‘Reflections on ‘Stress Awareness Month’: Taking a psychologically informed approach to understanding and dealing with stress’…
23.04.2021: After returning from some annual leave over the Easter school holidays, I am writing this week’s blog as the Lead for Psychologically Informed Environments (PIE) at the national youth homeless charity: Centrepoint, in a rare moment of calm at home. As we all know when we get back from annual leave, our email inbox can feel overwhelming and our ‘To Do’ list can seemingly be never ending. Having some time away from our work, whether that be in a frontline or support team role, is wonderful for our psychological well-being (even when that involves significant amounts of childcare!) and therefore, it is completely natural to feel an increase in our ‘stress levels’ when we return. As noted in our Centrepoint internal staff well-being communications at the start of this month, April has actually been ‘Stress Awareness Month’ (c.f. https://www.google.co.uk/amp/s/www.stress.org.uk/national-stress-awareness-month-2019/%3famp). Therefore, as this month draws to a close, I wanted to take this opportunity to reflect more on ‘stress’ as a concept and what psychologically informed approaches can tell us about stress, and how we can personally cope with it as well as support the homeless young people that we work with to do the same.
‘Stress’ is defined as ‘a state of mental or emotional strain or tension resulting from adverse or demanding circumstances’ and is something that all of us can experience from time to time. Modern life is stressful, and even for those of us for whom the recent lockdown has perhaps forced us to ‘simplify’ our lives to some degree, just the process of lockdown and separation from family and friends has been stressful. Moreover, as I am consistently hearing from our frontline staff in reflective practice spaces, recent months have been particularly stressful and many are feeling naturally tired and exhausted. Despite the ‘everyone in’ approach to homelessness during the pandemic, as an organisation we have seen that homelessness and the societal inequalities, family breakdown and unemployment that often underpin this, are actually increasing particularly for young people causing increased stress (e.g. https://centrepoint.org.uk/media/4773/a-year-like-no-other.pdf). This year has perhaps been a ‘year like no other’ for many of us in terms of stressors, as well as those we are supporting within our services and young people in the UK generally.
Specifically, stress is considered as three different things (Wallinga, 2014). Firstly as an actual stimulus event or environmental stressor. These stressors can be grouped into different types such as ‘a major life event’ (e.g. losing our job, moving house, having a baby or the breakdown of a relationship), ‘life transitions’ (e.g. puberty, changing jobs or schools), ‘daily hassles’ (e.g. arguments with family or friends, pressures at work) and ‘disasters’ (e.g. car accident, natural disasters, our computer crashing). However, ‘stress’ can also be considered as a process that we undertake to understand this stimulus event and it’s context, and lastly as the reaction we have to this stimulus event. In other words, the event, our understanding of that event and how we deal with it, will all contribute to our overall levels of ‘stress’. If an event is ‘stressful’, it must in essence overload our perceived and actual ability to cope with it. Hence, sometimes we may feel overwhelmed by something that is happening to us and at other times, we may feel able to cope with that event in that moment. Or to put it another way, one person may be able to deal with a particular stressful event whereas another person may feel unable to do so, perhaps as a result of their lack of coping resources, social support or as a result of their prior experiences shaping their view of that stressor.
This notion is known as the ‘Transactional Theory of Stress & Coping’ (TTSC; Lazarus, 1966; Lazarus & Folkman, 1984), which presents stress as ‘a product of a transaction between a person (including multiple systems: cognitive, physiological, affective, psychological, neurological) and his or her complex environment’. However, what may be surprising is that actually a little bit of stress can also be adaptive to us. Sometimes a little bit of ‘stress’ can focus our minds and trigger our biological responses to take action (e.g. to increase our ability to focus in an exam, or quickly respond to avoid a car accident). However, whilst a little bit of ‘stress’ is not a problem, we should care about our stress levels because too much stress can not only impact on our psychological well-being but also significantly impact on our physical health (see short video here: https://www.youtube.com/watch?v=v-t1Z5-oPtU&t=23s).
So how can we cope with ‘stress’, given that as human beings currently surviving a global pandemic we can’t avoid it? Moreover, how can we support those we work with, whether colleagues or the homeless young people in our services, or even our friends and family? There are many ways that psychologists have suggested to cope with stress, and ‘stress management’ is now a burgeoning industry in its own right. These can include cognitive or thinking strategies (e.g. hobbies, meditation or mindfulness, therapy, planning, reading, time management), physical strategies (e.g. creative expression, deep breathing, physical exercise, relaxation or yoga), environment strategies (e.g. music, nature, pets, social support) or spiritual strategies (e.g. prayer). These are often easier to say than perhaps to undertake, especially when we are actually right in the acute moment of feeling stressed, but they are important to help us to manage stress on a day-to-day basis and look after ourselves (i.e. self-care). Personally, walking my dog, doing yoga and spending time reading or watching TV have helped me to cope with lock-down but of course, it is about individual preference and interests. However, any time spent on addressing our stress and psychological / physical well-being is always time well spent whatever approach we adopt.
More specifically, taking a psychologically informed approach to understanding and coping with our stress, some psychologists have noted that we engage in a specific process of cognitive appraisal to determine whether we believe we have the resources to respond effectively to the challenges of a stressor or change (Folkman & Lazarus, 1988; Lazarus & Folkman, 1987). Our response to a particular stressor, including how we try to cope with it will then effected by this appraisal of the stressor as threatening or non-threatening as well as our view of whether we can manage it or not within our current internal or external resources. For example, we may adopt problem-focused versus emotion-focused coping strategies, active versus passive coping strategies (e.g. Folkman & Lazarus, 1980; Lazarus & Folkman, 1987; Jex et al, 2001), or approach / assertive versus avoidance or withdrawal coping strategies (Anshel, 1996; Roth & Cohen, 1986). As a result different types of coping strategies have been outlined by psychologists in research studies (e.g. Clarke, 2006; Folkman & Moskowitz, 2005; Skinner et al, 2003), although of course there is no one perfect coping strategy for all stressful situations.
Therefore, the most psychologically informed approach to coping strategies is to adopt the one that is most adaptive and possible in that moment but is not maladaptive in the long term. For example, avoiding a stressful situation (e.g. using drugs or alcohol) may work in the short term to block out negative emotions but will likely cause further negative problems (e.g. addiction) in the longer term. Problem solving or active coping strategies can include working on solving the problem, or making plans for action involving smaller manageable steps. Problem avoidance or distraction strategies can involve denying the current stress and trying not to think about it, leaving a stressful situation and staying away from it in the future, or distracting ourselves from the stress with other more positive or pleasurable activities. Emotional expression or emotional regulation strategies can include letting any negative emotions associated with the stressor out through discussing with another person we trust or engaging in physical activities, or soothing the emotion through calming activities or breathing exercises, or trying to change the emotional response to a situation by thinking differently about it. Finally, help or support-seeking strategies involve seeking aid, advice, comfort or understanding from others in our social support network.
The ideal coping strategy for stress can therefore depend on the context, as well as the individual themselves, however one psychological intervention to manage stress that can be helpful for both ourselves and those we work with is known as the ‘Shift & Persist’ approach (Chen & Miller, 2012). This two-stage approach requires us to start by shifting our view of the stress, by firstly recognising and accepting the presence of the stress, then engaging in emotional regulation strategies to control any associated overwhelming negative emotions and then taking a moment to distance ourselves from the stressor to gain some perspective. This can then allow us to engage in the persisting or dealing with the stress stage. For example, by making plans to deal with it perhaps by setting some goals, keep a wider perspective on the stressor to avoid us becoming overwhelmed, focusing on what we value in life and putting our energies into this instead, and finally trying to remain flexible in order to see what alternatives may be available to us in the face of the current stress.
Finally, in order to be psychologically informed about stress critically means ensuring that we can recognise stress in ourselves as well as any others we are supporting, hence the need for a ‘Stress Awareness Month’! The first step to any of the actions outlined above is to know that we need to apply a coping strategy in the first place because we are stressed! I often spend time speaking with staff in our organisation identifying and normalising stress as a natural response to the challenges of the work that we do, and highlighting that admitting to feeling stressed is not a sign of ‘weakness’ but of being human and of managing the often multiple and conflicting demands and challenges that we face each day. Taking a few moments to recognise our own stress, including what might trigger it, what thoughts it might lead to, where and what it feels like within our body and what behaviours we engage in as a consequence is important. This then enables us to make any necessary changes to our lifestyle, improve our self-care and replace any unhelpful thoughts, feelings and behaviours with more helpful ones. Moreover reflecting on previous times we have dealt with stress can be a useful learning exercise. For example, thinking about how we have coped in the past can help us to increase our confidence in our own coping resources or ‘resilience’ as well as to help identify what external support or resources have been useful or are needed to cope with stress in the future. Of course, as a PIE approach would also argue, and Maston (2001) also notes, ‘resilience’ [to stress] does not come from the rare and special qualities, but from the everyday magic or ordinary normative human resources in … relationships’ (p.235).
