Marmot (1977) found civil service, clerical and office support employees on the lowest grades were four times more likely to die of a heart problem than those on the most senior grades. He also found them to be more likely to suffer from cancer, strokes and gastrointestinal disorders.
Langer & Rodin found that the health and life expectancy of elderly residents in a nursing home improved once the patients were given a small increase in personal control.
Hartley (1987) found that unemployed men perceived their problem as severe in proportion to how much control they believed themselves to have.
c) In the relaxation process, the patients are trained to tense and relax muscles systematically. The aim is to use the technique to reduce bodily arousal at any time. During relaxation state, stress response mechanisms are inactive and the parasympathetic nervous system is dominant. Relaxation is non-invasive and fairly easy to practice. However, it involves time and space, and is non-specific and therefore does not treat the cause of the problem.
Meditation is similar to muscle relaxation. Its aim is to reduce bodily arousal and to achieve a state of transcendental calm. It is achieved by sitting quietly and repeating a mantra while breathing regularly and deeply with an aim to empty the mind of distracting and arousing thoughts, that activated the body’s stress response system. Meditation is more ‘portable’ than other relaxation techniques. Green (2000) suggests it may give people more confidence to deal with stressful situations. It is also non-invasive. However, it does not tackle the source of the stress.
Meichenbaun’s Stress Inoculation Training (1977) aimed to manage stress before anxiety sets in. This is done in three stages, the first being conceptualisation. The client is encouraged to relive stressful situations and analyse what was stressful about it, how they attempted to cope and how they could be eliminated. The second stage is stress reduction techniques. During this stage the client is taught a variety of specific and non-specific techniques (e.g. relaxation, social skill, time management etc.) in a therapeutic situation. The individual practices coping self-statements; negative self-statements are identified and rejected. The final stage is real life application and follow through. During this stage the client and therapist role-play until finally the techniques are put into practice in the real world. The model focuses on both the nature of the stress and ways of coping. It combines cognitive strategies and behavioural techniques. Meichenbaun himself claims encouraging results, however, few controlled studies have confirmed the predictions. It is successful for treating moderately stressed people, not the highly stressed (nor those lacking motivation, funds, time etc.), and there is evidence, which suggests coping with stressors is a basic aspect of personality. If correct, these techniques go against well-established habits.
Kobasa (1977) refers to hardiness, resistance to illness and ability to deal with stress. She studied highly stressed executives and identified characteristics of those who coped well/badly. She found that people that handled stress well were open to change, had feelings of involvement and commitment, and had a sense of control. Kobasa proposed that psychological hardiness helps individuals resist stress by providing buffers between themselves and stressful life events. She suggested three ways of doing this:- focusing; people are often unaware of stress because they are accustomed to tolerating small signs of stress such as muscle tension, reconstructing stressful situations by thinking about the situation and making two short lists (one of ways it might have turned out better and another of ways it may have turned out worse). Clients can feel more positive. The techniques are perhaps more effective than realised. Kabasa also suggested is self-improvement. If confronted by a stressor that cannot be changed or avoided, the client may be advised to take up a challenge that can be achieved. The relative importance of the three characteristics is unclear, but is likely a sense of control is important. Sarafino (1990) found that people who have followed this kind of programme do score higher on a test of hardiness, report feeling less stressed, lower pressure of more sense of control. However, it is based on a small, biased sample (white, middle-class business men), therefore generalization is a problem. Persevering with the programme requires personal qualities, which are characteristics of a hardy personality anyway. Fink questions the accuracy with which hardiness can be measured.
The effectiveness of all psychological techniques is related to various factors. Co relational studies, where levels of fitness and exercise are recorded, along with frequency of stress related disorders, such as high blood pressure and depression, show consistent exercise is associated with low levels of depression and lower incidence of hypertension. Physical exercise is an obvious and effective way of removing excess glucose and fats: they are mobilized to provide for physical activity and blood levels fall as the muscles burn them up. It is predictable that regular exercise should have beneficial effects on stress related arousal. Social support is another mediating factor. Social support helps protect us against the damaging effects of stress. The value of social support also helps explain the upsurge in unofficial support groups in particular areas. There are various categories of social supports, e.g. emotional support such as comfort and reassurance, practical support from friends and family, or advice. The concept of control is central to stress and stress management. Gaining control is an important part of coping strategy in stress management. Pervious experiences could provide useful techniques for future coping if stressful, or previous failure could provide the individual with a negative attitude. Individual differences could also affect the effectiveness of psychological techniques as some people may protect themselves through denial or detachment. Stress management techniques increase the stress felt by these individuals.
