Manage stress handout
If your methods of coping with stress aren’t contributing to your greater emotional and physical health, it’s time to find healthier ones. There are many healthy ways to manage and cope with stress, but they all require change. You can either change the situation or change your reaction. When deciding which option to choose, it’s helpful to think of the four As: avoid, alter, adapt, or accept.
Since everyone has a unique response to stress, there is no “one size fits all” solution to managing it. No single method works for everyone or in every situation, so experiment with different techniques and strategies. Focus on what makes you feel calm and in control.
Dealing with Stressful Situations: The Four A’s
| Change the situation: Avoid the stressor. Alter the stressor. | Change your reaction: Adapt to the stressor. Accept the stressor. |
1. Avoid unnecessary stress
Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed.
Learn how to say “no” – Know your limits and stick to them.
Avoid people who stress you out –Limit the amount of time you spend with people that cause you stress.
Take control of your environment – If the evening news makes you anxious, turn the TV off.
Avoid hot-button topics –If you repeatedly argue about the same subject with the same people, stop bringing it up or excuse yourself when it’s the topic of discussion.
Pare down your to-do list –If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.”
2. Alter the situation
If you can’t avoid a stressful situation, try to alter it. Figure out what you can do to change things so the problem doesn’t present itself in the future.
Express your feelings instead of bottling them up. If something or someone is bothering you, communicate your concerns in an open and respectful way.
Be willing to compromise. When you ask someone to change their behavior, be willing to do the same.
Be more assertive. Deal with problems head on, doing your best to anticipate and prevent them.
Manage your time better. Plan ahead and make sure you don’t overextend yourself.
3. Adapt to the stressor
If you can’t change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude.
Reframe problems. Try to view stressful situations from a more positive perspective.
Look at the big picture. Will it matter in a month, or a year?
Adjust your standards. Set reasonable standards for yourself and others, and learn to be okay with “good enough.”
Focus on the positive. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life, including your own positive qualities and gifts.
4. Accept what you can’t change
Some sources of stress are unavoidable, in such cases; the best way to cope with stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation you can’t change.
Don’t try to control the uncontrollable. Focus on the things you can control such as the way you choose to react to problems.
Look for the upside. As the saying goes, “What doesn’t kill us makes us stronger.” When facing major challenges, try to look at them as opportunities for personal growth.
Share your feelings. Talk to a trusted friend or make an appointment with a therapist.
Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes.
5. Make time for fun & relaxation
You can reduce stress in your life by nurturing yourself. If you regularly make time for healthy fun and relaxation, you’ll be in a better place to handle life’s stressors.
Healthy ways to relax and recharge
| Go for a walk. Spend time in nature. Call a good friend. Exercise. Write in your journal. Take a long bath. Light scented candles | Play with a pet. Work in your garden. Get a massage. Curl up with a good book. Listen to music. Watch a comedy |
Nurturing yourself is a necessity, not a luxury.
Set aside relaxation time. Include rest and relaxation in your daily schedule..
Connect with others. Spend time with positive people who enhance your life.
Do something you enjoy every day. Make time for leisure activities that bring you joy, whether it be stargazing, playing the piano, or working on your bike.
Keep your sense of humor. This includes the ability to laugh at yourself.
6. Adopt a healthy lifestyle
You can increase your resistance to stress by strengthening your physical health.
Exercise regularly. Physical activity plays a key role in reducing and preventing the effects of stress.
Eat a healthy diet. Well-nourished bodies are better prepared to cope with stress, so be mindful of what you eat.
Reduce caffeine and sugar. The temporary “highs” caffeine and sugar provide often end in with a crash in mood and energy. By reducing the amount of coffee, soft drinks, chocolate, and sugar snacks in your diet, you’ll feel more relaxed and you’ll sleep better.
Avoid alcohol, cigarettes, and drugs. Self-medicating with alcohol or drugs may provide an easy escape from stress, but the relief is only temporary.
Get enough sleep. Adequate sleep fuels your mind, as well as your body. Feeling tired will increase your stress because it may cause you to think irrationally.
Setting boundaries
Setting boundaries is an essential skill in life, especially for people in recovery. Addicts often grow up in dysfunctional homes, where boundaries were either too rigid (leading to suppressed emotions or distant relationships) or too enmeshed (depriving them of a sense of personal identity). Later in life, their interpersonal relationships may continue to be defined by old roles and patterns, increasing the risk of depression, anxiety and addictive or compulsive behaviors.
As part of recovery, addicts learn how to set boundaries and to respect other people’s boundaries in return. In the addiction field, treatment providers often refer to this process as embracing the authentic self. While it may sound like psychobabble, it is really a process of discovering who you want to be, how you want to interact with other people, and taking responsibility for the consequences of your choices.
Why are boundaries important? They keep you safe from being manipulated, abused or taken advantage of, while also protecting other people from harm you may consciously or unconsciously inflict. They prevent both parties in a relationship from blurring the lines between self and others, which can lead to enmeshment and codependency. With healthy boundaries in place, you can begin to tune in to your inner voice and trust your own thoughts and feelings, and then communicate those to other people.
Distinguishing Healthy and Unhealthy Boundaries
Without a healthy role model, it can be difficult to know what healthy boundaries look like. First, let’s cover what healthy boundaries are not. They are not threats or attempts to control or manipulate others into doing what you want. They are not rigid rules or “walls” designed to keep people out or shield you from expressing your emotions.
Healthy boundaries are simply a delineation of what type of treatment is acceptable to you, and what consequences will result from violating a boundary. People with healthy boundaries share their thoughts and feelings, take care of their own needs, and are able to say no when necessary.
By contrast, people with weak boundaries often:
• Sacrifice their personal values, plans or goals to please others
• Allow others to define who they are and make decisions for them
• Expect others to fulfill all their needs
• Feel guilty when they say no
• Hesitate to share their opinions or assert themselves if they are being treated unfairly
• Frequently feel used, threatened, victimized or mistreated by others
• Frequently offer unsolicited advice, or feel pressured to follow someone else’s advice
• Take responsibility for other people’s feelings
• Tell others how to think, feel or act
A Boundary-Setting Roadmap
Every individual is called upon to set their own boundaries. What works for some may seem either too intrusive or too distant to others. When laying out your boundaries, work through the following steps:
Create a Personal Bill of Rights. Before you can start setting boundaries, you have to recognize your right to have your own feelings, values and beliefs and to express to others how you want to be treated. For some, this requires a colossal leap in self-worth.
Identify Your Emotions. Our parents always admonish us to “think before you act.” When you have a strong response, take a time-out to identify the underlying emotion and figure out what you want to convey. Doing so allows you to interact with other people in an honest, direct way rather than blaming or lashing out.
Set Limits. Once you have a few guidelines in place for how you expect to be treated, practice setting limits with people in a clear, direct way. Examples of healthy boundaries are: “I choose to be around sober people” or “I’ll be happy to talk with you when your voice is calm.”
Assert Your Needs. If you feel that your boundaries are being violated, speak up. This doesn’t mean lashing out or blaming others, but rather assertively communicating your needs. Ask for what you want and say no, politely yet firmly, if something isn’t right for you.
Listen to Your Instincts. If a situation feels uncomfortable or inappropriate, chances are a boundary is being pushed. By tuning into your instincts, you’re more likely to respond in ways that are true to your authentic self.
Defend Your Boundaries. Once you set boundaries, expect that they will be tested. Before this happens, set consequences that you are willing and able to enforce (e.g., “If you continue this behavior, I will…”). Know that by setting limits, you may disappoint the other person, especially if they have weak boundaries themselves. While you should always act with dignity and respect, you can’t control other people’s feelings and behaviors.
If someone continually violates your boundaries, you may need to minimize contact with them, or if they are toxic to your recovery, cut ties altogether. By choosing not to let people violate your boundaries, you stop being the victim, stop blaming others and start reclaiming responsibility for your own life.
Respect Other People’s Boundaries. Just as important as honoring your own boundaries is respecting other people’s, even if they are different from yours. If they don’t have defined boundaries, show them the respect you know they deserve anyway.
Meditation and Pain Management
Meditation can relieve pain, and it does so by activating multiple brain areas, according to an April 2011 study in the Journal of Neuroscience. Fadel Zeidan of Wake Forest University and his colleagues scanned people’s brains as they received uncomfortably hot touches to the leg. When subjects practiced a mindful meditation technique that encourages detachment from experience while focusing on breathing, they reported less 
pain than when they simply paid attention to their breathing. Likewise, different patterns of brain activity emerged under the two conditions, with mindful meditating resulting in more activity not only in executive centers that evaluate experiences and regulate emotions but also in lower regions that control the signals coming from the body.
The volunteers learned the meditation technique in only four 20-minute sessions, which means this pill-free analgesia could be a feasible way to help real patients suffering from pain. “People can reap some of the benefits of meditation without extensive training,” Zeidan says.
When I work with patients using mindfulness I start by asking who has experience with any type of meditation, breathing techniques and/or relaxation exercises. We than have a brief explanation and question and answer period and I focus on removing any doubt, fear, or skepticism. I usually than do a 10 to 12 minute body scan moving right into a mindful meditation that focuses on the breath.
With the co-occurring patients I work with this process seems to work the best. The chat in the beginning warms people up, the body scan relaxes which helps the meditators enter into a more meditative state.
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