We’ve probably all
felt stress. Sometimes it’s brief
and highly situational, like being in heavy
traffic. Other times, it’s more persistent
and complex—relationship problems, an
ailing family member, a spouse’s death.
And sometimes, stress can motivate us to accomplish
certain tasks. The more connected we get in
this dot.com world the more we are assaulted
with pressure. While at first we tough it out
and "white-knuckle" our way through,
eventually the wear-and-tear takes its toll.
Hardiness is the ability to
minimize the harmful effects of stress and to
transform a perceived threat into a challenge.
With this skill difficult times become opportunities
for growth. Individuals can learn that they
can make choices and positively affect the course
of the current challenge.
Do you sometimes experience:
- Increased feelings of discouragement.
- Frequent irritation with work
colleagues, family or friends.
- Actual withdrawal, manifested
psychologically and/or behaviorally, from
contact with social or work settings.
- Obsessions with and fantasies
about looking for a new life by leaving your
current work and/or family relationships.
- Feeling threatened, inadequate,
- Physical pains with no apparent
- Physical disorders such as
high blood pressure, gastric distress, poor
Stress becomes dangerous when it interferes
with your ability to live a normal life for
an extended period of time. You may
feel “out of control” and have no
idea of what to do, even if the cause is relatively
minor. This in turn, may cause you
to feel continually fatigued, unable to concentrate,
or irritable in otherwise relaxed situations.
Prolonged stress may also compound any emotional
problems stemming from sudden events such traumatic
experiences in your past, and increase thoughts
Stress can also affect your physical health
because of the human body’s built-in
response mechanisms. You may have found
yourself sweating at the thought of an important
date, or felt your heartbeat pick up while watching
a scary movie. These reactions are caused by
hormones that scientists believe helped our
ancestors cope with the threats and uncertainties
of their world.
If the cause of your stress is temporary, the
physical effects are usually short-term as well.
In one study, the pressure of taking exams led
to increased severity of acne among college
students, regardless of how they ate or slept.
The condition diminished after exams were over.
Abdominal pain and irregularity have also been
linked to situational stress. The longer
your mind feels stressed, however, the longer
your physical reaction systems remain activated.
This can lead to more serious health
Physical wear and tear
The old saying that stress “ages”
a person faster than normal was recently verified
in a study of women who had spent many years
caring for severely ill and disabled children.
Because their bodies were no longer able to
fully regenerate blood cells, these women were
found to be physically a decade older than their
chronological age. Extended reactions to stress
can alter the body’s immune system in
ways that are associated with other “aging”
conditions such as frailty, functional decline,
cardiovascular disease, osteoporosis, inflammatory
arthritis, type 2 diabetes, and certain cancers.
Being stressed has very real physical consequences.
What is clear is that excessive stress
can worsen existing risk factors such as hypertension
and high cholesterol levels. It can
lead to headaches, back aches, poor sleep, irritability,
skin problems, gastrointestinal issues, and
many more physical disorders. It can also exacerbate
health problems such as chronic pain, asthma,
diabetes, and many more. In addition, being
ill can in itself be a stressor and interfere
with our coping ability.
Studies show that people who are quick to anger
or who display frequent hostility—a behavior
common to those under stress—have an increased
risk of heart disease. Feelings of despair that
accompany stress can easily worsen into chronic
depression, a condition that can lead you to
neglect good diet and activity habits. This,
in turn, can put you at a greater risk for heart
disease, obesity, and kidney dysfunction.
Stress can also complicate your ability to recover
from a serious illness. A Swedish study found
that women who have suffered heart attacks tend
to have poorer chances of recovery if they are
also experiencing marital stressors such as
infidelity, alcohol abuse, and a spouse’s
physical or psychiatric illness.
“Distress” is the adverse emotional
and physical reactions that individuals have
to what appears to be overwhelming sources of
pressure in their environment. The underlying
physiological response to stress is the same
for everyone, but some individuals will get
ulcers, others will abuse alcohol and drugs
and some will become angry and irritable with
their family and/or colleagues.
Reducing Your Distress
Learning to deal with stress effectively is
a worthwhile effort, even if you already consider
yourself capable of handling anything life sends
your way. Many of the most common long-term
stressors—family illness, recovery after
injury, career pressures—often arise without
warning and simultaneously.
Many medical conditions create and are exacerbated
by stress. It is critical to understand the
role stress plays in coping with your medical
condition. It's not "all in your head",
but your head and your emotions are what suffer
along with the rest of your body. Through understanding
the feedback process that exists in the Mind/Body
connection you can dramatically reduce the level
of suffering you experience.
Identifying Sources Of Distress –
Mark the following questions based upon how
often you experienced the issue in the past
month, including today.
0-Never, 1-Almost never, 2-Sometimes,
3-Fairly often, 4-Very often
0 1 2 3 4 How often do you find yourself overwhelmed
by your workload?
0 1 2 3 4 How often do you find yourself scrambling
to meet a deadline at work?
0 1 2 3 4 I’m leaving out important tasks
at work because I’m overwhelmed by fighting
fires and helping others.
0 1 2 3 4 Do you worry that you fight too much
with a partner or family member?
0 1 2 3 4 How often do you lose patience with
a partner or family member?
0 1 2 3 4 Are you expected to put your family’s
or partner’s needs ahead of your own?
0 1 2 3 4 Most of what happens in life is just
meant to be.
0 1 2 3 4 When I experience a stressful event
I can’t get it out of my thoughts.
0 1 2 3 4 When I’m upset about something
I try to distract myself so I don’t have
to think about it.
0 1 2 3 4 I get under thirty minutes+ of moderate
exercise three times per week.
0 1 2 3 4 I quite often feel physically in pain
and don’t know why.
0 1 2 3 4 I do not perform daily meditation
or relaxation exercises.
0 1 2 3 4 In the last week I found myself feeling
down or depressed.
0 1 2 3 4 Lately I have noticed I seem “jittery”,
worried, or fearful for no reason.
0 1 2 3 4 I don’t seem to get any pleasure
from things I do.
0 1 2 3 4 I have been feeling tense and easily
0 1 2 3 4 I feel like I can’t do anything
0 1 2 3 4 I feel like I can’t cope anymore.
0 1 2 3 4 I have been feeling down or depressed.
0 1 2 3 4 I have been having difficulty thinking
Interpreting Your Scores
The D - Distress section indicates
your overall level of discomfort. While you
may only have one or two areas of your life
which are not functioning optimally, this can
upset you in all phases and much of the day.
Average: 0 to 6 points
Moderate: 7 to 10 points
High: 11 to 14 points
Severe: 15+ points
The other categories, W - Work,
R - Relationships, A
- Attitudes and Self-Talk, P
– Physical, and M - Mood,
will pinpoint the origin of the Distress. The
higher your scores in each area the more that
is the source of your discomfort. Begin your
Stress Reduction Program by focusing on the
area with the highest score.
Three Primary Approaches To Reducing
First line defenses for Distress are Exercise,
Relaxation, and Coping Strategies. If you learn
and practice all three you will be well on your
way to managing whatever physical problems you
In addition to the direct physical-health benefits
of physical activity, several studies suggest
that engaging in physical activity or exercise
programs can also benefit emotional well-being.
Multiple studies indicate that physical activity
improves mood and reduces symptoms of depression
and anxiety (DISTRESS!). Individuals diagnosed
with major depression undergoing an aerobic-exercise
intervention showed significant improvements
in depression comparable to participants receiving
psychotropic treatment. Moreover, individuals
in the aerobic exercise condition had significantly
lower relapse rates than participants in the
medication group. Other evidence suggests that
consistent physical activity may prevent the
onset of depression.
Among healthy older adults, resistance
training has been associated with improved
mood states. McLafferty and colleagues[31*]
conducted a study examining the effects of a
24-week resistance training program with three
weekly meetings. Following the program, participants
reported significant improvements in total mood
scores, as well as reductions in confusion,
anger and tension. Similarly, physical activity
has been reported as a correlate of positive
mood among women. In a study evaluating predictors
of mood among women who had recently started
a walking program, in addition to social support,
physical activity was significantly associated
with greater positive mood.
Others have investigated
the effects of less conventional physical-activity
programs. West and colleagues evaluated whether
alternative physical-activity programs had an
effect on psychological well-being. Results
showed that participants randomized to two physical-activity
programs had significant reductions
in perceived stress and negative affect.
Other studies have evaluated the extent to which
physical activity can buffer age-related cognitive
declines. Among 766 women aged 70-81 years,
higher levels of physical activity were associated
with better overall cognitive performance. Women
in the highest physical-activity quintile of
the sample displayed a 20% lower risk of developing
Paradoxically, learning how to de-stress takes
some effort. The more "wound up" you
are the harder it is to learn, because this
skill is the exact opposite of what you instinctively
do. The goal is to learn to turn off the "Fight/Flight"
response. Briefly, this is the mechanism that
gives you instant energy in times of physical
danger. Unfortunately, our bodies can't tell
the difference between real physical danger
(a mugger attacking you) and threats to our
ego (criticism from the boss, being overdrawn
on your checking account, etc.) We rarely face
actual physical threats, but stressors of the
second type are constant. This results in what
we experience as "Distress".
Relaxation exercises will take you on the first
stage of learning to reduce your physical tension.
This is a crucial skill in mastering your body's
Fight/Flight response. Once you have mastered
this skill you can use it often to refresh your
body and spirit. You won't always need to go
through the entire exercise, once you have mastered
the skill you will be able to close your eyes
and go directly to the relaxed state. Do this
frequently, whenever you realize your body is
The Fight/Flight Response is triggered whenever
we perceive a threat to our well being. Our
bodies can't tell the difference if the threat
is physical or emotional, so it will activate
at the slightest provocation. Unfortunately,
our world is filled with these provocations
so we will often experience the response. The
effect of this is cumulative and destructive.
This exercise turns off the response, (you can't
be tense and relaxed at the same time), so as
to help your body heal and recover from the
damage it experiences from our pressured world.
this link to go to a page where
you will find two audio files to teach you the
Relaxation skills you need to turn off the Fight/Flight
3. Developing Effective
Coping Strategies To Transform Distress
The first step is to identify those issues you
want to target for improvement. List five stressors
that challenge your ability to cope with them.
We all use both effective and ineffective strategies
to withstand the pressure of stressors. Coping
is best defined as efforts to master conditions
of harm, threat or challenge in the work milieu.
Regarding the above five stressors, list five
methods you have previously used to attempt
to deal with them:
Two general types of coping styles are typically
used. They are transformational coping and regressive
Transformational coping involves altering
stressful events so they are less stressful.
To do this, individuals must take decisive actions
to change stressful situations so that they
become less stressful. Transformational coping
skills are usually called into action before
a stressful situation causes excessive strain.
Transformational coping provides an effective
buffer against stress. Stressful events are
kept in perspective and dealt with in an optimistic
manner, which decreases strain by neutralizing
the stressful events. Through decisive actions,
the individual alters the situation surrounding
the stressful event so that the intensity and
duration of the strain is reduced. Thus, the
individual avoids stress-induced illness and
Regressive coping is characterized
by withdrawal, avoidance and emotionalism. Individuals
who favor regressive coping strategies usually
have a pessimistic outlook on life and work.
Stressful events are seen as terrible disruptions
and as unavoidable, unmanageable, and unchangeable.
Regressive coping does not effectively ward
off the diseases of stress. In fact, the use
of many regressive coping strategies (e.g.,
internalizing problems) can actually cause illness
rates to increase. Regressive coping does little
to cut down the intensity of stress and even
less to curtail the duration of stressful episodes.
Hence, regressive coping is usually undesirable.
Confront the source of stress and problem-solve
it rather than avoiding dealing with it because
it makes you too uncomfortable. Stay optimistic
and confident you can resolve the issue as opposed
to being pessimistic and fearful. Take decisive
action to create change in the situation.
Transformational Coping Skills
- Confronts sources of stress
- Takes decisive action to change stressor
- Manages time and delegates
- Remains task oriented
- Negotiates solutions
- Helps others cope
- Seeks help and asks for advice
- Uses social support networks
- Gathers information
- Proactively manages resources
- Motivates employees
- Retains control over staff
- Uses effective planning
- Shows persistence
- Exercises and relaxes
- Maintains healthy lifestyle
- Stays optimistic and confident
- Finds positive aspects in situation
- Changes self
- Selectively ignores source of stress
- Thinks rationally
- Accurately appraises problems
- Remains problem focused
- Assumes responsibility for actions
- Maintains positive view of self
- Employs problem-solving strategies
- Tolerates and welcomes change
- Acknowledges and expresses feelings
- Exhibits self-control
- Remains patient
- Focuses on present and future
- Keeps problems in perspective
- Avoids sources of stress
- Withdraws and isolates self
- Drinks or uses drugs to relax
- Blames others
- Gives up
- Cuts off communication
- Keeps problems to self
- Becomes overly dependent on others
- Exhibits aggression and hostility
- Participates in gripe sessions
- Avoids staff and superiors
- Unsupportive of staff
- Acts out at work
- Reactively manages resources
- Punishes staff
- Becomes unproductive
and Interpersonal Mental and Emotional
- Remains pessimistic and fearful
- Intolerant of change
- Thinks irrationally
- Inaccurately appraises problems
- Devalues self and others
- Becomes overly fatigued
- Internalizes problems
- Denies or minimizes problems
- Engages in self-blame
- Becomes excessively angry
- Becomes apathetic
- Focuses on negative aspects in situation
- Fantasizes about leaving company
- Avoids responsibility
- Becomes impatient
- Catastrophizes problems
- Gets ill or injured
Personal Assessment of
Now review the five coping methods you listed
that you have previously used to address the
stressors that concern you. For each one, decide
if it is primarily transformational or regressive.
Transforming Adversity Into Advantage –
Drs. Salvatore Maddi and Suzanne Kobasa identified
a personality characteristic called “hardiness,”
which helps individuals cope with pressure to
prevent stress-induced diseases and loss. The
concept of Hardiness has been
developed over a twenty year period of application
and research. Beginning as a comprehensive stress
management program, it has evolved into a dynamic
approach which has been proven to enhance well-being
and performance in every field to which it has
been applied. Hardiness is designed to help
individuals cope with extreme demands such as
chronic illness and maximize their performance
in high demand environments.
Hardiness has achieved an overall 40% decrease
in burnout and anxiety, a 35% increase in job
satisfaction and loyalty, a 25% increase in
productivity and effectiveness, a 40% reduction
in health insurance benefits utilization, and
a 30% reduction in sick leave.
“Hardy” individuals have three traits
which provide a buffering or protective effect
against stress. Analysis of all data revealed
that hardy individuals, as opposed to stress-prone
managers, were found to be more committed
to family, friends and their jobs; they had
a greater sense of control over what
occurs in their lives and their jobs; and they
experienced life pressures as challenges.
Moreover, hardy individuals chose more effective
Dr. Pammenter has studied with the Hardiness
Institute and has been working with these techniques
for over fifteen years. Read the linked
articles for more information about
Hardy, resilient individuals also learn how
to go beyond focusing on their distress and
begin to develop Eustress, that place of
optimal functioning when they are in the “flow”,
feeling strong, positive, energetic and happy.
The “Youstress”™ (Eustress)
More than just managing stress, the “Youstress”
Program takes you to the next level of life
satisfaction. You will focus on becoming Hardy,
Healthy, and Happy. The "YouStress"
program builds on the work of Hardiness and
adds the principles of Positive Psychology which
focuses on developing your strengths and finding
happiness. To begin the comprehensive "YouStress"
program call Dr. Pammenter and make an appointment,
you will soon be on your way to moving from
Distress to YouStress!