Mental health articles

cognitive restructuring techniques for stress Maladaptive response to stress is typically multidimensional, oft en involving
cognitive distortion, physiologically disruptive responses, and ineff ective
behavioral choices. For stress management to be eff ective, an integrated
biopsychosocial approach is necessary. A combination of the following techniques
is generally more eff ective than employing a single approach.
Cognitive Restructuring
Addressing the cognitions that increase stressful reactions is essential. Stressful
situations are inevitable, but thinking about them in irrational and ineffective
ways intensifi es the distress. One example is perfectionistic thinking.
Granted that most test situations have the potential to be stressful, taking tests
is that much harder with the belief that scoring 100% or quite close is a measure
of one’s personal value. Preparing for the exam becomes more diffi cult,
and the likelihood of good performance is actually reduced. Perfectionism
also assures a chronic level of stress, because one of the facts of university life
is frequent evaluation.
A very diff erent cognitive set that also makes testing and papers unduly
stressful occurs when students angrily focus on the inadequacy of the teacher,
resentment toward parents who have put performance expectations on them,
or disdain for other students, who are “not very bright, but so compulsive
about preparing for the exam.” Harboring such negative cognitions can make
it impossible to concentrate.
Another irrational and stress-inducing way of thinking is to believe that one
must succeed in all social contacts, since, of course, no student will please every
potential friend or charm every potential boyfriend or girlfriend. Similarly,
the belief that it’s necessary to be appreciated and valued by all other students
or professors inevitably leads to frustration and unsuccessful relationships.
Clearly, a crucial ingredient in eff ective stress management is helping students
identify their irrational sets of beliefs. Some common stress-inducing
beliefs are
“I need to do extremely well [on exams, in sports, or in club elections]
or I am worthless.”
“If I don’t do extremely well, there’s no point in further trying.”
“If I don’t do extremely well, others are to blame.”
“Everyone should appreciate all aspects of me.”
“I should not have to study if I have other things I want to do.”
“Th ese professors should not expect so much from me.”
“My friends and family should never be angry with me.”
“Others should never disappoint me.”
In contrast to such stress-inducing beliefs, stress-resistant individuals
maintain positive attitudes toward their experience. Some common positive attitudes are an openness to change, a feeling of involvement, a
sense of loose control, and an acceptance of the inevitability of certain
unpleasant events or required activity.
Discussing more adaptive approaches to experience—thinking about challenges
and demands in constructive ways—is an important component of
stress management. Th is includes replacing perfectionistic, black-and-white,
catastrophic thinking with reasonable alternatives: “I didn’t get an A, but I’m
still proud of how I did,” “My roommate doesn’t seem that crazy about me, but
we can still get along, and I have lots of other friends.” Constructive thinking
also includes recognizing and accepting the inevitability of undesirable events
in life. Th e goal is not to promote passivity. On the contrary, it’s to assess
whether it’s possible to change the situation for the better. Some stressful life
events can be eff ectively managed. Others require a more accepting attitude.
Helping a stressed student understand the diff erence between situations
that can be actively addressed and situations that call for acceptance is a core
of good stress management. A fairly common example is a student obsessed
and irritated with a professor perceived as inadequate, too critical, or just too
annoying. Reviewing the eff ects of addressing the situation by confronting
the professor or transferring from the class versus more passive, but judicial
strategies assists the student in making the decision. Either pathway will be
stressful. Helping the student identify the beliefs and attitudes that make these
situations more stressful is crucial.
A cognitive therapy approach helps the student understand that the majority
of stress is self-induced, based on interpretation of events. Th e clinician
should strive to help the student identify dysfunctional, stress-inducing
beliefs without coming across as critical. Asking the client to keep a stress log
can be extremely helpful. Th e log should record moments when the client feels
particularly stressed, along with who is involved and what the client has been
doing and thinking. Th is exercise may bring to light self-defeating attitudes,
such as a striving for superiority; needing to be loved and respected by all, to
be competent in all pursuits, and to be right or to win; intolerance of others;
and hyperresponsibility.
Reviewing the stress log helps identify cognitions that may be increasing
stress or leading to the avoidance of stressful situations. A common example is
the student who does very well on examinations but feels more internal pressure
to perform well when writing papers. Gently exploring and addressing
that student’s cognitions about writing papers is a crucial aspect of the student’s
learning to manage that stressor.
Th e cognitive approach helps clients become self-assured, not ego
focused. It shift s attention away from the self and toward objectively processing
information from the environment, and raises awareness of and
replaces stress-inducing personal beliefs (like perfectionism) with constructive
alternatives.

Tags: stress