Stress management: Ways to cope with stressors large and small

Then there’s the added stresses of the holiday season — can you really keep your cool while dealing with your inebriated uncle or nosy cousin at the dinner table yet again? We asked Spiegel to break down the impacts of stress on our health, and what to do to combat its negative effects.

1. Pay attention to what stress is telling you

Even if it’s unpleasant, a stress response is an important clue, Spiegel said. While it might be tempting to stuff your problems away, denial and avoidance are not effective stress-relief strategies. Stressed at work or in your home life? There might be concrete issues you should tackle to improve your situation, which would lower your stress.

“Sometimes stress mobilizes you to identify and deal with the problem. It’s important to recognize when things are troubling you, and then use that knowledge to formulate means of responding,” Spiegel said. “Stress is not all bad. It can be a way of bringing your attention to things that you need to do something about.”

That advice applies to problems small and large, he said. Is your boss angry at you because you were late for a meeting? Outline a plan to keep yourself on time in the future. Are you stressed because you’re worried about the state of your community or the world? Pick a cause you care about and donate time or money to make small changes.

2. Calm the body, calm the mind

Because the stress response is so tightly connected to our bodies, we can tackle it through those physical responses, Spiegel said. Calming the body can also calm the mind. Several techniques have been proven in studies led by researchers at the Center on Stress and Health to reduce the stress response. These techniques include focused breathing techniques, meditation and hypnosis.

“Most of the stressors we deal with don’t involve immediate threats to health or life, yet we tend to respond physiologically as well as psychologically,” Spiegel said. “Finding ways to manage the body-mind effects of stress can be a useful way of handling it.”

In Spiegel’s own research, he’s seen that hypnosis can be effective for patients facing difficult medical procedures. In one study, children undergoing a painful but frequently used radiology procedure who were taught and used a self-hypnosis technique saw shorter procedure times, and their parents and medical staff reported they seemed less distressed than the control group, who did not use hypnosis. Spiegel is also a co-founder of a self-hypnosis app, Reveri. Other popular mindfulness apps, like Insight and Calm, have also been shown to reduce stress, he said, and such apps are making effective stress relief easily available.

3. Social support matters

Social support can be a buffer against the negative effects of stress. Long-running research at the Dana-Farber Cancer Institute in Boston has shown that married cancer patients, especially married men, fare better than do single patients. Some of Spiegel’s foundational work on support groups for cancer patients, begun in the 1970s, found that women with metastatic breast cancer who met in regular groups with their peers reported less anxiety and pain and better quality of life than those who did not join such groups. Indeed, the women randomized to group therapy lived on average 18 months longer than control participants. When he started this research, he was met with skepticism by many in the community, Spiegel said.

“We were warned that we would demoralize these patients by having them watch one another die, as though death is a novel concept to a cancer patient,” he said. “The women did grieve the deaths of other women in their group, but they would also encourage one another and see that there are better and worse ways to face death.”

The positive effects of our social environment is why the COVID-19 pandemic was so hard on our collective mental health, Spiegel believes: Social connections, once a source of comfort and stress relief, became themselves a major stressor. That dark side of social support might be lingering for some even now, Spiegel said.

“It contaminated our view of our social world,” he said. “That sense of fun and enjoyment that you thought was guaranteed is a bit different now.”

4. Severe and mild stress have similar roots

Although there’s a gulf of difference between everyday stressors like planning a holiday dinner or work tasks and severe trauma like living through a war or assault, much of Spiegel’s coping advice remains the same.

He’s seen many patients with post-traumatic stress disorder in his career and uses many of the same techniques with them as he does with patients with lower levels of stress or anxiety.

While someone with PTSD may need expert care, and someone with lower stress levels might be able to manage on their own with evidence-based techniques, both situations require confronting the source of stress head-on, Spiegel said. One of the most effective types of psychotherapy for PTSD is something called controlled re-exposure, he said, which entails reliving and reframing memories of the traumatic events in a safe and trusted environment.

5. Taking control of how you feel

Stress is scary in part because it makes us feel helpless, Spiegel said. Physical stress reduction techniques are effective not only because they reverse stress’s physiological impacts, but because they show us that we can control how we feel. Mastering our bodies’ responses tells our brains we have agency in the situation.

Exercise can be a big help, Spiegel said, because it engages your body in something constructive that counterbalances the destructive physical effects of stress. The more you engage with what’s going on — whether it’s by tackling the problem at its source or by trying physical calming techniques — the better you will feel.

“It’s a matter of, do you face it or flee from it?” Spiegel said. “If you face it, you’re more likely to handle it better.”