Strategies for Stress Reduction, Part 1

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By Bruce Campbell

(Note: The first article in this series described sources of stress and the toll stress takes on people with ME/CFS and FM. This article and the next one focus on stress reduction.)

 
Often, how we view and react to a source of stress determines how much stress we experience. For example, if you worry in response to an increase in symptoms, you may tense your muscles. Muscle tension can create pain, draining energy and causing fatigue. By learning to relax, you can lessen muscle tension and ease symptoms.

Similarly, stress can be increased by our thoughts. Negative thoughts can make us feel anxious, sad and helpless, creating a vicious spiral. Negative thoughts increase stress, which in turn triggers another round of negative thoughts. It is possible to interrupt this negative spiral using the principles of Cognitive Therapy.

This article describes the two strategies we believe are particularly powerful for stress reduction: a daily relaxation period and modifying self-talk. In the next article, I’ll describe 11 additional stress reduction strategies.

Relaxation

When we become stressed in the face of challenge, we often respond with a fight-or-flight reaction. Adrenaline flows, and we feel charged up. If the challenge is brief, the initial reaction is followed by relaxation. If, however, you feel yourself to be under constant threat, as you may if you are always in pain or have other ongoing stressors, your body stays in a state of tension.

Activities that are physically relaxing counteract both the physical and the emotional aspects of stress. Through relaxation, you can reduce muscle tension and anxiety. Relaxation is also very helpful for pain control. Combining rest with a relaxation procedure or meditation can be an even more effective means of stress reduction.

Examples of stress reduction procedures include focusing on your breathing, the body scan, progressive relaxation, the relaxation response and guided imagery. In my response to stress, I used two formal stress reduction practices, the body scan and the relaxation response.

The body scan is a relaxation procedure in which you focus your attention on one part of the body at a time. The relaxation response is a form of meditation that uses a focus on a word or image. (You can find step-by-step instructions for these techniques and three more in the article Stress Reduction: Five Practical Techniques.)

I found the body scan a helpful way to relax but, surprisingly, it became less effective as the years went on. Through that disappointment, I learned that sometimes I could develop “tolerance” for a relaxation practice, similar to the tolerance sometimes experienced with medications.

I used the relaxation response when I noticed that sometimes my daily rests were somewhat stressful because my mind was racing, full of anxious and worried thoughts. I found that the relaxation response put me into a state of deep relaxation, which produced a more complete rest than I got just by lying down.

We recommend combining a relaxation procedure with daily scheduled rests. Doing the two together provides a way to quiet the mind and turns off the fight-or-flight response, producing deep relaxation.

Because everyone is different, some techniques work well for one person and other techniques work better for another. In particular, techniques using imagery seem very helpful to some people, but not useful to others. Try several techniques to see what works for you.

Also, as I mentioned in discussing how I developed a “tolerance” for the body scan, you may find that a particular technique works for a while, and then becomes ineffective. If that happens, try something else or rotate among several different strategies.

 
It usually takes several weeks or more of practice to develop skill in using a technique, so allow some time before expecting results. To be fair, you should practice four or five times a week, setting aside ten to 20 minutes for each session and choosing a time when you won’t be disturbed. Learning to concentrate is a common problem when doing a relaxation practice. The mind tends to wander, so having patience is necessary.

There are many good relaxation and meditation CDs and apps available today. Some have step-by-step instructions to lead you through a relaxation procedure, while others have music or relaxing sounds from nature. You may want to use such resources or record your own from the techniques you find on our website or elsewhere.

If relaxation makes you anxious or seems unpleasant, try other stress reduction techniques. These include exercise, baths, massage, acupuncture, rest, listening to relaxation tapes or music, doing calming and quiet hobbies like knitting, painting, and playing with pets.

Mental Adjustments

Our thoughts can be another source of stress and changing our thoughts can reduce our stress. For example, you may have unrealistic expectations for yourself. You may think that, as a “good mother” or “good wife,” you should keep the house as you did before becoming ill or do other things that intensify your symptoms and increase stress.

If that’s the case, you can reduce suffering by changing your expectations, so they better match your current abilities. Becoming aware of and changing the standards you have for yourself reduces stress and helps you avoid overdoing.

I made good use of this approach as well as relaxation. Being aware of what I told myself, especially during relapses, helped me to reduce my stress.

When I caught myself saying things like “You’ll never get better” or “You’ll be like this the rest of your life,” I countered by telling myself “You’ve bounced back from all your previous setbacks, so just relax” or “Remember how things always look hopeless when you’re at your worst.”

The theory behind this approach is called Cognitive Therapy. It is based on the idea that thoughts increase stress through our “self talk,” the internal dialogue we have with ourselves, especially about negative events. This can create a vicious cycle.

An increase in symptoms triggers negative thoughts like “I’m not getting anywhere,” or “It’s hopeless.” The thoughts and the stress they create may make your symptoms worse and trigger another round of negative thoughts. The cycle can be very demoralizing, leading to an overly pessimistic view of your situation and making it difficult to motivate yourself to do things to feel better.

The thoughts and the stress they create may make your symptoms worse and trigger another round of negative thoughts. The cycle can be very demoralizing, leading to an overly pessimistic view of your situation and making it difficult to motivate yourself to do things to feel better.

But you can learn how to recognize and change habitual negative thoughts so that your self-talk is more realistic and more positive. Using this healthier way of understanding your experience, you acknowledge the negatives in your life, but praise yourself for your successes. This approach reduces stress by helping you feel better, less anxious and sad.

Cognitive Therapy takes work and improvement is usually gradual, but the long-term results can be dramatic.

There are many self-help manuals for changing self-talk. Our favorite is Mind Over Mood by Dennis Greenberger and Christine Padesky. Others include Feeling Good by David Burns and Learned Optimism by Martin Seligman.

Also, you can get professional help; look for a counselor who specializes in Cognitive Therapy. And, for a step-by-step introduction, see either of two articles: Changing Self-Talk: A Cognitive Therapy Primer or Taming Stressful Thoughts.