Stress, and stress related illnesses are, without doubt, the silent killers of twenty-first century life. Our scientific advancements, technological improvements, and modern advancements have only complicated its’ detection and treatment. Despite all the progress mankind has made, stress remains inevitable. Too bad there wasn’t some kind of vaccination for it… or is there?
Dr. Donald Meichenbaum, a pioneering psychologist in the field of Cognitive Behavioral Therapy, has developed an approach to coping with stress, anxiety, and fears that, while not an instant fix, works extremely well in developing an individual’s coping skills. He calls his approach Stress Inoculation Therapy, or SIT. Don’t worry, no needles or shots are involved, just a willingness to get out of your comfort zone and learn to be comfortable there.
SIT is a type of psychotherapy intended to prepare clients in advance to handle stressful events with a minimum of upset. SIT is based on the idea that low levels of exposure to stress builds a tolerance and ability to cope over time. These exposures to stressors are analogous to being inoculated or vaccinated as we are physical ailments in the same way in which we are inoculated for measles, mumps, or other physical diseases. While SIT does not pretend to make us immune to stress, it is designed to help us function with less distress and more efficiently when facing life’s difficulties.
Stress inoculation has three components:
1. The initial conceptualization phase, where the therapist educates the client about the general nature of stress, fear, and anxiety. The therapist also helps the client identify their own, unique stressors, and habitual ways of appraising and evaluating those stressors.
How does the client speak to themselves? What is the internal dialogue that surrounds the stressful event? Does this dialogue help or hurt the situation? How does the client’s body respond? How does the client breathe, sit, stand?
The goal of this stage is to educate the client as much as possible about the nature of stress in general, as well as their own unique responses to it.
2. Skills acquisition and rehearsal is the second phase. In this phase the therapist helps the client develop positive coping skills to address the stressors, with the goal being “getting a little comfortable with being uncomfortable.” The therapist and client work to utilize the clients unique resiliency factors. New ways of viewing and processing the stressors are explored. Clients focus on controlling their physiological responses through breath control and relaxation, as well as their internal dialogue. Negative self talk is replaced with a more positive, realistic, internal appraisal.
Some of this work is done the in session, as the therapist discusses events that are disturbing to the client, and the client experiments with coping skills in the safety of the therapy room. Clients then practice these skills in the real world, returning to the therapy room to process what worked and what did not. The process is repeated, usually over the course of 8 to 15 weeks, while the client becomes “inoculated” through repeated, low level exposures.
3. Application and follow through is the final phase. In this stage the therapist looks to find opportunities for the client to develop even more skills by intensifying the experience. A variety of simulation methods are used to increase realism such as visualization, modeling, vicarious learning, role-play, and repetitive behavioral skills. These are down until the skills are not merely learned, but over learned, making success second nature.
To help grasp these concepts, think about what it was like when you learned to drive an automobile. Remember the initial anxiety, fear is, hopes, and anticipation that went along with your first episode behind the wheel of a car? Overtime, you went through these three stages to the point where you are now. You have probably overlearned what it takes to drive an automobile. If you are a typical driver, you probably do much of your daily commute on autopilot with your physical body driving the car, while your mind is somewhere else.
Stress Inoculation Therapy has been shown to be useful in treating all types of anxiety, irrational fear, and anticipatory stress. It is systematic and relatively permanent, as it accelerates the way in which we normally learn. The exposure, and tolerance of it, is a type of learning, controlled by a collaborative effort of therapist and client. The focus is placed on the behavior and progress, rather than the reasons the negative emotions exist. The goal of the treatment is to create behavioral change.
Donald Meichenbaum’s Stress Inoculation Therapy, while best done with a trained psychotherapist, can be used by anyone for self-help. Sitting down with a notebook, and making a careful study of your own unique stressors, and responses to them, is a great way to start. Some key points to remember if you are using SIT for self-help are:
1. Get comfortable with being uncomfortable. This paradoxical statement is critical to remember. Over time your comfort level, or “distress tolerance,” will rise.
2. The stress will not, and may never, go away entirely. The goal is to increase your ability to function and remain comfortable in the face of the stressful event.
3. This is a process, not an event. While you may see some results immediately, to fully over learned these skills can take 3 to 4 months. The coping skills you develop, however, are likely to be more permanent and long-lasting than any you would get from medication alone.
4. Recording progress is extremely helpful if you are doing this as a self-help strategy. A notebook dedicated to this, and daily practice will be required. As stated previously, this will take time, but it will be worth it.
5. Use the categories search box of this blog to get more information about anxiety, worry, and fear. This will give you background information to develop your own self-help plan.
So there it is, your own road map into your life’s Danger Zone. Go boldly, you can do this!
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