Divya C. Berry is an MBPsS and MBACP accredited Gestalt therapist and counsellor in London, with degrees from LSE, University of London and City University London in Social Psychology and Health Psychology at the MA level. She is currently accepting stress management consultations via online sessions.
Dealing with stress in practical terms
Counselling is a safe and secure zone to bring your ‘stresses’. It can be broken down into three stages:
- Firstly, it is the sheer ventilation of the stress, without careful construction of facts, bur rather letting the experiential reality to be shared and thus allowing for a connection to be made between the counsellor and the client.
- Next is the formulation of stressors and triggers, while thinking deeply about what brings about a stress state for that person. This step is helpful in building awareness.
- Lastly, we focus on physical ways to alleviate stress by modulating its impact on the body. This is done through breathing, and by making consistent changes that allow the individual to raise their own resource pool rather than ‘avoiding’ or ‘escaping’ the trigger for stress.
As the term suggests, stress can be ‘managed’ outside of ourselves in advance, gently, before it overwhelms the system and becomes a problem to our everyday lives.
Stress and stress disorder: an overview
Stress, simply put, is a physiological and mental condition, where the external situation overwhelms the person’s internal resources to cope.
The World Health Organisation (WHO) defines stress as: “the reaction people may have when presented with demands and pressures that are not matched to their knowledge and abilities and which challenge their ability to cope.” It is not a disease.
Understanding stress as a coping state is as vital as understanding it symptomatically, in terms of what it does to the body and mind. Is it a state, or is it a trait? This is often a question that emerges in dialogues around stress. It is both – some people are naturally wired to get ‘stressed’ more frequently than others, making it a trait; while others have a coping repertoire that is more resilient to stressors, but different types of stress make it challenging and impact them. Counselling and psychotherapy by trained counsellors and therapists can go a long way in helping to manage stress and improve one’s coping repertoire.
A ‘stress disorder’, however, is defined as a disease, in terms of matching the criterion needed to clinically diagnose it as so. It involves a psychiatric diagnosis, and can range from generalised anxiety disorder, post traumatic stress disorder, obsessive compulsive disorder, panic disorders, phobia disorders, and social anxiety. Typically, these types of disorders are best managed by a clinical team combining a psychiatrist and clinical psychologist.
How does stress affect your health?
The link between ‘stress’ and health – both mental and physical – is long established. Physically, stress can quite literally burn a hole in your stomach! Stress is a person’s response to threat or danger, and the fact of not having the resources needed at that point to manage, hence falling into a ‘stressed state’.
It’s important to differentiate chronic stress from other stress disorders – being in a state of continued stress without much management or relief can get the body and mind used to being in a state of hypervigilance, where one may not even notice the state anymore. The effect that this has on the body is the most devastating – there is adrenal fatgiue, which basically means the adrenal glands get used to releasing the chemical adrenalin and cortisol frequently. These are useful agents when the body needs the energy to fight an extrenal stressor or in sport situations, but having a high level of adrenal response in ordinary life situations causes long term physiological damage, as the body is literally constantly responding to a challenge.
In lay language, this translates into heightened respiration, which is heavy breathing, increased pulse rate due to the heart beating faster in order to respond to the danger, a rise in blood pressure, increased muscle tension, pupuls dilation and sweating. You may be familiar with some or all of these symptoms together. Familiarity with all of them all the time means its time to consider if you are suffering from chronic stress, which is indeed a very challenging form of stress condition in terms of its deep physical impact and its relation to anxiety and depression.
Related: Anxiety Counselling London
How to manage stress
One of the best ways to manage stress is to first understand it in terms of its symptoms. This is called ‘psychoeducation’, which means becoming psychologically aware, through education, about what stress is and its impacts on the body, mind and soul. It also involves identifying the specific stressors, both real and imagined, for that particular person.
Simply dismissing triggers or stressors that do not match what would ordinarily cause stress is not helpful at all for individuals suffering stress, because it undermines their own experience – everything that stresses someone is real to them, and for a brief moment, it may seem as severe as fighting an invisible tiger.
One of the keys to stress management is in in activating the parasympathetic nervous system. This sounds complicated, but it’s very simple. It begins with deep breathing, which then activates chemicals involving dopamine and serotonin. This allows the body to come back to a rest and digest state – a state which is very different physically, and hence mentally, from the fight and flight state that is part of the sympathetic nervous system.
Ironically, the names of these nervous systems are the opposite to their effect – there is no sympathy or empathy when the sympathetic nervous system is activated, because its only outcome is indeed stress, in order to fight the danger faced.
Beyond the therapy room, the counsellor will eventually equip the client with techniques and tools that enable them to start recognising stress when it first begins in the body. Gestalt therapy specifically focuses on techniques that involve the body as the reservoir and canvas for feelings to be exhibited and experienced. While it is easy to list these, the actual deep understanding and capacity to follow a stress-free life is best achieved through first-hand stress counselling sessions.
How can stress management counselling help?
Stress management counselling can help firstly by addressing the issue head on. The discovery that simple techniques of self-care and honest management of feelings can begin to reduce the brutality of the stress response is a liberating place to begin.
Talking about stress triggers, describing how one may think about them or how frequently, ventilating deep feelings around them, learning to recount how they impact the body and eventually creating a toolbox of one’s own skills and techniques guided by therapy are some of the steps that make up part of the session.
What to expect from a stress management session
A stress management session would not begin with any kind of agenda or plan – we would flow with whatever the client brought to the session. If a client comes in with the intention of managing stress and wants to focus on their stressors, then we would go with that. ‘Going with it’ simply means we would move from a starting point through conversation and dialogue, into what types of stress are crowding their mental space and how that impacts them physically.
The specific form of stress management that I practice, which is Gestalt Therapy, relies on the body as a space that holds our emotional states, and so understanding where the stress is felt, where it fixates and is located in a particular zone, is important – understanding muscle tension and chronically sore parts is part of the process.
Stress and anxiety often go hand in hand, so some time may be spent differentiating the individual’s response to their triggers would be part of the process. The word ‘process’ is key here, because working with a client looking at stress management is always a process, rather than a clear cut set of strategies.
A minimum of 6 sessions is recommended in general, to be able to establish rapport, benefit from the consistency and commitment of the therapy contract, and start to feel some sort of ease. The most important outcome would be an increased awareness of the stressors and being able to pre-empt their arrival, quite literally, in the body.
Awareness brings about choice, and allows for the individual to see all the various possibilities more clearly from afar, without being deeply entrenched in them. Choice is empowering, because it means we can slowly move to a state of self-support, rather than wait for the environment to change. Effectively, we teach ourselves to be better equipped and deal with stress more effectively with an enhanced coping repertoire, rather than wish or will the stressful situation away.
Resources and further reading on managing stress
- Why Zebras Don’t Get Ulcers by Fritz Perls
- When The Body Says No by Gabor Mate
- Chatter: The Voice In Our Head and How To Harness It by Gaie Houston
- The Power of Now by Eckhart Tolle