59.9 F

Stress Management and Emotional Health


When appropriately applied, stress management training can reduce the degree and intensity of your current stress reactions and help you develop skills for preventing additional, harmful stress reactions.

Concepts of stress management training Stress reactions take five general forms:

–Subjective experience of distress, as in feeling tense, anxious, worried, harassed

–Physical symptoms in response to stress, such as raised blood pressure, tension headaches, upset stomach

–Responding to stress with unhealthy habits, such as smoking, overeating, and overdrinking

–Suffering deterioration in performance

–Increased conflicts with people or decreased satisfaction in personal relationships

To reduce stress, you must be able to:

–Be aware of initial signs of stress reaction

–Develop basic stress management skills

–Be able to apply the stress management skills in real life

Stress management skills include:

–Relaxation through deep breathing techniques, relaxation imagery, tension-relaxation contrasts, cue-controlled relaxation, and biofeedback

–Cognitive techniques–Review your attitudes and values, restructure your thinking, set goals, use positive imagery, rehearse mentally, schedule

–Behavioral changes to better manage interpersonal situations and distress

–Check your assumptions, share your expectations with others, be assertive, exercise and consume sensibly

–Relationship review

–Review past hurts, forgive, communicate feelings, listen, reward

General procedures in stress management training
–Develop an awareness of your stress reaction and its early signs

–Learn a relaxation skill that you adopt as your own

–Learn to apply the relaxation skill when the first signs of stress develop

–Master abdominal breathing techniques

–Expose yourself to simulated stressors so you can practice your skills in real-life situations

–Practice at home by using a video or audiotaped relaxation and/or imagery program

–Practice transferring stress management skills to real-life situations

–Develop behavioral strategies to prevent stress reactions and to reduce the frequency of stressful situations.

–A thorough assessment of life stressors and coping skills is essential for the development of an effective stress management plan for any given individual.

* J. Melvin Witmer, Professor, School of Applied Behavior Sciences and Educational Leadership. Ohio University, Athens, Ohio. March 1979.

Betty Yorde, Ph.D., Counseling, Stress Management and Biofeedback Associates, Nelsonville Professional Building, 370 Popular Street, Nelsonville, Ohio, March 1979.

Brief bibliography of self-help books
1)Burns, D.D., Feeling Good: The New Mood Therapy. Signet: NY, NY, 1981.

2)Davis, M., McKay, M., and Eshelman, E.R. The Relaxation and Stress Reduction Workbook. New Harbinger: Richmond, CA, 1980.

3)Farquhar, J. The American Way of Life Need Not Be Hazardous to Your Health. Standford Alumni Association: Stanford, CA, 1978.

4)McKay, M., Davis, M., and Fanning, P. Thoughts and Feelings: The Art of Cognitive Stress Intervention. New Harbinger: Richmaon, CA, 1981.

5)Woolfolk, R.L., and Richardson, F.C. Stress, Sanity and Survival. Monarch: NY, NY, 1978.

6)Benson, Herbert, The Relaxation Response.

7)Hymans, Joe. Zen in the Martial Arts.

Breathing Exercises
Deep Breathing:
Imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air.
Let the air fill you from the abdomen up, then let it out, like deflating a balloon.
With every long, slow exhalation you feel more relaxed.

Rhythmic Breathing:
–If your breathing is short and hurried, slow it down by taking long, slow breaths.

–Inhale slowly, then exhale slowly.

–Count slowly to five as you inhale, then count slowly to five as you exhale.

–As you exhale, pay attention to how your body naturally relaxes.

Stress Management: Ten Ways to Ease Stress
–Eat and drink sensibly

–Assess yourself

–Stop smoking

–Exercise regularly

–Study and practice self-control techniques

–Take responsibility for feelings

–Reduce stressors

–Explicate your values and live by them

–Set realistic goals and expectations

–Sell yourself; have self-esteem

Stress Indicators*
Physical/Behavioral; Emotional/Social; and Intellectual Response to Stress (May be causal or related factors)

Physical or Behavioral

Accident prone Alcohol or drug abuse

Allergies Appetite (loss or increase)

Arthritis Backaches Breathing difficulties
–shallow breathing
–shortness of breath

Bruxism (teeth grinding/at sleep)

Chest tightness Cholesterol (high)






Dry mouth

Eye pain

Eye squinting

Face downcast

Face flushed

Fainting spells


Fingernail biting

Forehead, raised and wrinkled


Gait slowed


Grinding teeth

Hair twisting

Hands cold

Hay fever

Heart rate increased

High blood pressure

Hive, rash, itching Hypermotility (can’t sit still)




Low resistance to infection and minor illness

Migraine headaches

Muscle tightness, face, jaws, back of neck shoulders, etc.



Numb or tingling extremities


Pounding and rapid heart beat

Premenstrual cramps

Premenstrual tension

Pupils dilated

Sexual disinterest Shaking

Skin pale

Sleeping too much

Shoulders raised


Slumped posture


Speech slowed



Stomach butterflies

Stomach gas

Stomach ulcer


Sweaty palms



Tension headaches


Trembling, tics, twitching

Urinating frequently

Voice: change in pitch volume, shaky


Weakness, especially in legs Weight gain Weight loss

Emotional or Social


Anger or angry outbursts

Anxiousness; general or specific

Blaming others

Critical of self



Difficulty in relationships


Emotional instability

Fear of groups or crowds

Fears–general (please name)

Guilt feelings


Impulsive behavior




Lack of initiative

Loss on interest in living

Loss of self-esteem





Withdrawal from relationships

Worthlessness feeling


Concentration difficulties

Errors in judging distance

Errors in language (grammar, enunciation, pronunciation)

Errors in use of numbers

Fantasy life increased (escape)

Fantasy life lessened



Lack of attention to details

Lack of awareness to external events

Loss of creativity

Mental blocking

Over attention to details

Past-orientated rather than present or future



Thoughts of death or suicide Worrying

© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.

Content is from The Cleveland Clinic Foundation

You can read more health information at their website, http://my.clevelandclinic.org/

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