Psychology

Coping with Stress If living is inevitably stressful, and if chronic stress can disrupt your life and even kill you, you need to learn how to manage stress. Coping refers to the process of dealing with internal or external demands that are perceived as straining or exceeding an individual’s resources (Lazarus & Folkman, 1984). Coping may consist of behavioral, emotional, or motivational responses and thoughts. This section begins by describing how cognitive appraisal affects what you experience as stressful. We then consider types of coping responses, including both general principles of coping and specific interventions. Finally, we consider some individual differences in individuals’ ability to cope with stress. coping The process of dealing with internal or external demands that are perceived to be threatening or overwhelming. Appraisal of Stress When you cope with stressful situations, your first step is to define in what ways they are, in fact, stressful. Cognitive appraisal is the cognitive interpretation and evaluation of a stressor. Cognitive appraisal plays a central role in defining the situation—what the demand is, how big a threat it is, and what resources you have for meeting it (Lazarus, 1993; Lazarus & Lazarus, 1994). Some stressors, such as undergoing bodily injury or finding one’s house on fire, are experienced as threats by almost everyone. However, many other stressors can be defined in various ways, depending on your personal life situation, the relation of a particular demand to your central goals, your competence in dealing with the demand, and your self-assessment of that competence. The situation that causes acute distress for another person may be all in a day’s work for you. Try to notice, and understand, the life events that are different for you and your friends and family: Some situations cause you stress but not your friends and family; other events cause them stress but not you. Why? Table 12.2 Stages in Stable Decision Making/Cognitive Appraisal Stage Key Questions 1. Appraising the challenge Are the risks serious if I don’t change? 2. Surveying alternatives Is this alternative an acceptable means for dealing with the challenge? Have I sufficiently surveyed the available alternatives? 3. Weighing alternatives Which alternative is best? Could the best alternative meet the essential requirements? 4. Deliberating about commitment Will I implement the best alternative and allow others to know? 5. Adhering despite negative feedback Are the risks serious if I don’t change? Are the risks serious if I do change? Richard Lazarus, whose general theory of appraisal was addressed in the discussion of emotions, distinguished two stages in the cognitive appraisal of demands. Primary appraisal describes the initial evaluation of the seriousness of a demand. This evaluation starts with the questions “What’s happening?” and “Is this thing good for me, stressful, or irrelevant?” If the answer to the second question is “stressful,” you appraise the potential impact of the stressor by determining whether harm has occurred or is likely to and whether action is required (see Table 12.2). Once you decide something must be done, secondary appraisal begins. You evaluate the personal and social resources that are available to deal with the stressful circumstance and consider the action options that are needed. Appraisal continues as coping responses are tried; if the first ones don’t work and the stress persists, new responses are initiated, and their effectiveness is evaluated. Cognitive appraisal is an example of a stress moderator variable. Stress moderator variables are those variables that change the impact of a stressor on a given type of stress reaction. Moderator variables filter or modify the usual effects of stressors on the individual’s reactions. For example, your level of fatigue and general health status are moderator variables influencing your reaction to a given psychological or physical stressor. When you are in good shape, you can deal with a stressor better than when you aren’t. You can see how cognitive appraisal also fits the definition of a moderator variable. The way in which you appraise a stressor will determine the types of coping responses you need to bring to it. Let’s now consider general types of coping responses. stress moderator variable Variable that changes the impact of a stressor on a given type of stress reaction. Types of Coping Responses Suppose you have a big exam coming up. You’ve thought about it—you’ve appraised the situation—and you’re quite sure that this is a stressful situation. What can you do? It’s important to note that coping can precede a potentially stressful event in the form of anticipatory coping (Folkman, 1984). How do you deal with the stress of the upcoming exam? How do you tell your parents that you are dropping out of school or your lover that you are no longer in love? Anticipating a stressful situation leads to many thoughts and feelings that themselves may be stress inducing, as in the cases of interviews, speeches, or blind dates. You need to know how to cope. anticipatory coping Efforts made in advance of a potentially stressful event to overcome, reduce, or tolerate the imbalance between perceived demands and available resources. The two main ways of coping are defined by whether the goal is to confront the problem directly—problem- directed coping—or to lessen the discomfort associated with the stress—emotion-focused coping (Billings & Moos, 1982; Lazarus & Folkman, 1984). Several subcategories of these two basic approaches are shown in Table 12.3. Let’s begin with problem-directed coping. “Taking the bull by the horns” is how we usually characterize the strategy of facing up to a problem situation. This approach includes all strategies designed to deal directly with the stressor, whether through overt action or through realistic problem-solving activities. You face up to a bully or run away; you try to win him or her over with bribes or other incentives. Your focus is on the problem to be dealt with and on the agent that has induced the stress. You acknowledge the call to action, you appraise the situation and your resources for dealing with it, and you undertake a response that is appropriate for removing or lessening the threat. Such problem-solving efforts are useful for managing controllable stressors—those stressors that you can change or eliminate through your actions, such as over-bearing bosses or underwhelming grades. The emotion-focused approach is useful for managing the impact of more uncontrollable stressors. Suppose you are responsible for the care of a parent with Alzheimer’s. In that situation, there is no “bully” you can eliminate from the environment; you cannot make the disease go away. Even in this situation, some forms of problem-directed coping would be useful. For example, you could modify your work schedule to make it easier to provide care. However, because you cannot eliminate the source of stress, you also can try to change your feelings and thoughts about the disease. For example, you might take part in a support group for Alzheimer’s caregivers or learn relaxation techniques. These approaches still constitute a coping strategy because you are acknowledging that there is a threat to your well-being and you are taking steps to modify that threat. You will be better off if you have multiple strategies to help you cope in stressful situations (Bonanno et al., 2011). For coping to be successful, your resources need to match the perceived demand. Thus the availability of multiple coping strategies is adaptive because you are more likely to achieve a match and manage the stressful event. Consider a study that examined the ways in which women cope with the stress of undergoing surgery for breast cancer (Roussi et al., 2007). The women reported their distress levels and coping strategies (such as problem-directed and/or emotion-focused strategies) a day before the surgeries, three days after the procedure, and again three months later. The women who reported that they were using multiple coping strategies in the days after their surgeries reported less distress three months later. Table 12.3 Taxonomy of Coping Strategies Type of Coping Strategy Example PROBLEM-DIRECTED COPING Change stressor or one’s relationship to it through direct actions and/or problem-solving strategies Fight (destroy, remove, or weaken the threat) Flight (distance oneself from the threat) Seek options to fight-or-flight (negotiating, bargaining, compromising) Prevent future stress (act to increase one’s resistance or decrease strength of anticipated stress) EMOTION-FOCUSED COPING Change self through activities that make one feel better but do not chnage the stressor Somatically focused activities (use of antianxiety medication, relaxation, biofeedback) Cognitively focused activities (planned distractions, fantasies, thoughts about oneself) Therapy to adjust conscious or unconscious processes that lead to additional anxiety Researchers who study coping have discovered that some individuals meet stressors with a particular degree of resilience—they are able to achieve positive outcomes despite serious threats to their well-being (Stewart & Yuen, 2011). Research has focused on the types of coping skills that resilient individuals have acquired and how they have acquired them. An important part of the answer is that children who become resilient have been raised by parents with good parenting skills (Masten, 2011). For example, research with homeless families suggests that higher-quality parenting helps children to acquire the cognitive skills necessary to control their attention and behavior (Herbers et al., 2011). These control skills have positive consequences for the children’s performance in school. Why are multiple coping strategies beneficial for individuals such as Alzheimer’s caregivers? Up to now, we have been considering general approaches to coping with stressors. Let’s now turn to specific cognitive and social approaches to successful coping. Modifying Cognitive Strategies A powerful way to adapt to stress is to change your evaluations of stressors and your self-defeating cognitions about the way you are dealing with them. You need to find a different way to think about a given situation, your role in it, and the causal attributions you make to explain the undesirable outcome. Two ways of mentally coping with stress are reappraising the nature of the stressors themselves and restructuring your cognitions about your stress reactions. You have already seen the idea that people control the experience of stress in their lives in part by the way they appraise life events (Lazarus & Lazarus, 1994). Learning to think differently about certain stressors, to relabel them, or to imagine them in a less-threatening (perhaps even funny) context is a form of cognitive reappraisal that can reduce stress. Worried about giving a speech to a large, forbidding audience? One stressor reappraisal technique is to imagine your potential critics sitting there in the nude—this surely takes away a great deal of their fearsome power. Anxious about being shy at a party you must attend? Think about finding someone who is more shy than you and reducing his or her social anxiety by initiating a conversation. You can also manage stress by changing what you tell yourself about it and by changing your handling of it. Cognitive-behavior therapist Donald Meichenbaum (1977, 1985, 1993) has proposed a three-phase process that allows for such stress inoculation. In Phase 1, people work to develop a greater awareness of their actual behavior, what instigates it, and what its results are. One of the best ways of doing this is to keep daily logs. By helping people redefine their problems in terms of their causes and results, these records can increase their feelings of control. You may discover, for example, that your grades are low (a stressor) because you always leave too little time to do a good job on your class assignments. In Phase 2, people begin to identify new behaviors that negate the maladaptive, self-defeating behaviors. Perhaps you might create a fixed “study time” or limit your phone calls to 10 minutes each night. In Phase 3, after adaptive behaviors are being emitted, individuals appraise the consequences of their new behaviors, avoiding the former internal dialogue of put-downs. Instead of telling themselves, “I was lucky the professor called on me when I happened to have read the text,” they say, “I’m glad I was prepared for the professor’s question. It feels great to be able to respond intelligently in that class.” This three-phase approach means initiating responses and self-statements that are incompatible with previous defeatist cognitions. Once started on this path, people realize that they are changing—and can take full credit for the change, which promotes further successes. Table 12.4 gives examples of the new kinds of self-statements that help in dealing with stressful situations. Stress inoculation training has been used successfully in a wide variety of domains. Many children live in situations in which, tragically, they are very likely to be exposed to stressful circumstances. Let’s consider successful stress inoculation for children. Featured Study The teachers of 748 fourth- and fifth-grade students in southern Israel provided a program of stress inoculation in their classrooms (Wolmer et al., 2011). Over the course of 14 weeks, the children received a series of lessons that taught them coping skills and gave them opportunities to rehearse those skills. The lessons also helped students recognize their strong emotions and, again, taught them skills for regulating those emotions. A control group of 740 children did not receive this training. After the training period, a conflict began in the Gaza Strip. All 1,488 of the children experienced three weeks of rocket and mortar attacks. Three months after the conflict ended, the children completed measures to assess the presence of posttraumatic stress disorder. Among the students in the control group, 11.3 percent met criteria for PTSD; among the students who had received the stress inoculation training, 7.2 percent met criteria for PTSD. Thus, stress inoculation training reduced the number of children experiencing PTSD by about one-third. This study suggests how classroom-based stress inoculation training could help children cope with stressors that,