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Stress Management, Stress Reduction and Relaxation

What Is Stress and How does it Affect Me?

Stress is in inescapable fact of life. We’re bombarded daily with challenges ranging from traffic to bills -- from deadlines to last minute changes. We’re also faced with a variety of personal problems such as health concerns, poor nutrition, and aging. And we have to deal with our thoughts, which often make us question the wisdom of our decisions, performance, and worth. The answer to why some people manage much better than others with these universal problems has to do with how stress works.

Stress is not unexpected bills, a traffic accident, a canceled flight, or getting laid off from your job. Rather, stress results from interpreting those events as dangerous, difficult, painful, or “unfair,” and/or feeling that you don’t have the resources to cope with them. The fact that stress is the result of how we interpret events explains why some people fall apart during a crisis, while others, facing exactly the same situation, rise to the occasion and perform admirably. As Shakespeare wrote: “Things aren’t good or bad, it’s thinking makes them so.”

Reacting to various events as threats triggers the “fight or flight” response, which speeds up the heart rate, breathing rate, raises blood pressure, metabolism, and muscle tension. In addition, various chemicals are released that slow down digestion, growth, reproduction, and tissue repair. In other words, chronic stress can be very harmful to your health.

The good news in all this is that if stress is the result of how we interpret and react to events, by being more conscious of those events that trouble and upset us and changing the way we interpret and react to them, we can change our levels of stress.

What is Stress Reduction and Relaxation?

Simply put, stress management and stress reduction methods include a variety of coping tools used to recognize and assess stress and interpret it in a more positive way. They are tools that are used to release stress and reduce its negative effects on our lives. In general, stress management consists of examining the five steps of the stress process shown below, and then altering your response in order to interrupt the process and reduce the effects.

The stress response pattern looks like this:

Life Situation: caught in traffic jam; late for work

Perceived as Stress: I’m incompetent; boss will be angry; lose promotion

Emotional Arousal: irritable, paranoid; poor concentration; overly sensitive

Physiological Arousal: elevated heart rate and breathing; sweating

Consequences: loss of tranquility, poor performance; stinky

Problems arise because people often respond to these emotional stressors with the physical responses mentioned earlier -- increased heart and breathing rate, muscle tension and lots of adrenaline -- instead of using productive and useable emotional responses. In the process, they usually end up creating both physical and emotional problems.

The solution begins with a close examination and keeping track of those situations that cause you stress. Once various situations are identified, knowing exactly how you react and what the consequences are enable you to alter your response in order to maintain a more even keel. In almost every case, effective stress management involves slowing down and staying in the moment, rather than worrying and jumping into the future or remembering and falling back into the past. Many find it useful to determine exactly why certain situations cause them stress, as their assumptions may be ill-founded. But knowing why isn’t always enough. The following methods can help with coping.

Common and Popular Stress Management Tools


Meditation consists of attempting to focus attention on one thing -- a word, an image, simply counting slowly, or focusing solely on the flow of breath in and out of the body -- to the exclusion of all other thoughts. By focusing on only one thing, it’s much more difficult to worry, be afraid, hateful, or angry. This type of focus is also helpful in choosing what thoughts to focus on, as well as insight into persistent patterns of thinking.


Yoga can be done from a chair and not only involves the same level of concentration and focus as meditation, but also improves flexibility -- a plus for people with SCI.

Visualization and guided imagery

This uses the power of the mind to achieve overall physical relaxation, often by visualizing very detailed peaceful and relaxing scenes. Several studies have documented increased athletic performance with the regular use of visualization. Actors regularly visualize themselves performing before they ever take the stage. More importantly, visualization has been practiced, studied and used with success in people with cancer, chronic pain, and those with headaches, muscle spasms and general or specific anxieties.

Progressive relaxation

This is the process of methodically tensing and relaxing specific muscle groups throughout the body, beginning with the head and working down, or with the feet and working up. The tensing phase normally lasts five to ten seconds, followed by 20 to 30 seconds of conscious and focused relaxation of the same muscle group.

Controlled breathing

Controlled breathing focuses on the process of breathing – the full inhalation, the expansion of the belly and the lungs, exhalation, the contraction of the midsection, and all the various physical sensations and sounds that accompany breathing that we normally ignore. Improper or shallow breathing can lead to higher levels of anxiety, depression, muscle tension, fatigue, and headaches. Deep, controlled breathing increases the amount of oxygen taken into the lungs, as well as the amount of carbon dioxide expelled from them, helping the body and mind to work more efficiently and effectively.

Various controlled breathing methods are often used for one to five minutes, three to five times a day, or as needed to relieve symptoms or stress. Spinal cord injury may affect full and complete breathing capacity, either directly or as a result of poor posture. Practicing deep, controlled breathing may require reclining or lying down for some, but the benefits of managing stress, calming the body and the mind, and increasing oxygen flow are well worth the effort.

These are all very brief descriptions of rather complicated and involved stress management techniques. If you want to learn more it’s recommended that you take a course, or at least read a book or two on a specific technique in order to gain any significant results.

Are Stress Management and Stress Reduction Widely Used?

The various stress management tools outlined in this brochure – yoga, meditation, controlled breathing, visualization, guided imagery – are used by millions throughout the world as they have been for thousands of years. Some have their origins in the Middle East or Asia, and some are associated with various religions, even though they are now commonly practiced by people of all faiths.

What are the Benefits?

There are numerous benefits to be had from reducing and managing stress, beginning with an increase in concentration, a decrease in anxiety, and a reduction in pain. Effectively managing stress often leads to improved health. Stress management programs are drug-free. Most importantly, stress management programs put you in charge and give you a sense of control, which leads to enhanced self-esteem, less likelihood of depression, and an overall improvement in quality of life. The primary cost consideration is an investment of your time.

What About Stress Management, Stress Reduction, and Spinal Cord or Brain Injury?

All those things which non-disabled individuals find stressful -- financial difficulties, employment problems, health problems, issues of dependency, last minute changes, lack of control – are often more prevalent for people with spinal cord or brain injury. That’s the bad news. The good news is that stress management and reduction are possible.

What’s The Cost?

Many, if not most, stress reduction and stress management programs and methods are either low cost or free. However, stress reduction and stress management programs do require time, effort and commitment, often over a lifetime.

In our fast paced lives, we’ve grown accustomed to the immediate gratification of buying things to improve our lives, whether it’s cable and big screen TV, vacations, microwaves, or a prescribed medication for symptom relief. Stress management and stress reduction are no different. “What do you mean I have to do something?” people ask, “can’t I just take a pill?” The short answer is “No.” Be prepared -- stress management and stress reduction will require time and effort in order to produce results.

How Can I Learn More?

You can usually learn basic techniques and principles of stress management for the price of a book or two or an educational audio or video tape. Check out your local library, community or adult education center, community colleges, or recreation or wellness centers, as they often offer various stress management classes.

The most important part of any stress reduction and management program is practice and regularity, regardless of whether it’s meditation or counseling or yoga or visualization. All these methods work, but many require months of persistent practice before they can be fully effective and appreciated.

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Revised: 1/2015

This resource is provided as a courtesy of Craig Hospital. For more information, contact the Craig Hospital Nurse Advice Line at 1-800-247-0257.

Disclaimer: The content in this document is intended for general informational purposes only and is not a substitute for professional medical advice or treatment for specific medical conditions. No professional relationship is implied or otherwise established by reading this document. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Many of the resources references are not affiliated with Craig Hospital. Craig Hospital assumes no liability for any third party material or for any action or inaction taken as a result of any content or any suggestions made in this document and should not be relied upon without independent investigation. The information on this page is a public service provided by Craig Hospital and in no way represents a recommendation or endorsement by Craig Hospital.