Stress Management & Resilience

It may seem that more people than ever are feeling stressed, and that perception may actually reflect the reality that more people, in fact, are experiencing higher levels of distress. Studies show that anxiety disorders are up to 28.3% globally and that prevalence rates of anxiety disorders have been increasing over time (as cited in Kim & Kim, 2018). It’s not hard to think of stressors contributing to this distress, including but not limited to pandemic ramifications, a changing workforce atmosphere, relationship breakdowns, chronic loneliness, family dysfunction, systematic oppression domestically and abroad, and environmental concerns, to name only a few. In this article, you’ll find information about what stress is, how it impacts us, and some strategies that can help us navigate stress. It is important to note, however, that the aim of this article is not to convince you that psychotherapy or the following stress management strategies are the answer to widely threatening global events but to affirm your agency in finding ways to keep moving forward. We are inspired by Viktor Frankl’s words that “everything can be taken from a man but one thing: the last of human freedoms - to choose one's attitude in any given set of circumstances, to choose one's own way” (Frankl, p. 65). Our hope is that this article helps you understand your stress better and try some strategies to take care of yourself and choose your own way.

So what is stress?

In academic terms, stress has been defined as “the subjective state of sensing potentially adverse changes in the environment” that “signifies a potential or actual threat that requires immediate changes in behavior as well as a modification of future behaviors” (Joëls & Baram, 2009, p. 459). In our terms, stress is a cognitive, emotional, and physiological response to a perceived threat to our wellbeing and safety. What this means is that stress impacts us on multiple levels, from our thinking to our emotional experiences to our physical sensations when we encounter a stressor.

Stress, and our compensatory responses to stress, are part of everyday life. Some stressors originate from extrinsic sources like in the case of ongoing discriminatory practices at work, whereas other stressors originate from intrinsic sources like in the case of anxiousness, worry, and low self-esteem. Oftentimes, negative stressors, like in the event of the sudden death of a loved one, are easily noticed due to the marked disturbances in emotional, physical, and psychological functioning as well as the potential long-lasting implications of such stressors. Importantly, we may tend to overlook the impact of positive situations that evoke stress (e.g., having a baby, planning for a wedding), likely due to the short-term and temporary nature of the stressor but also because the marked disturbance in functioning may manifest as increases in excitement and motivation rather than elevated levels of anxiety and a reduction in productivity, for example. As illustrated in these examples, stressors can be acute (i.e., short-term), chronic (i.e., long-term), or even episodic (i.e., cyclical and reoccurring). Moreover, our responses to stress may be determined based on whether or not the stressors stem from what is considered a normative pattern of development (e.g., forming a family, establishing a career; Wrosch & Freund, 2001). It seems reasonable to believe that when stressors are non-normative, it will require a greater degree of adjustment and self-regulation as compared to stressors that stem from expected life events and transitions.

How does our stress impact us?

When you think about the impact of our stress responses on our bodies, minds, and lives, please consider that our responses to stress are intended to be adaptive. For example, when we face an imminent threat to our physical safety, having a higher heart rate helps to deliver oxygen-rich blood to our muscles more quickly. In turn, faster breathing helps bring in more oxygen to our bodies and muscle tension helps to warm up our muscles to move more efficiently and quickly. Even gastrointestinal distress felt during periods of stress can sometimes be the result of gastrointestinal activity decreasing to prioritize resources for other bodily functions aimed at helping us respond to a threat. In addition to physiological responses, we also experience cognitive and emotional responses. For example, increased cognitive focus on problem-solving rather than relating to others is meant to help us concentrate on the problem at hand and an emotional response, such as anxiety, fear, anger, or guilt, can signal to us that there is a problem to be addressed.

That said, even though these responses that we have to stress are meant to be helpful, they can also make it difficult to function if they get in the way of being present, sleeping, eating, moving our bodies, and connecting with others. Chronically having difficulty sleeping, eating, moving, focusing on other aspects of our lives besides stressors, and connecting with others can have major impacts on our physical and mental health. Even difficulty connecting with others can have significant implications for longevity. In fact, according to a 2015 meta-analysis “encompassing seventy different studies and over three million research participants from around the globe.... social isolation and loneliness increased a person’s odds of an early death by 25 to 30 percent.” (Nagoski & Nagoski, 2019, p. 134). Chronic loneliness has even been described as “having the same impact on mortality as smoking fifteen cigarettes a day.” (Burnout, p. 134). This supports the idea that not only do we experience a variety of stressors, our responses to the stressors can themselves cause more stress when our needs aren’t met as a result.

What can we do about that?

When discussing stress management strategies, it’s important to note that because the causes of stress and anxiety are diverse, a comprehensive strategy addressing many of the causes and maintaining factors is key. That being said, there are two themes that may be able to address at least some of these causes: mindfulness and physical relaxation.

Why do we think these may be helpful? Naturally, the mind will focus on the most visible triggers of our stress, which is meant to be helpful with problem-solving, but new problems arise when these stressors are chronic or long term because our own needs may be put on the backburner to focus on the stressors as a result. With that in mind, our first recommendation is a practice of mindfulness to disengage from unhelpful problem-solving and check in with yourself and your needs. How do I even start, you may ask? Great question. The first mindful strategy we like to share with our clients is a popular grounding technique involving all five of your senses. It’s often called the 5-4-3-2-1 grounding technique because the idea is you mindfully acknowledge a number of things you can sense using the numbers 5, 4, 3, 2, and 1.

Here’s how it works: First, begin with acknowledging FIVE things you can see. Next, take some time to acknowledge to yourself FOUR things you can physically feel. After that, move on to acknowledging THREE things you can hear. Next, acknowledge TWO things you can smell. And finally, acknowledge ONE thing you can taste. This may or may not be a quick exercise. Practice a healthy dose of grace for yourself as it gets harder and harder to identify some things our senses are taking in. Consider the time it takes you to tune into what your senses are taking in, like a TV antenna tuning into the signal. Once you have been able to practice this grounding, we would invite you to turn your attention inward to your own body and internal experiences. A progressive scan of how the different parts of your body feel may help you recognize some needs that may not currently be met. Some of these needs may include a need for exercise, connection, sleep and rest, and nutrition and water.

Why is this important? And what happens if you are having a hard time regularly tuning into your own body’s needs? Time and again, there are emotional and cognitive barriers that can make it difficult for us to prioritize our own needs. We may be automatically ignoring our needs to prioritize other demands in our lives. Again, we call this unhelpful problem-solving because it ultimately comes at the cost of important bodily needs and we may suffer physically and emotionally as a result. Authors of Burnout: The Secret to Unlocking the Stress Cycle Emily and Amelia Nagoski have provided a useful approach that can help us reframe some thinking surrounding our needs by posing the visualization, “imagine that your body is the body of someone who needs your care, like an infant.” (Nagoski & Nagoski, 2019, P. 125). If we were to imagine this, we can then ask ourselves, how would we respond if these needs were coming from a child? And maybe a better question is, “would we say ‘you don’t deserve to rest or go to the bathroom yet’ or ‘suck it up a little longer?’” If you’re willing to practice this and would like a little more focus on what to look for, some needs that may arise include the needs for: rest/sleep, movement, connection, nutrition/water, and bathroom needs. We would encourage you to try this and see if your response to your needs may be different, and if so, how you might feel over time when you meet your body’s needs. Our prediction is you may feel a reduction in some of the stress generated by your body’s unmet needs.

The second strategy is practical and has many benefits universally. Studies show that there is a large body of evidence supporting the efficacy of relaxation strategies when used for anxiety disorders (Kim & Kim, 2018). Why do they help? Using relaxation techniques to trigger the relaxation response, which is said to be the exact opposite of the physiological state our bodies are in when experiencing stress or panic, can help the body generally be in a calmer, more relaxed state. Even though researchers are still trying to learn exactly why deep relaxation is so effective (Dusek et al., 2008), the idea is that it’s much harder to have an anxious mind in a calm body. Some strategies for reducing physical tension include abdominal breathing and progressive muscle relaxation.

One of our favorite abdominal breathing techniques comes from Edmund Bourne’s seventh edition of The Anxiety and Phobia Workbook. In it, Bourne includes an exercise in which one practices deep breathing in sets of ten, counting down backwards from ten all the way down to one. Bourne’s recommendation is to repeat each set of ten deep, abdominal breaths two or three times. When inhaling, make sure to breathe through your nose and allow your abdomen to rise and expand in order to fill your lungs as much as comfortably possible. Following a rich, deep inhale, breathe out through your mouth slowly, as though releasing the air gently from a balloon.

Progressive muscle relaxation is also part of the deep relaxation strategy “family.” Progressive muscle relaxation, or PMR, is meant to target tension in the body that one may not even be aware of but that may still be contributing to one’s overall stress. To engage in PMR, begin by getting in a comfortable position and closing your eyes or lowering your gaze. Start off with some deep breathing, allowing your abdomen to slowly rise and fall with each inhale and exhale. Beginning at your feet, tense the muscles in your feet and calves as much as you can without straining. Hold this tension for ten seconds and then release all of the tension all at once. This is not a slow release but a quick letting go of all tension. Moving from your feet and calves up to your upper legs, continue to practice tensing the muscles and releasing. If you feel any pain, discontinue tensing in that particular area. From your upper legs, continue this process muscle group by muscle group, up to your pelvic area, abdomen, chest, back, arms, shoulders, neck, and facial muscles.

How do we build resilience to stress?

So, the above are practical strategies to tune into and manage some stress, but how can we build resilience to stress? Resilience refers to one’s ability to withstand and recover from trauma, stress, and other challenges using a combination of personal, environmental, and relational resources (e.g., Hu, Zhang, & Wang, 2015; Unger & Liebenberg, 2011). Researchers at the Positive Psychology Center at the University of Pennsylvania have developed the Penn Resilience Program (Penn Resilience Program, 2024), which targets resilience skill building in the following areas:

• Self-awareness: paying attention to thoughts, emotions, behaviors, and physiological reactions
• Self-regulation: managing and moderating thoughts, emotions, behaviors, and physiology
• Mental agility: the ability to look a things from different perspectives
• Strengths of character: using personal strengths to engage authentically with challenges in ways that align with personal values and beliefs
• Connection: building and maintaining secure relationships
• Optimism: focusing on the positive and what you can control

In addition to these components of resilience, self-compassion is also an important part of building resilience. Dr. Kristen Neff has described self-compassion as a way of turning toward ourselves in times of suffering that is characterized by increased kindness and reduced self-judgment, increased recognition of our common humanity and decreased social isolation, and greater mindfulness and less overidentification with our thoughts and feelings (Neff, 2003a; Neff, 2003b). When we use self-compassion as a strategy to turn toward our suffering, we can actually begin to soothe the fight-flight-freeze response that our body naturally goes into to cope with stress, and, instead, enter into a caregiving response that is helpful in regulating our thoughts, emotions, and our body. So, how do we do this? Well, first, in order to experience compassion, you have to actually notice that you’re in a moment of suffering (mindfulness), and if your response is one of compassion rather than pity, you understand that suffering is something that we all feel—a part of our shared human experience (common humanity). Finally, you respond to yourself, much in the same way you might respond to a friend who is suffering, with understanding, warmth, care, and kindness such that you’d like to help yourself in some way (loving kindness). This process is one in which you’ve identified your needs and can use your skills and resources, both internal and external, to approach the stressor in a kind and courageous way.

Our parting thoughts

Much can be written about managing stress, including managing highly impactful stressors outside of our control, and this article is only a drop in the bucket of the resources that already exist. Our hope is that these strategies are a starting point to consider as you take care of yourself, your loved ones, and the world around you. If you find yourself struggling to put these strategies into practice or would like to talk about stress management further, we encourage you to reach out to schedule an appointment.