Drug-Free, Holistic Stress Management: The Stress Management Handbook



by Lori A. Leyden-Rubenstein, PhD

Keats Publishing, Inc., 27 Pine St., New Canaan, Connecticut 06840 USA 1998, softcover, $14.95, 207pp.

Stress is so much a part of our lives now that most people, at least until they face serious illness, do not realize that stress causes many physical symptoms. In fact, researchers have shown that between 80 and 90% of all illness is stress-related (other researchers believe that all illness -- at least in part -- is stress-related.) The speed of change in the world over the last 20 years has had significant psychological repercussions. The stress of rapid change in the way we live has led to many people seeking help -- for both physical and psychological symptoms. However, as the author of this book makes clear, Americans are being needlessly medicated with pharmaceutical drugs which have serious side effects, including addiction. The Wall Street Journal reported that in 1995, Prozac had the unique distinction of being the world's first psychiatric drug to reach $2 billion in annual sales. And also uniquely new, the prescriptions are being written by family physicians (not psychiatrists), whose only information comes from the pharmaceutical drug salesmen.

Most physicians who prescribe these drugs know they are a band-aid approach but they are locked into the current paradigm -- drugs represent "scientific" medicine -- and their medical school training did not teach them other methods of treatment. Another factor is that the mind/body/spirit research of recent years is proving that our thinking and emotions may have more effect on our health than any other factor. I suspect that the findings of psychoneuroimmunology (PNI) research are overwhelming the vast majority of doctors -- they may be interested, but have no time to keep up with these new findings -- they are too busy prescribing the latest drugs to their many chronically stressed patients.

The Stress Management Handbook for $14.95 might be a much better choice, and not just because dangerous drugs can be avoided. The author gives an example of when medication is prescribed for generalized anxiety and/or panic attacks, researchers say that without concomitant psychotherapy 70 to 90% will relapse with more severe episodes within two months. In other words, these drugs are ineffective, as well as dangerous and expensive.

This book is several degrees above most "self-help" books in providing a solid scientific basis for the efficacy of non-drug stress reduction strategies. The author cites the many new studies validating the connection between mind and body i.e. strong emotions and negative thinking elicit specific biochemical responses in the body. A number of studies have shown that even short-term stress affects immune system function, and new research suggests that stress may play a more important role in ischemic heart disease, than previously thought. (The stress reduction strategies in Dean Ornish's program to reverse heart disease may be just as important as the diet).

The Stress Response Profile is helpful in understanding how thoughts, beliefs and emotions can lead to stress. A person perceives a condition, situation, event, or person as some kind of threat and this leads to an emotion, generally fear or anger. These emotions stimulate the body to produce biochemical responses which in turn, produce physical symptoms, such as insomnia, free-floating anxiety, depression, confusion, fearful thoughts, and many, many more listed in this Handbook. Many people develop maladaptive coping behaviors in response to chronic stress. These can include "numbing" ourselves to our own emotions and needs by engaging in negative thinking or poor eating, drinking, smoking, sleeping, busyness or other habits. Cognitive therapists believe that we experience stress because of what we tell ourselves about ourselves and our environment and that many of these thoughts are based on irrational beliefs. The author explains the origin and consequences of negative thinking, and lists it as a primary stresser.

Negative thinking includes: Black or White Thinking (all or nothing); Assumptions (jumping to conclusions); Excessive Self-Criticism ("I'm not okay"); Negative Expectations (always expecting the worst); Overgeneralizing (every situation will have the same outcome). There are many excellent strategies given for understanding ways in which we might be distorting our thinking, and how we can learn to eliminate negative self-talk.

Along with negative thinking, the "shoulds" are examined, what the author refers to as "a particularly treacherous cognitive distortion." This is an excellent section, showing how adapting the "shoulds" of others sets us up for stress and anxiety. The author states: "People who experience a high degree of stress and anxiety are either unaware of their needs or are aware of their needs but not working to get them met."

Self-reflection, coping with worry, dealing with guilt, working with emotions, exercise and diet, and learning to communicate better, are all important steps to reducing stress. One of the virtues of The Stress Management Handbook is the research-based and comprehensive presentation of the many ways in which we can learn to improve our health -- and happiness.

"Living in the Present Moment" is the #1 stress reducer, according to the author. Worry and guilt create a tremendous amount of stress. We feel guilty about the past and worry about the future and this book presents many strategies for staying in the present. Lori A. Leyden-Rubenstein is a psychotherapist with a doctorate in Health and Human Services, with postgraduate work in psychology, and her book reflects a solid academic background -- the strategies presented are similar to those used in well-known clinics such as Herbert Benson's Mind/Body Clinic at New England Deaconness Hospital in Boston and Jon Kabat-Zinn's Stress Reduction Program at the University of Massachusetts Medical Center.

Of the many stress reduction methods discussed in the book, diaphragmatic breathing is a major technique, and the first strategy to be learned. Modern scientific research has confirmed that diaphragmatic breathing decreases heart rate, metabolic rate, blood sugar levels, pulmonary stress, muscle tension and fatigue, and the perception of pain, In addition, there are psychological effects including an increase in emotional stability, confidence, alertness, and a decrease in anxiety, phobic behavior, depression and psychosomatic illness. It is a simple, immediately available, effective tool that anyone can easily learn to use.

A major stress reducer is meditation/relaxation, which usually incorporates diaphragmatic breathing. One may choose to do Yoga, autogenic relaxation, imagery/visualization, and affirmations. All of these practices are clearly explained, including the scientific research validating them. The specific strategies for stress reduction encompass both cognitive reprogramming and physical techniques.

The Stress Management Handbook is one of the best books on the subject I've reviewed. It clearly demonstrates the reality of the mind/body/spirit connections, and how our thinking, belief systems, and emotions can make us ill. Holistic practitioners would do well to integrate these stress reduction strategies into their armamentariums -- it might be the most important preventive medicine they can give their patients.

Townsend Letter for Doctors & Patients.


By Irene Alleger

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