Understanding stress management in psychology

Stress management involves strategies to reduce or control the negative effects of stress on the body and mind. Effective management can use psychological therapies to help people recognise and alter these responses, promoting better mental health.

Psychological therapies: Biofeedback

Biofeedback is a psychological therapy that helps individuals gain control over their body's stress responses. It is based on operant conditioning, which is a learning process where behaviours are shaped through rewards and punishments. In biofeedback, positive feedback acts as a reward for reducing stress signs.

How biofeedback works

Biofeedback uses technology to monitor and display physiological reactions to stress in real time. This allows people to learn how to manage their responses consciously.

Key components of biofeedback:

• Monitoring equipment - Devices measure bodily functions like muscle tension using electromyography (EMG), brain activity with electroencephalography (EEG), and sweating through skin conductance response (SCR).
• Feedback mechanism - When stress increases these measures, visual or audio signals alert the individual.
• Relaxation techniques - Individuals are taught methods like deep breathing or muscle relaxation. As they apply these, positive feedback reinforces success, helping to lower heart rate and tension.
• Learning process - Over time, people associate the techniques with reduced stress, enabling them to use them independently in stressful situations.

Research on biofeedback: Budzynski and Stoyva (1969)

This study explored how biofeedback, combined with operant conditioning principles, could help reduce muscle tension related to stress. It aimed to develop and test a biofeedback instrument for potential use in treating psychosomatic disorders, which are physical conditions influenced by psychological factors.

Method

• The study used an experimental design with EMG to measure muscle action potential (electrical activity in muscles) over 20 sessions.
• Fifteen participants were randomly allocated to one of three groups: an experimental group receiving correct feedback, a control group with no feedback (silence), and another control group with irrelevant feedback.
• Experimental group: Participants heard a tone that varied with forehead muscle tension; they were instructed to relax and keep the pitch low (high pitch indicated more tension).
• Control group 1: Participants relaxed in silence, focusing on the forehead muscle.
• Control group 2: Participants relaxed with a low monotone sound, told it would aid relaxation, but it was unrelated to their muscle tension.
• All participants were paid $1.50 per session, with a bonus based on their performance ranking to motivate effort, out of the group of 15.
• The experimental group received continuous feedback on muscle activity.

Results

• The experimental group showed a 50% mean decrease in muscle action potential.
• The silent control group had a 20% decrease.
• The irrelevant feedback group had a 28% decrease.
• This indicated that accurate biofeedback was more effective at reducing tension.

Conclusions

• Biofeedback, using operant conditioning, can effectively train people to reduce physiological stress responses.
• It may be particularly useful for managing psychosomatic disorders by giving individuals control over their body's reactions.

Evaluation

• Strengths - The standardised procedures, such as consistent feedback methods, make the study reliable and replicable.
• Limitations - The small sample size limits generalisability to broader populations.

Preventing stress: Stress inoculation training (SIT)

Stress inoculation training (SIT) is a cognitive-behavioural approach to prevent stress by building resilience, much like a vaccine builds immunity. Developed by Meichenbaum, it equips individuals with skills to handle stressors before they become overwhelming. It progresses through a series of distinct phases, each building on the last to foster coping abilities.

Phase 1: Conceptualisation

• This phase establishes a collaborative relationship between the client and trainer.
• The client learns about the nature and impact of stress through Socratic questioning, which involves guided questions to promote self-discovery.
• Goals include increasing awareness of personal stress responses and recognising anxiety triggers.

Phase 2: Skill acquisition

• Clients identify their negative self-talk, which are internal thoughts that heighten anxiety.
• They learn positive self-statements to replace negative ones.
• Additional techniques include problem-solving strategies and self-reward for successful coping, helping to reframe stressful situations.

Phase 3: Rehearsal and application

• Known as the 'inoculation' stage, clients practise skills in increasingly challenging scenarios.
• Methods like role-playing and mental imagery simulate stressors.
• Clients provide feedback to the trainer and refine techniques, ensuring they can apply them in real life.

Key study: Bridge et al. (1988)

This study investigated ways to reduce stress in women with early breast cancer undergoing radiotherapy. It built on prior research suggesting that relaxation and imagery could help manage psychological stress and even prolong life in cancer patients (e.g., Simonton and Simonton, 1975). The aim was to test if relaxation training with imagery reduced stress more than relaxation alone.

Method

• An opportunity sample of 139 women, average age 53 (all under 70), who had undergone mastectomy or lumpectomy and were attending six-week radiotherapy at a UK hospital.
• A randomised controlled trial using questionnaires to measure mood.
• Participants completed the Profile of Mood States and Leeds General Scales Questionnaire at the start.
• They were allocated to one of three groups: control, relaxation, or relaxation plus imagery.
• All met individually with the researcher weekly for 30-minute sessions over six weeks.
• Treatment groups learned diaphragmatic breathing for relaxation.
• The relaxation plus imagery group also visualised a peaceful scene of their choice.
• The control group engaged in casual chatting.
• Treatment groups received audio tapes for home practice.
• Questionnaires were repeated at the end.
• Ethical considerations included informed consent, confidentiality, and assurance that participation would not affect medical care.

Results

• No initial differences in questionnaire scores between groups.
• Overall, the relaxation group showed no significant mood improvement; the relaxation plus imagery group had a small improvement; the control group's mood disturbance worsened.
• When split by age, results varied: interventions were more effective for women over 54, showing greater mood improvements compared to those under 54.

Conclusions

• Combining relaxation with imagery effectively reduces mood disturbances in breast cancer patients.
• Without intervention, mood can worsen during treatment.
• Older women benefit more, possibly due to having more time to practise techniques without work or childcare demands.

Evaluation

• Strengths - The standardised procedures, like uniform teaching of relaxation techniques, enhance reliability and allow replication. The skills can be applied in everyday life, such as using audio tapes at home.
• Limitations - Ethical concerns arise as SIT can be expensive and time-consuming, excluding some people. The control group's worsening mood suggests they should have been offered therapy post-study. The sample size per subgroup was small, reducing generalisability.

Issues and debates in managing stress

Stress management research touches on key psychological debates, highlighting how individuals can influence their own wellbeing.

Determinism versus free will

• Determinism suggests behaviour is controlled by external or internal forces, but stress management techniques like biofeedback and SIT emphasise free will.
• By choosing to learn relaxation or reframe thoughts, individuals can override automatic stress responses, reducing helplessness and promoting empowerment during challenges like cancer treatment.
• This shows mental wellbeing can be shaped by personal attitudes and choices rather than being fully determined.

Application to everyday life

• Techniques such as relaxation and imagery are practical for home use, helping manage stress in various situations.
• Research indicates they are especially effective for older women, allowing targeted interventions to maximise benefits.
• Overall, these methods address stress causes, enabling broader application beyond clinical settings to improve daily coping.