We produced this infographic for our colleagues at Envision Physiotherapy as a guide to help them assess the levels of stress and the resiliency of coping strategies in their patients. We present it here as a (hopefully) helpful guide in assisting readers to assess their own levels of stress and capacity to cope.
We produced the infographic below for our colleagues at Envision Physiotherapy as a guide to help them assess the levels of stress and the resiliency of coping strategies in their patients. We present it here as a (hopefully) helpful guide in assisting readers to assess their own levels of stress and capacity to cope.
There is a high cost to our powerful coping strategies, and this is why they often only work temporarily. At some point, the costs come to outweigh the benefits. When these coping systems exhaust their temporary efficacy, they start to progressively add more stress then they eliminate.
Problems are not the problem; coping is the problem.
When we are overwhelmed by intolerable stress and have resolved to escape, we use powerful coping strategies: think of numbing boredom, putting on a happy face, or the pain relieving benefits of substance use. These approaches all make good sense, because each of us is hard-wired for survival and safety, and when we are in the strange situation of being threatened by feelings inside us it takes creativity to run away. We are very lucky to have these powerful coping mechanisms, and we are benefited tremendously by their ability to diminish our pain and fear. Unfortunately, unlike the gentler coping strategies, these powerful tools come at a cost of their own.
Maladaptive Coping Systems: There is a high cost to our powerful coping strategies, and this is why they often only work temporarily. At some point, the costs come to outweigh the benefits. When these coping systems exhaust their temporary efficacy, they start to progressively add more stress than they eliminate.
These lower quality coping strategies often leave people oscillating between a near-full and an overflowing stress container. The more we desperately search for feelings of relief and safety the more we rely on these once useful-strategies even as returns diminish. As the desperation rises, the effectiveness of these strategies fails. What are typically labelled mental health problems, and what we can instead think of as symptoms of “Affect Dysregulation” can onset at this time. For example, the use of pain relieving substances becomes “addiction” when relied upon too often. Ignoring internal calls to action against our stressors becomes the defeated melancholy of depression. Unfamiliarity with difficult emotions eventually becomes a fear of those unknowns, and when this becomes more common it can take the shape of general anxiety. (Though not every “mental illness” conforms to stress management in this way, clinical and therapeutic research demonstrates that this is a powerful re-conceptualization of once familiar categories).
Mental Health Symptoms: When “maladaptive coping strategies” become our only source of managing stress and then outlive their usefulness, a downward spiral of overwhelm can begin. Symptoms of depression, anxiety, emotional volatility, numbing, and substance use are common. Coping strategy and symptom become indistinguishable.
This is why The Stress Container is a helpful tool to assess if things are likely getting better or worse. On one hand we know that events that create severe distress can actually be well managed by proactive, high quality coping systems. And so the presence of hard times alone doesn’t necessitate the need for therapy. Births and deaths in the family, children growing up and moving out, moving houses and careers—many of these highly stressful events are also sources of love, growth, and connection. But we also know that less effective coping systems can be overwhelmed by more routine stressors and that low quality coping strategies can be sources of additional distress in their own right. Because of this, we can’t wait for “acute stress” before considering the usefulness of therapy. The Stress Container metaphor encourages us to look at both the level of distress and the capacity of the coping system to tolerate and manage that stress. This relationship between the two gives us a more accurate sense of whether help is needed for things to improve.
Getting Better or Getting Worse: The interactions between stressors, healthy and maladaptive coping, and symptoms of psychological distress determine if things are likely to get better or get worse, regardless of the amount or intensity of stressors.
In the following four posts, we will discuss how our understanding of the stress container informs our approach to healing.
The size of your container is largely formed during early childhood. Children who are supported in the experience of appropriate stress—neither too much nor too little—can more easily tolerate large volumes of stress.
The Stress Container makes easy sense for most of us when we think of our own daily processing of normal stress, but this model actually makes an important shift in the way we typically think about mental health symptoms. In this model, experiences like depression, anxiety, anger, and panic are not seen as discrete syndromes with various symptoms, but are themselves understood as being the symptoms. This is a profound difference in the way we understand these difficult experiences and provides clinicians access to powerful strategies for treatment. To see how, we need to take a deeper dive into our model.
Fifty years of advancement in attachment science and interpersonal neurobiology show that this ability is learned in our formative years, taught by the adults who parented us. These lessons then become “hard-wired” in our brains, like a pattern of movement that becomes easily accessible to us once we’ve been taught, coached, and well practiced. (One of the most profound insights of this science is that managing our emotions is a social activity at least as much as it is an internal activity. This is one of the key explanations of why psychotherapy can be so effective.)
The skills we learn about managing stress (what psychologists call “Affect Regulation”) can be high quality or low quality, proactive or reactive. Proactive stress management requires two things: first, the sensitivity to perceive small doses of stress, and second, the courage to acknowledge and attend to it. Many people in our culture are taught to ignore “the little things” and over time this limits our ability to “attune and attend.” This leads to reactive stress management, the state we find ourselves in when we wait until we are nearly overwhelmed by the pressure of our circumstances before we turn on our coping systems.
And those coping strategies can also take on a huge range of styles, some of which are better than others. Which coping styles we use depends on which ones we have in our repertoire—that is, which strategies we learned from our parents. It also depends on how powerful of a tool we need, which is why we cope differently with small doses of stress and big overwhelming doses. If we’ve learned to attune to stress, are willing to acknowledge the uncomfortable feeling it gives us (butterflies, anxiousness, sadness, etc), and then proactively regulate those emotions before they become intolerable, we don’t need very powerful coping strategies to get the job done. A healthy dinner with friends, and a quiet walk before a good night’s sleep might do the trick.
But other situations demand more powerful strategies. We can become overwhelmed in two simple ways: too much stress or too little coping. Even the best of us are overwhelmed at times: when sickness, loss, insecurity descend on our house, it can be too much too quickly for any coping system to handle. Alternatively, those with weaker coping strategies, or with strategies that once worked but are no longer successful, can find that small doses of stress are routinely enough to overflow the container. In both cases, as distress increases it demands more of our attention. It doesn’t matter whether we are trying to keep up with that enhanced demand or trying to ignore it. In either case it requires substantial resources. We then have less energy and focus for connection with loved ones, less ability to relax or recognize moments of joy, and experience difficulty turning our focus down in order to sleep.
The Demands of Stress:
In the same way that coping actively diminishes stress, distress makes it increasingly difficult to “attune and attend.” Our standard proactive strategies like exercise, relaxation, and connection are harder to achieve as distress makes demands on our focus and energy.
If we learned that being “tough” or “hanging in there” meant ignoring those butterflies, a different story unfolds. Sometimes, it’s true, ignoring does work! But unlike higher quality strategies, this method has a very hard ceiling. We can end up in trouble if our stressors surpass our ability to engage in distractions and ignore them. People who have less experience acknowledging stresses such as anxiousness or sadness often find the discomfort intolerable compared to those who have greater familiarity with those feelings. When the discomfort is so deep, we reach for more powerful tools—we are no longer attending to the feelings but are actively spending personal resources to escape them.
Reactive Stress Management:
Paying attention to stressful feelings lets us see more clearly what is at the root of the matter. With that information, the possibility to attend to, deal with, and resolve the problem becomes possible. It sounds counterintuitive, but it is only by a movement towards that which is difficult that issues in our lives change for the better. The attempt to escape stressful feelings—a movement away from that which troubles us—is the work of desperation. It is a kind of self imposed ignorance, which only makes our own difficult feelings foreign to us.
