Research Paper By Natalie Hilton
(Stress Coach, UNITED KINGDOM)
Stress in itself is neither positive nor negative. It is the response of our body to external or internal stimuli, commonly referred to as the “fight or flight” response. Stress is a condition or feeling experienced when a person perceives that the demands placed on them exceed their resources (The American Institute of Stress, What is Stress?). Acute or limited stress is helpful to the human system, allowing us to respond more effectively to pressing needs. However, chronic stress has a wide-ranging negative impact on human functioning across all main systems: physiological, cognitive, emotional, and behavioral (Butler, G. (1993) Definitions of stress. Occasional paper Royal College of General Practitioners, 61, 1-5).
Chronic stress leads to a higher state of arousal which is extremely demanding and tiring over time. This state of hyper-vigilance can lead to avoidance, fatigue, and irrational thought processes. All damaging to an individual’s cognitive functioning. Emotionally, chronic stress leads to tension, worrying, and heightens emotions. It can change how individuals can express themselves, including unassertiveness, hostility, or sudden emotional outbursts. Many people feel as if they can’t cope. This leads to panic, hopelessness, demoralization, helplessness, or even suicidal thoughts. If individuals blame themselves for stress and their inability to cope, stress can hurt self-esteem and self-confidence(Butler, 1993).
The behavioral impact of stress is wide-ranging and generally, people’s reactions can be categorized into a fight, flight, or freeze. Fighters try to take more action and so become progressively overloaded and inefficient. Those who default to fleeing look to avoid or escape the situation, therefore, missing opportunities to solve their stressors. Avoidance can materialize as changes in eating patterns, or a rise in alcohol, caffeine, nicotine, or other drug use, possibility leading to addiction. Sleep patterns can also be disrupted and speech problems, including hesitancy and trouble with articulation, may arise(Butler, 1993). Those who freeze take no action, which may be characterized by procrastination and avoidance.
The most under-recognized impact of stress is on our biological systems. Chronic stress changes how many internal systems work, including our hormones and immune response. Chronic stress has been linked to increased risk of cancer, heart attacks, anxiety, and depression. It has also been linked to higher blood pressure and, due to the suppression of our immune response, to increased vulnerability to viral infections, including the common cold (Schneiderman, N., Ironson, G. & Siegel, S.D. (2005). STRESS AND HEALTH: Psychological, Behavioral, and Biological Determinants. Annual Review Clinical Psychology, 1, 607–628.).
The symptoms of chronic stress manifest differently in individuals. Although they always hurt an individual’s ability to function, wellbeing, and life. Consequently, the population and societal impact of stress are wide-reaching. For instance, APA’s Stress in America survey found that more than 40% of adults lie awake at night due to stress (American Psychological Association, How stress affects your health. Accessed at https://www.apa.org/helpcenter/understanding-chronic-stress). In the UK, nearly three-quarters of people (74%) in 2017 felt so stressed they were unable to cope (Arnold, S. (2018). Stressed Economy, Stressed Society, Stressed NHS. New Economics Foundation). In the EU the European Commission calculated in 2002 that the cost of work-related stress alone was 20 billion Euros a year (Hassard, J. et al. (2014). Calculating the costs of work-related stress and psychosocial risks – A literature review. European Agency for Safety and Health at Work).
Reducing the widespread impact of stress could positively impact society and the wellbeing of millions of people. The ever-growing social and economic burden of chronic stress means more steps need to be taken to counter its impact. With the increasing pressure on health services, resulting in long waiting lists for support, shorter consultation appointments with GPs, and higher medical costs, coaching provides an opportunity to help alleviate this burden. Coaching can be employed as an intervention before serious illness takes hold, and in addition to other treatments to help individuals deal with daily stresses more effectively.
On an individual basis, coaching can build resilience, develop healthy coping strategies, support problem solving, and provide accountability. Research has been carried out into how coaching can reduce stress, although to date this has primarily been in the workplace. Across multiple studies reviewed, stress was found to be reduced after coaching compared to controls (Gyllensen, K.& Palmer, S. 2005. Can Coaching Reduce Workplace Stress? A Quasi-Experimental Study. International Journal of Evidence-Based Coaching and Mentoring, 3, 2.). Hearn (2001) suggests that coaching may be useful in reducing stress as it can help identify stressors, find permanent solutions, and maintain these changes.
Interestingly, in multiple studies, quantitative measures of stress found no change after completion of coaching. Yet through qualitative reporting participants reported reduced stress. They also reported higher feelings of relaxation, confidence, productivity, and tolerance (Gyllensen & Palmer, 2005). This suggests that coaching may be useful to reduce an individual’s perception of their stress. If considering cognitive appraisals and perceptions as a primary determinant of stress then coaching can be seen as a useful intervention.
To effectively utilize coaching to help reduce chronic stress the best models, techniques, and tools need to be used. To be able to do this, the underlying mechanism needs to be understood. One widely accepted theory is that chronic stress can be viewed as a vicious cycle (Butler, 1993). This cycle needs to be broken for the stress to be reduced. It is unhelpful coping strategies, habits, cognitive appraisals, and structures that continue this cycle.
When confronted with stressors strong feelings surface and individuals tend to react by these emotions. As the consequential actions are emotion-driven, they are often not constructive or useful and contribute to the vicious stress cycle. What emotions arise and the actions that are taken stem from the individual’s appraisal of the event. (Lowe, R. & Bennett, P. (2003). Exploring coping reactions to work-stress: Application of appraisal theory. Journal of Occupational and Organizational Psychology, 76, 393-400). Coaching can help individuals alter this appraisal, thus minimizing negative emotions and engaging in helpful coping strategies.
Utilizing aspects of Cognitive Behavioural Therapy (CBT) within coaching sessions can be useful to alter how individuals appraise an event. The fundamental aim of CBT is for individuals to respond to situations appropriately. This does not mean positively and to eliminate all upsetting emotions. But for an individual’s cognitive, emotional, and behavioral response to being in-line and appropriate to the event, in this case, stressors (Edelman, S. (2018).Change Your Thinking with CBT: Overcome stress, combat anxiety and improve your life. Random House).
The ABC model can be used to support individuals to identify and dispute negative thoughts and beliefs, replacing them with more appropriate ones. The ABC model is comprised of the antecedent, the situation that triggers a response; the beliefs, our cognitions about the situation; and the consequences, the way we feel, and behave. Generally, individuals focus and blame the antecedent for the way they feel. However, it is the beliefs that influence emotions. Through adding in “D” to the model, for dispute, coaches can support clients to challenge the way they think about situations(Edelman, 2018). By disputing thoughts and beliefs, clients can amend their thoughts to more appropriate cognition and appraisal of the stressor. Thereby, improving the emotional and behavioral responses to stressful events, thus engaging in more appropriate coping strategies and acting less from immediate emotion.
Chronic stress is mostly due to the cumulative effect of multiple small stressors. However, generally, this isn’t recognized by the individual. This leads to the assumption that it is their own “personal failure or weakness for the stress” (Butler, 1993). This negative appraisal of themselves becomes normal, automatic, and, thus, impossible to disengage from the individual’s truth of themselves.
CBT techniques can also be used to interrupt these negative appraisals of self, using the ABC model explained above. Appreciative Inquiry Coaching (AIC) can also be used to focus on the positive, rather than the negative. Appreciative Inquiry (AI) is considered to be a positive, strengths-based approach (Gordon, S. (2008). Appreciative Inquiry Coaching, International Coaching Psychology Review, 3, 1, 19-31). The theory behind AI is extensive but the base, fundamental beliefs are that within every individual something works and what individuals focus on becomes their reality. Also, AIC focuses on appreciative language and questioning (Gordon, 2008).
AIC uses the AI 4-D cycle as a guiding framework for coaching relationships. This cycle is discovering, dream, design, and destiny. In the discovery stage, the coach focuses on establishing a positive connecting, drawing the client to a more empowering perspective, affirming the possible, and cultivating the belief in a positive future. Within the dream stage, the focus is on encouraging the client to imagine possibilities, inviting the client to give voice to their desired future, and affirming the dream. At the design stage, the coach focuses on helping the client bring the dream into focus, affirming the reality of it, and supporting the client with mindful choices and actions. In the final stage, destiny, the coach supports the client to recognize and expand their capacity to create the dream in the present, and to support the client when taking action becomes difficult (Gordon, 2008). Within the space of supporting clients with stress, AIC can move the client from a negative focus to a positive forward-focused mindset.
Chronic stress lowers an individual’s resilience and ability to adapt. It also contributes to other symptoms, outlined above, such as fatigue and demoralization, that make it more difficult to constructively problem solve (Butler, 1993). This impacts how an individual copes and what strategies they engage in to do this. When caught up in chronic stress, individuals attempt to minimize the negative emotions arising from the stressful experience. So, the strategies they use are generally short-term and emotion-focused rather than long-term and problem-focused(Butler, 1993). Unintentionally, these coping strategies maintain rather than release the problem.
Coaches can help individuals identify the coping strategies that aren’t supporting them and can help them to engage in more adaptive strategies. Coaches can create a safe, non-judgemental space for the client to investigate how their coping strategies truly impact them in the short- and long-term. For many, coaching sessions may be the only time they have to recognize the real and honest impact of these.
With the client gaining a new perspective on their current actions, they can then identify more adaptive coping strategies available to them. As part of this, coaches can use Strengths Finder and other psychosocial tools to support the client to identify predispositions and strengths to help themselves. The coach can then provide ongoing support and accountability whilst the client builds these new coping strategies into their lives.
Coaching can be employed to break the cycle of chronic stress. Different models, techniques, and tools can be used to break negative coping strategies, reduce symptoms, take action against triggers, identify and utilize strengths, create structures, and improve self-belief and confidence. What is most effective depends on the individual client and multiple approaches will need to be engaged in. Changing an individual’s appraisal of a stressor can change how they feel, how they react, and how they cope. Amending cognitions can also support the client in viewing themselves and the situation more positively and realistically. Thereby, changing their mindset and approach to stressors. Alongside this, supporting clients to engage in more adaptive, long-term, and problem-focused strategies can help break the vicious cycle of stress.
American Psychological Association, How stress affects your health. Accessed at: https://www.apa.org/helpcenter/understanding-chronic-stress
Arnold, S. (2018). Stressed Economy, Stressed Society, Stressed NHS. New Economics Foundation. Accessed at: https://neweconomics.org/2018/05/stressed-economy-stressed-society-stressed-nhs
Butler, G. (1993) Definitions of stress. Occasional paper (Royal College of General Practitioners), 61, 1-5. Accessed at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2560943/?page=3
Edelman, S. (2018).Change Your Thinking with CBT: Overcome stress, combat anxiety, and improve your life. Random House
Gordon, S. (2008). Appreciative Inquiry Coaching, International Coaching Psychology Review, 3, 1, 19-31
Gyllensten, K.& Palmer, S. 2005. Can Coaching Reduce Workplace Stress? A Quasi-Experimental Study. International Journal of Evidence-Based Coaching and Mentoring, 3, 2.
Hassard, J. et al. (2014). Calculating the costs of work-related stress and psychosocial risks – A literature review. European Agency for Safety and Health at Work.
Hearn, W. (2001). The role of coaching in stress management. Stress News, 13, 15-17., 13, 15-17.
Lowe, R. &Bennett, P. (2003).Exploring coping reactions to work-stress: Application of appraisal theory. Journal of Occupational and Organizational Psychology, 76, 393-400
Schneiderman, N., Ironson, G. & Siegel, S.D. (2005). STRESS AND HEALTH: Psychological, Behavioral, and Biological Determinants. Annu Rev Clin Psychol., 1, 607–628. Accessed at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568977/
The American Institute of Stress, What is Stress? Accessed at: https://www.stress.org/daily-life