In this guide we’re going to address strategies that help you cope with psychological stress. You might be surprised to hear that stress management techniques are not only applicable to people who suffer from disease or disorder, but also to the general population. Stress management can serve as an effective tool to enhance health by reducing or preventing distress and adequately contribute to future health and wellness. Since this guide is made for different people following either coaching or are part of the PT course, several sub-sections are added in an attempt to make strategies more specific to certain groups or fields of work such as sports coaches or professional athletes.
So how can we manage psychological stress effectively?
There are dozens of strategies out there just as there is an abundance of meal plans and exercise regimens, but just like those, there are a few key concepts that determine the success and effectiveness of those concepts.
In the section below we’re going to review the current literature on the effectiveness of different strategies on stress management. But before we go into details, we first need to understand what coping is.
Definition
In the existing literature, collective coping behaviors have been defined differently by different researchers. The first step on how to cope with psychological stress is to actually know what coping is. A few attempts by researchers at defining coping are by:
Rather than working from a single definition, some researchers also describe rather than define coping by relating it to the stress response via determining types or ways of coping or by naming specific coping strategies. Examples of description:
Skinner et al. (2003) ‘’The basic categories used to classify how people cope’’, such as help-seeking or problem-solving.’’
Puskar, Sereika, and Tusaie-Mumford (2003) ‘’Although coping is a process, and there is no “right or wrong” manner of coping, adolescents who used more approach and problem solving than avoidance strategies and who appraised the stressor to be a challenge were more often associated with an adaptive outcome.’’
We’re going to use one of the earliest and most-cited definition as portrayed by Lazarus and Folkman (1984), who defined coping as:
‘’…constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person.’’
‘Effectiveness’ in this document will refer to ‘’the applicability, feasibility, and usefulness of an intervention in a local or specific setting where it is offered’’, while ‘efficiency’ solely refers to systematic and scientific evaluation of whether a treatment works, both defined by the American Psychological Association.
Now that we have identified a situating fit definition of coping and understand the definition of what we mean by talking about an ‘effective’ and ‘efficient’ strategy, we’re going to go over some classic stress management strategies in de section below.
A look at general coping strategies
Despite the lack of consensus regarding coping strategies, there have been a few general theoretical frameworks that have provided a basis, namely those postulated by Pearlin and Schooler (1978) and Billings and Moos (1984). The frameworks postulate that psychological stress induced by stressful events induce both passive (avoidant) and active (facing) coping strategies.
Passive coping means not dealing directly with situations or emotions and instead resort to reaching out to others (social diversion), or engaging in different activities that ignore the stressor and provide short-term relief such as self-medicating through food or drugs, or via low-demanding tasks such as watching television or scrolling Facebook (task diversion). Thus, passive coping is mainly external, contrasting with active coping below.
Active coping means trying to directly address or eliminate the situations or emotions itself (task-focused) or manage the resultant emotions that come with the stress itself (person-focus) via your own resources. They are also further divided into cognitive (remaining positive, reframing) and behavioral approaches (obtaining information). These strategies are designed to change the nature of the stressful situation or event in order to decrease the problematic nature of that situation or event, or to modify how one thinks and feels about it in order to change one’s reactions to it.
Globally speaking, there are 2 key concepts of coping that originated from the early research by Lazarus: • Problem-focused coping strategies aimed at trying to directly change, eliminate or alternate the problem in order to reduce psychological stress; • Emotion-focused coping strategies, primarily aimed at changing or reducing the emotional distress when it is outside of your own control
Although both are advocated to cope with psychological stress, a meta-analysis performed by Penley, Tomaka, & Weibe (2012) found emotion-focus based strategies to be less effective compared to problem-focused strategies. However, since the early research on those two coping strategies were either viewed as fixing or changing problems (problem focused) or dealing (regulating) with emotion (emotion focused) in an intervention, an approach vs. avoidant distinction was adopted because one was adaptive and the other was maladaptive.
• Approach-oriented coping strategies are aimed at approaching a stressor either via strategies (not losing weight, deciding to lower calories) or via emotional response (accepting that a deficit tends to make you hungry, talking with your coach about your experience); • Avoidance-oriented coping strategies are aimed at behavioral or emotional disengagement (e.g. convincing yourself there is nothing wrong with a certain approach, stop attempting to do the diet altogether, lying to your coach that you’ve not eating the full bag of cookies)
The takeaway message it that an ideal coping strategy depends on multiple factors, such as the type of stress (e.g. before or after the situation, acute or chronic), your own resources (e.g. if you’re sick, how are you going to use a problem-focused strategy in the absence of resources) and countless other variables that affect an ideal strategy such as your socio-economic status, your culture (e.g. having an intentional agent, supportive family), age (e.g. prior experiences) and gender (e.g. gender inequalities in Japan), but we’ll largely focus on the average effects of the research taken as a whole.
The above coping strategies are generally viewed as a response to psychological stress of mainly past or already occurred harm, while not a lot is future-oriented. In the next section we’re going to review more future-oriented coping strategies, which are more goal-orientated instead of a form of (prior) risk-assessment.
Functional Flexibility
Dozens of years ago, a Norwegian group performed multiple studies on young paratroopers and found that if you repeatedly expose soldiers to psychological stress by jumping 12 meters down a tower practicing sky jumping, biomarkers of stress would sky rocket above resting levels for the first few days after multiple practices. After that, a concept we’re familiar with occurs, called ‘adaptation’. But what exactly causes people to adapt to that kind of extreme stressors?
By repeatedly reacting to specific stressors the soldiers were able to turn the stressful event into a positive one, greatly reducing the amount of both perceived and measured psychological stress. However, in real life, we often don’t face stressful events that occur repeatedly. Even if there are certain event that occur with relative similarity, a lack of diversity of effective strategies to cope with psychological stress stimulates the overuse of a single or set of strategies.
If we have 2 humans and 2 mice in a maze whose mission it is to find cheese every day from the same location, everything is repetition (or habit) and getting the cheese doesn’t require that much effort. Until one day for no particular reason, the cheese is gone from the usual location. Where mice in this maze will simply acknowledge an alteration in their environment and find a new source, the humans in this example have trouble overcoming change and trying a different approach. The mice in this story demonstrate a flexible coping strategy, while the humans in this example solely rely on a single coping strategy that leads to psychological stress because of lack of flexibility and ultimately die.
A recent meta-analytic review found that being more flexible increases your effectiveness of managing psychological stress via adjusting yourself. In this large analysis, the authors looked at different conceptualizations of coping flexibility since there are multiple camps that define coping flexibility in different manner. Based on the average (mean) amount of effect sizes for each different conceptualization of coping flexibility, this meta-analytic review shows that more coping strategies are not necessarily better in terms of psychological adjustment (r = .12), as described as having a broad repertoire of coping strategies. The same yields for the other distinction being made, called cross-situation variable coping (r = .12) that is used to handle distinct stressful events which can largely be influenced by personality or mood, and lack appropriate evaluation.
The remaining 2 distinctions called strategy-situation fit (r = .27) and perceived ability (r = .32) show greater promise in terms of average effect sizes, which implies coping flexibility involves (a) the formulation of strategies that match specific situational demands and (b) that the possession of a higher order of meta-coping skills support flexible strategy deployment. So how do we effectively apply the 2 synthesized conceptualizations of coping flexibility? In the example below, we’re going through the different stages of what is necessary to adjust to situations that induce psychological stress
The planning phase
I want you to pick a stressful situation that you might have encountered before or that might occur in a present manner, or are about to have in the near future, and write it down, even if it is totally unpredictable. Now try and imagine the stressful situation from multiple perspectives and determine the strengths and weaknesses of various coping responses that you would normally have in such a particular situation. Then assess to what level you’re in control of the coping strategies and make a trade-off between the strategies that you’ve written down based on your own ratings. Great, you’ve already done the planning phase. This does not implicate that the developed planned strategy-situation fit applies in a different situation of similar time-frame, but it should certainly make you pay attention to recognition and prediction of (future) events. After you’ve planned an appropriate strategy based on your analysis from multiple perspectives, we can start with the executive phase.
The executive phase
In this stage, evaluation and adaptation is key. Why take an easy approach instead of finding a new source of cheese? Despite your feelings of comfort with a certain coping strategy because it requires little to no thinking, it might not be appropriate and increase the amount of psychological stress that you could possibly scale down if you were to use a different approach. Revising the planning phase if you’re already having doubts at this moment about the strategy you picked in the planning phase might be a smart move. If something doesn’t work a client of yours, I’d expect most of you to make an adaptive move to stimulate the goal of the client. So should you as you’re reading this guide and are having trouble managing psychological stress.
After this step, actually picking a new strategy with confidence is the next logical step, while continuously monitoring this strategy to make sure it operates smoothly in different conditions.
The feedback phase
After you’ve successfully evaluated and executed an appropriate coping strategy, monitoring can also take place with others by interacting with them about your strategy, further developing your strategy and adjusting it. If you run into other obstacles, make sure to start with the planning stage again re-applying it (e.g. I feel that I have failed to cope with stress via this strategy, I change the way I deal with stress OR when a stressful situation has not improved, I try to think of other ways to cope with it).
While the authors noted that most of the studies have been done on young people, the authors postulate that it may be more beneficial to elderly. Other research in young adults showed that coping flexibility is an effective strategy to deal with psychological stress. Last but not least, coping flexibility was more strongly associated with lower depressive symptoms longitudinally in a summary of 5 studies, thus contributing to future health and wellness.
Summarized, the research on coping flexibility highlights that individuals with a lower flexibility tend to overuse one type of strategy, while neglecting other strategies, suggesting having a balanced coping profile is useful to avoid repetitive and unchanged behavior to both relevant and irrelevant stimuli. It further postulates that the ability to discontinue an ineffective coping strategy and produce and implement an alternative coping strategy is an effective strategy to cope with psychological stress.
In the next section we’re going over some specific research done on both coping strategies for athletes and for coaches themselves, which are largely ignored in coping research but have gained more attention in recent years.
Coping as a sports coach
Sports coaches deal with an ever-changing environment that imposes numerous challenges and thus require them to cope psychological stress, especially for those who operate in higher levels of sports where those challenges can be even more demanding.
Other coaches can face short employment with both tenuous and highly sought after positions and pose a risk for more psychological stress. It’s thus no surprise that recent research has turned their attention to coaches and how stress affects health and job performance.
Coaches can face a variety of symptoms that can relate to multiple environmental conditions. Luckily, there are evidence-based stress management recommendations that can assist coaches, which are mainly categorized in 3 kinds of interventions:
Primary: A problem-solved based approach that attempts to alleviate the overall demand by eliminating or reducing the quantity, frequency and/or intensity of stressors. As portrayed by Frey (2007) and Thelwell et al. (2008a), this intervention should include coping strategies like:
• Skill assessment and development; • Time management training; • Communication training (assertiveness, active listening, communication- and learning styles); • Formal and informal discussion groups (sharing ideas and strategies); • Active management of the organizational environment.
Secondary: a reactive (flexible) approach to stress in attempt to modify your response to stressors by increasing self-awareness and enhancing resilience to external stressors via the early mentioned 3-stage model. Interestingly, Thelwell and colleagues’ (2008b) pointed out that coaches are advised to practice similar psychological skills to those of their athletes. Giges et al. (2004) elaborated that present-day coaches face various obstacles, setbacks and hurdles just like their athletes, that demand the necessity to possess skills and develop traits to increase psychological resiliency in stressful situations similar to the athlete. Coping strategies include:
• Practice similar psychological skills as your athletes (practice what you preach); • Self-talk, relaxation and visual imagery (this is not necessarily meditating); • View events as challenges rather than obstacles or hurdles; • Having access and utilizing your network for social support.
Tertiary: a rehabilitative approach to stress management that aids with or recover from already induced damage as a result from psychological stress. This intervention is specifically for coaches who already suffer from induced strain (ill-health and/or burnout symptoms/diagnosis) that primarily focus on recovery. There isn’t research specifically done on effective strategies, other than the recommendation to seek professional counseling.
Summarized, coaches are not unique people that can’t benefit from the earlier mentioned strategies, but might sometimes require additional strategies that further develop a coach to be more effective in managing their psychological stress. Just like people that suffer from a chronic disease such as inflammatory bowel disease or type-I diabetes, they might require additional support.
In the next section we’re going over some strategies that are recommended to be practiced by athletes, not for the sole purpose to increase performance-related outcomes, but increasing mental health and well-being and thus the ability to cope more effectively with psychological stress.
Coping as a (professional) athlete
In terms of stress management in athletes, most of us only seem to think about methods solely to improve performance-related outcomes. We tend to notice the ones that make it to the finish line, yet we tend to pay little to no attention to those that don’t. Athletes are also people that experience stress, perhaps even more so due to a higher chance of major setbacks such as injury, performance slumps, illness or career transitions. So how should an athlete practice resilience, or what should a coach do in the case of an athlete that is visually stressed?
Numerous stressors have been identified in elite athletes by Fletcher & Saskar (2002) and Gould et al., (2002) on how to deal with the early mentioned events. Various personal and situational markers determine the most effective stress management strategy and thus requires prior evaluation. As one might figure, certain strategies in the case of an athlete are less effective, think for example about anxiety training in sports that require high cognitive and physical effort. While a lot of interventions look at anxiety reduction, naturally, one can understand that relaxation via meditation or other anxiety reducing techniques before a 400m sprint in the Olympics might not be the most effective approach at that particular time, as for hitting a new PR in a powerlifting competition. Therefore, it is important to understand the main characteristics of a sport and strategies that either reinforce or hinder it from a performance- and mental-well-being perspective.
In a recent systematic review by Rumbold et al., (2016), the researchers grouped common interventions utilized in sports in groups:
• Cognitive (e.g. cognitive-behavioral therapy, coping, goal-setting, , imagery, rational-emotive therapy, and self-talk) • Multimodel (e.g. arousal control, attentional training, cognitive and somatic relaxation training, meditation, pre-performance routines, positive thinking, self-talk etc.) • Alternative Interventions (e.g. anger awareness, biofeedback, music interventions, personal goal management, applied relaxation etc.)
When examining the effectiveness of the 3 types of interventions, studies measuring athlete’s perception of anxiety found that self-talk was both effective via cognitive as for multi-model interventions. Relating to the cognitive interventions, relaxation as mentioned earlier might not be appropriate to certain situations, but in others it might reduce anxiety combined with imaginary talking.
In 2002, researchers Gaudreau and Blondin developed an assessment tool called the ISCCS to determine the different coping strategies used in competitive sport settings via three dimensions within a sports context (thus slightly altered from the earlier mentioned coping strategies that are relatively similar):
• Task-oriented coping (logical analysis, support seeking, relaxation, mental imagery) • Emotion-oriented coping (resignation, venting of unpleasant emotions) • Distraction-oriented coping (mental distraction, disengagement)
Recent research by García Secades et al., (2016) used the ISCCS assessment tool to determine which coping strategies were most strongly associated with increased psychological resilience. They investigated both before the beginning of the last competitive meso-cycle and immediately after the end of the most important competition of the season. Simply put, they found that athletes’ ability to cope both in team and individual setting to enhance their psychological resilience was on average of the 2 evaluation moments most strongly influenced by task-oriented coping, compared to emotion- and distracted-oriented coping. Also on average, both relaxation and mental imagery, part of task-oriented coping, appeared to be the most effective strategies. They thus had similar finding in elite team sports and individuals competing as the systematic review by Rumbold mentioned before did.
Participants with lower resilience scored higher on emotion-oriented coping, which again related to the early mentioned meta-analysis by Penley et al., (2012). Distraction-oriented coping, relatively similar to the earlier mention avoidance-oriented coping strategy, also wasn’t the best option to increase psychological resilience. In summary, it appears that for non-performance related outcomes, (professional) athletes should practice anxiety reducing techniques such as self-talk and self-imaginary, on top of general coping strategies less
Summary
For nutritional- and exercise science, there is no one-fits-all approach. We do however have solid frameworks on which to build on. The same yields psychology. We have a lot of factors to consider before we can actually adopt a new strategy, but this should be no different than a customized approach and adopting the best strategy available. Ultimately, the best strategy is the one you can adhere to, or can implement in the life of a client and positively contribute to mental health and well-being.