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...helping navigate cancer survivorship

Stress Management

Stress is a normal part of  life. How one copes with that stress likely has a strong impact on one’s physical and emotional health. Coping with stress has two aspects: stress awareness and stress management

For an overview of this topic watch the Don’t Stress the Stress webinar recording.

Quick Guide to Stress Management

Stress Awareness:

Each individual has their own personal sources of stress (called stressors), as well as physical reactions to acute stress, and physical, psychological, and behavioral reactions to chronic stress (called stress responses). Many people are often unaware of the scope and/or intensity of their stressors as well as the pattern of their stress response.  Completing the following stress awareness worksheets is the first step in learning to cope with stress.

  1. Sources of Stress
  2. Signs of Acute Stress
  3. Signs of Chronic Stress
  4. Three Day Stress Diary

Once theses worksheets are completed, the following stress management tools can be utilized.

Stress Management

Stress management techniques include problem solving, changing attitudes or cognitive appraisal, and relaxation techniques. While presented in this sequential order, any of the techniques can be used independently and in any order.

1. Problem Solving

Problem solving is the first step in the management phase of coping with stress. This should be tried after the sources of stress (stressors) as well as physical reactions to acute stress  and physical, psychological, and behavioral reactions to chronic stress (called stress responses) have been identified. The goal of problem solving is to eliminate major stressors or, at the very least, to make them less stressful.

At some point it will become clear that: 1) the problem is solved, or 2) the problem is at least less stressful, or 3) the problem can’t be problem solved away.

2. Changing Attitude or Cognitive Appraisal

If a stressor cannot be eliminated or at least altered through problem solving, the next management technique to try is altering how you think about the stressor. Changing your attitude towards a stressor would involve asking yourself if it really is all that important. For instance, how important is it really if the house in not perfectly clean or if someone else got the office with a window? Of course, some stressors really are important and can be a threat (e.g., cancer) but many of the daily hassles that we get upset about are not all that crucial. Ask yourself: “Is this really important in the grand scheme of things, life altering, or will it really matter in 20 years?”

To understand how individuals can perceive or assess the same thing quite differently is clearly demonstrated by the cartoon.

3. Relaxation

Finally, it is helpful to know how to alter physiological responses to stressors when they do occur. A variety of relaxation techniques are helpful for this purpose. One of these is a simple Progressive Muscle Relaxation (PMR) with Guided Imagery (GI). PMR was first described in the medical literature in the 1930s. Since that time it has been used with good effect in the management of a whole range of emotional and physical problems including pain management. As we become stressed our muscles begin to tense (even though we may be unaware of this) in readiness for action. PMR consists of becoming progressively aware of the level of tension in each of the major muscle groups in your body by contracting those muscles and then releasing the tension. By learning to relax the body, it is possible to achieve a simultaneous state of mental relaxation. In the process, we redirect our attention from stressful thoughts and images and can become immersed in the activity of “letting go” of tension. Guided Imagery is a technique that individuals can use to achieve a positive mental imaginary state. Initially, individuals can learn the GI technique with the help of a trained health care professional.  PMR and GI should be thought of as a skills, and like any other skill, it requires practice. Once these skills has been mastered it will require only a few seconds to initiate and can be used effectively to decrease physical responses and master stress. Patience and practice are the keys to learning relaxation. To learn these techniques listen to the recorded exercise below a few times.  The goal is to eventually learn these techniques and to be able to initiate and perform them on your own.

Progressive Muscle Relaxation (PMR) and Guided Imagery (GI) Exercise

NOTE: The exercise below involves physically tensing and relaxing your muscles. If you are experiencing any physical limitations, you can skip tensing any muscle groups necessary, and still benefit from this exercise. 

If after using these resources you are still struggling with stress management please communicate with your health care team to access additional professional services.

There are different types of health care professionals that can help manage the various psychological and psychosocial issues that can arise after a cancer diagnosis, treatment, and survivorship issues. However, different types of health care professionals provide different services. Therefore, it is important to be clear in communicating your needs in searching for and selecting a mental health professional.

To find a mental health care professional in your area you can start with your existing health care team or contact the American Psychosocial Oncology Society (APOS). APOS’s Helpline is a national referral program to help people with cancer and their caregivers find emotional support in their own communities.

It is also beneficial to ensure that any health care professional you visit is within your health insurance plan’s network. You can typically call the number on the back of your insurance card for more information about providers and your plan’s network. For more information about health insurance basics watch our short video: Triage Cancer Presents: Health Insurance Basics