What is stress reduction? |

Indications and Procedures

Stress can exacerbate difficulties in daily functioning, slow recovery from mental or physical problems, and impede immunological functioning. Stress reduction techniques represent a cluster of procedures that share the goal of reducing bodily and emotional tension: drug and physical therapies, exercise, biofeedback training, meditation, hypnosis, psychotherapy, relaxation training, and stress inoculation therapy.

The drugs used in stress reduction are designed to provide overall bodily relaxation, to induce rest, or to decrease the anxious thinking that exacerbates stressful experiences. Sedatives, tranquilizers, benzodiazepines, antihistamines, beta-blockers, and barbiturates are examples of such drugs. Similarly, physical therapies and exercise are recommended for these purposes. Baths (hydrotherapy), massages, and moderate exercise can also be part of a stress reduction program.

Psychotherapy is a common treatment for stress implemented by psychiatrists, psychologists, social workers, psychiatric nurses, and counselors. Not only does it help individuals to sort out their problems mentally but it is also an effective stress management strategy. When individuals analyze their lifestyles and life events, stress-inducing behaviors and life patterns can be explored and targeted for modification.

Biofeedback
training, meditation, hypnosis, and relaxation training all focus on inducing relaxation or altered consciousness by shifting a person’s attention. Biofeedback uses monitoring devices attached to the body to provide visual or aural feedback to the trainee. Such devices include the electromyograph (EMG), which measures muscle tension, and the psychogalvanometer, which measures galvanic skin response (GSR). An EMG involves placing sensors on various muscle groups to record muscular electrical potentials. GSR also relies on sensors, but these sensors record bodily responses caused by sweat gland activity and emotional arousal. The feedback from such devices allows a trainee to learn to control certain bodily processes (for example, muscle tension, brain waves, heart rate, temperature, and blood pressure). Biofeedback training is used to treat headaches, temporomandibular joint (TMJ)
syndrome, high blood pressure, and
tics, and it can also facilitate neuromuscular responses in stroke patients.

Meditation is a focused thinking exercise involving a quiet setting and the repetition of a word or phrase called a mantra. By blocking distracting thoughts and refocusing attention, meditation reduces anxious thinking. It is useful for mild anxiety, minor concentration difficulties, and daily relaxation.

Hypnosis involves the use of suggestion, concentrated attention, and/or drugs to induce a sleeplike state, or trance. Hypnosis can be induced by a hypnotist or via self-hypnosis. Hypnotic states are characterized by increased suggestibility, ability to recall forgotten events, decreased pain sensitivity, and increased vasomotor control. The ability to be hypnotized varies from person to person based on susceptibility to suggestion and psychological needs. Hypnosis is used as a brief therapy targeting such problems as insomnia, pain, panic, and sexual dysfunction. In addition, hypnosis is sometimes used when drugs are contraindicated for anesthetic use, particularly for dental procedures.

Relaxation training involves three primary methods: autogenic training, which involves such techniques as head, heart, and abdominal exercises; progressive relaxation, which involves becoming aware of tension in the various muscle groups by relaxing one group at a time in a specific order; and breathing exercises. Relaxation training is best learned when a therapist trains an individual in person and then the exercises are practiced independently. Relaxation can be practiced several times daily, as well as in response to stressful events. High blood pressure, ulcers, insomnia, asthma, drug and alcohol problems, spastic colitis, tachycardia (rapid heartbeat), pain management, and moderate-to-severe anxiety disorders are treated with relaxation training.

Stress inoculation therapy is a specific type of psychotherapy involving techniques that alter patterns of thinking and acting. It comprises three steps: education about stress and fear reactions, rehearsal of coping behaviors, and application of coping behaviors in stress-provoking situations. It is useful for treating anxiety disorders related to stress.

Uses and Complications

Individuals should not apply stress reduction procedures without proper consultation; medical conditions that might be causing symptoms should be assessed or ruled out first. Biofeedback training for headaches, for example, would be unwarranted until other, more serious causes of headaches had been eliminated from consideration. Similarly, exercise, drug, and physical therapies could actually worsen conditions such as high blood pressure, alcohol and drug problems, and chronic pain if applied incorrectly. For example, where stress or pain is chronic, drug therapies might encourage the development of drug dependence.

Instead, skilled providers should administer these procedures. Training via self-help materials alone or by an unskilled provider may provide no benefit or create difficulties. Poor training could result in frustration, hypervigilance, heightened anxiety, depression, or pain caused by overattention to symptoms or conflicts. In fact, some individuals are prone to these effects even with good training. Therefore, ongoing assessment is necessary. Finally, interpretation of any memories provoked by hypnosis should be done with caution because of the suggestibility that is characteristic of hypnotic states.

Perspective and Prospects

Stress reduction techniques evolved from ancient meditation practices and simpler methods of pain management predating the development of modern anesthetics. The palliative and preventive effects of these techniques have given these procedures a sure hold in future medical practice, while benefits such as decreased absenteeism and increased feelings of wellness in employees have secured these strategies in the workplace. The expanded use of stress reduction procedures in prenatal care and with the elderly is likely.

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