stress management
by Wendy Moore
More and more people today are trying stress management as a way of reducing their stress levels. Almost half (49%) of workers now have access to stress management of some kind through their employers, according to a survey by Warwick University in 2000. Many more people are signing up for stress management as individuals, to help them cope with pressures of work, home life or other anxieties. But what does stress management involve and does it really work?
what is stress management?
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Stress management is different to most stress-busting therapies. Most remedies – like massage or yoga – offer ways to relax and wind down when stress gets too much. The aim of stress management is to help you recognise and tackle the root causes of stress in your life, then find ways of managing the pressures without causing harm to your health. At the same time it may also offer some relaxation techniques.
Different stress management counsellors work in different ways. Some use talking therapies, some focus on practical measures to help you manage stress, while some may even offer hypnotism. But there is no quick fix. Ultimately stress management involves making choices about your lifestyle and how you behave.
we test the therapy
We went along to a typical session with Gladeana McMahon, a stress management counsellor and psychotherapist working in south London. Gladeana began counselling in 1977 and has worked with many individual clients and organisations. She has several qualifications in counselling and psychotherapy and is a member of various professional bodies, including the British Association for Counselling and Psychotherapy (BACP), the British Association for Behavioural and Cognitive Psychotherapies and the International Stress Management Association.
what happens?
Gladeana begins by asking how she can help. She has already sent a pack of information on her methods and what to expect. We sit in low chairs in her comfortable office. The atmosphere is informal and Gladeana is easy-going without seeming over-casual. People's needs vary, she says. Some clients are so stressed they are off work, while others simply feel their stress levels are out of hand. The main causes of stress in my life – juggling work and young children – are commonplace. Gladeana explains how stress management can help identify the pressure points, suggest choices about life-style and offer coping strategies to handle stress.
what causes stress?
Gladeana starts by explaining exactly what stress is. Our bodies naturally respond to any perceived threat by releasing hormones to enable us to either confront the danger or make a quick get-away – the so-called 'fight or flight response'. When the danger is passed the stress response should switch off. This reaction is useful if you are jumping out of the way of a speeding car. But when something that is not life-threatening – like a deadline or meeting – is felt as a threat it may provoke the same chemical response which fails to switch off again. If this carries on too long it can cause distress and health problems. Pressure can be a motivating force, she says. But when demands seem to outstrip your ability to cope, this is unhealthy stress.
'We are not saying you can avoid stress. Life is stressful,' she says. 'What we are talking about is minimising the unhealthy aspects and maximising your ability to cope.'
signs and symptoms
Next Gladeana asks me to tick any stress signs on a list. The list includes physical symptoms (such as palpitations, tiredness, skin problems, frequent colds or stomach upsets); emotional signs (like mood swings, increased worrying, feeling tense or low self-esteem); and behavioural symptoms (such as increased smoking or drinking, problems sleeping, loss of appetite, loss of sex drive, irritability or taking more work home). The exercise helps establish my 'individual package' of stress.
She then asks me to go through a second list, to find out where I fit on the 'burnout scale'. This details stress warning signs on a scale climbing from stage one to stage four. Stage one includes bringing work home, spending too little time with family or friends, and having doubts about coping. Stage two involves tiredness and anxiety, working long hours and becoming irritable. Stage three escalates to increased anger and resentment, extreme exhaustion and lack of enjoyment in life. The final stage four involves full scale withdrawal, illness, absenteeism, extreme distress and alcohol or drug abuse.
Thankfully, I come in at a middling stage one to two. Gladeana explains: 'If you see stress as a bus journey, you have got yourself on the wrong bus but you have only gone a few stops. If you are at four, you are at the terminus and that is a long way back.' Recognising these warning signs is a useful way of realising when you are becoming too stressed, she adds.
personality clues
Next Gladeana wants to identify my personality type. There are two basic types when it comes to handling stress. Type A people are generally ambitious and driven – and more prone to stress, while type B personalities are more laid-back and easy-going. But Gladeana divides these types into four sub-groups, which basically amount to healthy and unhealthy types A or B. While healthy As are fast moving and in control, unhealthy As are hostile and competitive. Similarly healthy type Bs are relaxed and content while unhealthy Bs are tense and liable to explode under challenge.
I am already too well aware I fit type A but need to complete another questionnaire to gauge where I sit on the A scale. The bad news is I emerge as an 'unhealthy' A, only about 30 points from the top of the scale. The good news is I don't have to stay that way. We cannot change our personality types, says Gladeana. 'That is like saying I am a brunette and I want to be a natural blonde.' There is nothing wrong with being a type A in itself, she reassures. 'They are movers and shakers and drivers.' But within any personality type, it is possible to be healthier and less stressed.
lifestyle changes
Firstly, Gladeana checks my lifestyle for obvious changes which could reduce my stress. This may mean cutting down on caffeine (in coffee, tea and cola) and alcohol, drinking more water or herbal teas, eating a nutritious diet, taking more exercise, getting good rest and sleep, finding more outside interests and quitting smoking. Some people need caffeine or alcohol reduction plans as too fast a withdrawal can cause problems.
She also suggests a simple relaxation exercise which can be done anywhere – in the car, on the tube, in a meeting – to calm nerves. Just breathe in deeply for four counts then breathe out slowly for five, lowering shoulders as you do. Easy, but it seems effective.
Secondly, and at least as difficult, I will need to adapt my approach to life – literally change the way I think.
thinking patterns
For some highly-stressed people, the only way to reduce stress is to remove the cause. 'For a few people leaving your job is the only answer,' says Gladeana. But for the majority, it is possible to manage pressures by facing them in a different way. This is where Gladeana's training in cognitive behavioural therapy – which challenges negative thinking patterns – comes in.
People can become locked into unrealistic thinking patterns, she explains. When they make a mistake, for example, they automatically assume they are a total failure and will lose esteem. Cognitive behavioural therapy trains you to recognise negative automatic thoughts – or 'NATs' – and challenge them with more realistic attitudes. If a train is late, you need to accept there is nothing you can do about it. If you miss a deadline, it is not the end of the world.
Gladeana also explains 'twisted thinking' – where everything is seen as 'all or nothing' and problems are blown out of proportion. The therapy can help 'untwist your thinking' – by letting you befriend yourself and reminding yourself of praise as well as criticism. There is even some homework: a 'thoughts form' where I have to jot down how I respond to a stressful situation and suggest a more positive response.
It is a lot to pack into just over an hour and certainly offers food for thought. Most clients need between four to six sessions to learn ways of managing their stress but they may want to return occasionally for refreshers.
verdict
If you want to get to the root of your stress problems – rather than simply find a way of unwinding – this could be the answer for you. The approach seems logical and realistic, although it may mean some hard choices. Would certainly go back.
the basics
Stress management is an unregulated profession, which means anyone can practice and there are no checks on performance. It is essential, therefore, that you are clear about what you are getting. Gladeana McMahon suggest some useful checkpoints:
- make sure your counsellor has relevant qualifications and experience
- find out the approach the counsellor uses and ask how it relates to your problem
- check the counsellor belongs to a reputable professional body and abides by a code of ethics
- discuss your expectations and goals
- check fees and how long counselling is likely to last
- do not enter a long-term contract unless certain this is right for you.
Professional bodies, which have codes of ethics, include the British Association for Counselling and Psychotherapy, the British Association for Behavioural and Cognitive Psychotherapy and the British Psychological Society. The International Stress Management Association is currently working on a code of ethics.
cost
Gladeana McMahon charges £40 for a one-hour session to individuals and £60 for couples. Fees elsewhere can range from around £15 up to £80 an hour, although £30-40 is about average.
where's the evidence?
A review of more than 80 different studies of workplace counselling – including stress management – found it helped reduce stress in more than half of participants. The review, by Professor John McLeod of Abertay University, Dundee, for the British Association for Counselling and Psychotherapy, found counselling helps reduce sickness and absence.
help and info
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organisations
British Association for Behavioural and Cognitive Psychotherapies
(BABCP)
Globe Centre
PO Box 9
Accrington BB5 2GD
E-mail: babcp@babcp.com
Website: www.babcp.org.uk
The leading body for cognitive-behavioural therapy in the UK. The website has a search facility to find an accredited therapist and gives information on how the therapy works.
British Association for Counselling and Psychotherapy
35-37 Albert Street
Rugby CV31 2SG
Tel: 0870 443 5252 (Mon-Fri 8.45am-5pm)
E-mail: bacp@bacp.co.uk
Website: www.bacp.co.uk
BACP can provide you with a list of private counsellors in your area, plus information on counselling and choosing a counsellor.
British Confederation of Psychotherapists (BCP)
6 Swains Lane
London N6 6QS
Tel: 020 7267 3626
E-mail: mail@bcp.org.uk
Website: www.bcp.org.uk
A linking association of psychoanalysts, analytical psychologists, psychoanalytic psychotherapists and child psychotherapists.
British Psychological Society
St Andrews House
48 Princess Road East
Leicester LE1 7DR
Tel: 0116 254 9568
Website: www.bps.org.uk
The representative body for psychologists and psychology in the UK.
Foundation for Psychotherapy and Counselling (FPC)
607 The Chandlery
50 Westminster Bridge Road
London SE1 7QY
Tel: 0207 721 7660
Website: www.therapy-fpc.demon.co.uk
The professional body for the counsellors, psychotherapists and group psychotherapists who have trained at and graduated from WPF Counselling and Psychotherapy.
International Stress Management Association UK (ISMA)
PO Box 348
Waltham Cross EN8 8ZL
Tel: 07000 780430
E-mail: stress@isma.org.uk
Website: www.isma.org.uk
Promotes sound knowledge and best practice in the prevention and reduction of stress and sets professional standards.
United Kingdom Council for Psychotherapy
167-169 Great Portland Street
London W1W 5PF
Tel: 020 7436 3002 (Mon-Fri 9am-5pm)
E-mail: ukcp@psychotherapy.org.uk
Website: www.psychotherapy.org.uk
Umbrella group for over 5000 practitioners all registered through member organisations. Will provide lists of registered psychotherapists free of charge; the database can be searched by local area or other criteria such as wheelchair access or language.
United Kingdom Register of Counsellors (UKRC)
35-37 Albert Street
Rugby CV21 2SG
Tel: 0870 443 5232
E-mail: ukrc@bacp.co.uk
Website: www.ukrconline.org.uk
A register of counsellors in England, Scotland, Wales and Northern Ireland.
websites
Centre for Stress Management
www.managingstress.com
Contains information about the centre, plus articles relating to stress, stress management, stress counselling, health, cancer, nutrition, exercise and heart disease. Also has lots of links.
Checklist
www.managingstress.com/articles/checklist.htm
A checklist for clients interested in receiving counselling, psychotherapy or hypnosis, to aid them in asking their counsellor the right questions and to avoid any pitfalls.
HSE: Management Standards for work related stress
www.hse.gov.uk/stress/standards/
Advice from the Health and Safety Executive aimed at helping anyone responsible for tackling work-related stress to manage the impact of stress on their business.
Mental Health – BBC Online
www.bbc.co.uk/health/conditions/mental_health/therapy_index.shtml
Discusses therapists and counsellors, plus qualifications and warning signs you should look for.
Prevention of Professional Abuse Network (POPAN)
www.popan.org.uk
POPAN provides information and support to those who have been abused in counselling or therapy. Its website contains a factsheet covering what to look for when you go into therapy.
Stress UK
www.stress.org.uk
Describes how to find a therapist in the UK, questions you should ask, and what to expect during a session. Also contains a comprehensive list of complementary therapy organisations.
TherapyIndex.com
www.therapyindex.com
Website contains information on counselling and psychotherapy, with a section on frequently asked questions about therapy plus points to consider when choosing a therapist.
UKTherapists.com
www.uktherapists.com/
Comprehensive website containing directories for finding psychotherapists, counsellors and complementary practitioners in your area.
YouthInformation.com
www.youthinformation.com
Contains articles on relaxation and stress management, suggests ways of dealing with stress, anxiety and depression, and lists referral organisations.
reading
 |
Choosing a Psychotherapist: A Guide to Navigating the Mental Health Maze by Dr Matthew S Zimmerman and Dr Donna V Strouse (Writer's Club
press, 2001) |
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Conquer Your Stress by Cary Cooper and Stephen Palmer (Chartered Institute of Personnel and Development, 2000) |
 |
Stress Management for Busy People by Carol Turkington, David Barlow (McGraw-Hill Publishing Company, 1998) |
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Stress Management for Dummies by Allen Elkin (Hungry Minds Inc, 1999) |
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|
(updated November 2002, resources updated May 2005)
