful natural resource that can be harnessed to combat stress. Visualisation means using imagination in a three dimensional way incorporating all our senses to heighten awareness.

It is easier to imagine something happening than to will ourselves to make it happen. Visualising a positive outcome to events can help overcome irrational fears and reduce anxiety. It has been found to be effective in the treatment of physical illness and disease as well as assisting stress reduction in other situations. I have found it to be an effective “active” relaxation tool for people who find other methods of relaxation difficult to achieve as it occupies the creative parts of the brain accessing this pathway to the subconscious while allowing the rational parts to “switch off”. It can be used to promote positive orientation towards life and achieving success in desired endeavours. The basic visualisation techniques include four steps:-

1. Relaxation and release of muscle tension.

2. The formation of mental impressions using all the senses.

3. The use of affirmations in the present tense , i.e. short positive statements that affirm a desire you have.

4. Allowing the energy of the subconscious to connect to the collective energy of the universe by letting go and trusting events to harmonise in a positive configuration.

Thus, one is opened opened up to growth and change by welcoming any increased awareness that follows and being willing to follow any intuitive urges that emerge.

Expressing feelings

Expressing how we feel is a natural healing process and essential to healthy human functioning. Many people are inhibited about expressing feelings both positive as well as negative ones, and this can increase stress levels. When we experience hurts and are denied the opportunity to express how we feel, we develop rigid behavioural patterns that hold the trauma in place. Emotional discharge of distress experiences, eg. loss or anger, helps heal the hurt and reinstate the possibility for flexible behavioural choice. This dis­charge refers to non-repetitive recounting of experiences as well as to crying, trembling, raging, laughing and yawning. The latter is particularly useful when recovering from physical hurts. Expressing our feeling to another person helps break the isolation that can be a combination factor in many original traumatic experiences. Even when sharing is not an option, admitting feelings to ourselves can help the healing process. Claiming responsibility for our feelings and expressing them to others is very different from dumping feelings onto others.

The latter causes trauma to others and does not help the “dumper” to take responsibility for their own behaviour. This inhibits learning and growth for both. Laughing therapy is now being developed in the U.S. as experiencing happy feelings physiologically improves the body’s ability to combat stress.

Positive Attitude

“Attitude” refers to the way we mentally look at the world around us. It influences the focus taken on life, i.e. one’s perception of situations in the past and present and one’s expectations for the future. An optimistic outlook can help improve personal performance levels and enrich relationships. Good relationships are a basic factor in the recipe for a quality life.

Taking control

We can control our lives by choosing behaviour that helps harness the energy of stress. Keeping stress at a productive level requires regular self-evaluation of the behavioural choices made as well as adding new skills to an existing repertoire.

To avoid the danger zone of strain from lack of balance, these choices must satisfy the basic areas of need to a comprehensive level – those of loving and being loved, self-worth and achievement as well as those of freedom and fun. Stress from over fulfilment of work needs, as happens with workaholics, can lead to neglect of relaxation and fun needs or to lack of care to physical well being.

Relating Assertively

Assertive behaviour is active, direct and honest. It communicates both respect for self and others without hostility. It deals with one’s own feelings and those of others with a focus on active listening and negotiation skills that leads to successful encounters without retaliation.

Systemic Awareness

Systemic thinking views people as embedded in a structure of relationships that influence behaviour. These relationships often induce symptoms of stress which can be carried by a person not directly involved in the conflict. A common example of this is found in the tnangulation of a child into the covert emotional conflict between parents who will exhibit symptoms to distract attention from the unresolved parental tensions. Triangulation can occur in systems other than the family, eg. work systems. Systemic interven­tions help people look at situations from a broad focus and from new perspectives that promote a different understanding of events. This can alleviate stress by empowering people to re-establish appropriate bound­aries.


Just as a map can help us find our destination more easily, so too can clear objectives point us down the path of action in life and help maintain our focus to achieve goals set.

Guidelines to goal setting include:

(1)    Start with small achievable steps with short term goals aimed towards attainable achievement which will increase confidence.

(2)    Celebrate achievements and share them with others.

(3)    Review progress and sift valid reasons for lack of attainment from excuses when goals are not reached. Allow for flexibility to change focus if original objectives are no longer appropriate.

(4)    Long term goals can include visions and ideals as this inspires effort beyond present limitations. Here focus on the essential goal rather than details and enjoy allowing them to materialise rather than exerting strenuous efforts to make them happen.

(5)    Build a mind picture of what you would like to achieve using weekly, monthly, yearly and even five to ten year time sets. Focus on the areas that are important to you and on what success would mean to you.

(6)    Share your goals with people who encourage and support you. Tell people your long term dream as if it were going to happen tomorrow or even try writing it down like a story. This makes ideals seem more con­crete and attainable.

There is much more to be said about stress management (diet and time management are two areas not covered here) I hope this article will “whet the appetite” and encourage people to seek the information they need to manage their own particular life circumstances to combat stress and bring more enjoyment and fulfilment into their lives.

Recommended Reading

1. Bradshaw J., The Family 1988, Health Communications Inc., U.S.A.

2. Chapman E.N., Stay Positive 1992, Crisp Publications Ltd., U.S.A.

3. Dallos R., Family Belief Systems, Therapy and Change 1991, St. Edmundsbury Press, England.

4. Davis M., Robbins Eshelman E. & McKay M.,  The Relaxation and Stress Reduction Workbook 1988, New Harbinger Publications Inc., U.S.A.

5. Gawain Shakti Creative Visualisation 1982, New World Library, U.S.A.

6. George E., Iveson C, and Ratney H. Problems to Solutions 1990, Brief Therapy Press, London, England.

7. Goliszek Dr. A., 60 Second Stress Management 1993, Bantam Books, Great Britain.

8. Hanson D. P., Stress for Success 1989, Collins Publishers, Canada.

9. Livingston Booth Dr. A., Stressmanship 1985, Severn House Publishers Ltd., England.

10. Lloyd S.R., How to Develop Assertiveness 1988, Crisp Publications Ltd., U.S.A.

11. Thompson Dr. Stress and How to Live With It 1987, Arlington Books Ltd., London, England.

Nuala Cadwell has been working in the field of therapy and counselling for over twenty years in both the voluntary sector and as a private practitioner. Initially trained as a physiotherapist she is particularly interested in the stress caused to individuals and families by physical illness and disability. She has trained as a Reality Therapist and a Systemic Family Therapist and now works in private practice in Connect Associates, Blackrock, Co. Dublin.