Arthur Pammenter Ph.D.

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 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, or powerless.
  • Physical pains with no apparent cause.
  • Physical disorders such as high blood pressure, gastric distress, poor sleep, etc.

Dangerous Stress Distress
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 of suicide.

Natural reactions
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 issues.

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.

Pressure points
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 – Stress Questionnaire
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.
Total ___

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?
Total ___

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.
Total ___

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.
Total ___

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.
Total ___

0 1 2 3 4 I have been feeling tense and easily irritated.
0 1 2 3 4 I feel like I can’t do anything right anymore.
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 clearly.
Total ______

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 Distress
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 are experiencing.

1. Exercise
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 cognitive impairment.

2. Relaxation
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 tense.

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.

Click 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 response

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 coping.

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 loss.

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.

Transformational Coping Styles
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

Behavioral and Interpersonal

  • 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

Mental and Emotional

  • 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

Regressive Coping Strategies

  • 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
  • Complains
  • Becomes unproductive

Behavioral 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 Coping Styles
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 – Generating Eustress

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 coping skills.

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 his work.

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) Program
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!

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Arthur Pammenter Ph.D.
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