Stress Management

The ability to manage stress is a fundamental skill required for healthy functioning. Although life can be filled with joy and happiness, it is also full of challenges and unexpected difficulties. I remind patients that for whatever reason they wish to ascribe for this state of affairs, life is meant to present us with challenges (A strategy we call: “It is supposed to be like this”). Most of us carry a little bit of that mistaken belief that if we just did everything right, and if those around us just did everything they are supposed to do, we could be free of all pain and difficulty. But even if that was possible, we would likely encounter the opposite problem of being too bored. Then our minds may seek some unhealthy ways to become excited.

Since challenges are for the most part unavoidable, it is important to understand how each client views obstacles and what are his or her favorite ways of coping with difficulty. My approach is to try to recognize the positive flip side of any seemingly negative approaches that clients describe in the office. For people who are obsessive, we recognize that the same tendency that makes them worry, may help them analyse situations ahead of time. The trick is to see that tendency for what it is, and not over-interpret the significance of one’s thoughts or feelings (“DON’T BELIEVE EVERYTHING YOU THINK OR FEEL, FOR THAT MATTER”). The feelings are valid and the thoughts are wonderful hypotheses, but we need an observing part of the brain to decide what is applicable to a given circumstance. As clients learn to SEE CLEARLY  what different parts of their brain are doing and how this translates into their feelings, thoughts and impulses, they become less affected by their reactions, and by adverse circumstances around them.

I tease clients to “KEEP THEIR INNER GUARDIAN HANGING OUT ON THE COUCH.”  There was a wonderful mask art exhibit here in Colorado a few years ago, where a High School Student made a mask entitled the “Inner Guardian.” I wish I had succeeded in buying that mask. It was a wonderful portrayal how we all feel when we are triggered into fear or a sense of being threatened. I call it “THE INNER GUARDIAN IS COMING OUT.” I remind my clients that we want to keep the Inner Guardian watching TV. This is a silly but often effective way for clients to remember their FIGHT OR FLIGHT REACTIONS.  The Inner Guardian is but a mental state in which neurons fire in such a way that we feel as if a mountain lion was on our backs.

We do have mountain lions roaming in our beautiful Rocky Mountains of Colorado. It is a rare sight to see them, but if you do, you can count on your Inner Guardian waking up. And you will be glad for it. Your body will shut down all unnecessary processes, including higher level logical centers, and it is going to execute an alarm response. You will likely try to fight or flee. The survival-driven fight-or-flight part of our brain and body is amazing and wonderful. It is indispensable. But it can also cause problems. The trouble is that we can learn to overuse this wonderful system of survival in our daily lives (where there are no mountain lions). I joke that we might have a lot of mountain goats, but very few mountain lions. For example, we may worry that we have offended someone. or that our boss does not like us and may fire us. These are unpleasant thoughts, and may even be unfortunate realities, but they are not mountain lions. But if we are prone to stress, these more minor, regular life thoughts or events can trigger the same neuronal-hormonal sequences as a mountain lion would. At a time when we need all of our complex problem solving parts of the brain, the fight-or-flight survival circuits shut all that complex neural circuitry down, and we lose our capacity to think logically! Our tendency to be so careful and cautious can actually backfire and make us even less able to solve regular problems in our lives. Moreover, such repeated sequences of fight-or-flight responses are exhausting to our bodies and minds, and lead to increased stress responses in the future. They can also lead to depression, anxiety and health problems. It is therefore very important to interrupt such habitual patterns of over-reacting to unpleasant but rarely deadly triggers. In the office, we work first on learning to become HABITUAL ABDOMINAL BREATHERS. We review many other strategies of stress management, including regular sleep, healthy nutrition, exercise, assertiveness, and effective prioritizing. We learn the skill of OBSERVING our thoughts and our feelings. We challenge maladaptive thoughts and develop alternative ways of viewing the situations as challenging rather than overwhelming (the distinction between those two ways of perceiving challenges can result in very different hormonal responses to stress, with lower cortisol release when we see a problem as a challenge).

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