Stress and Coping

Stress Definition

Stress occurs when an individual perceives that the demands of a personally important situation tax or exceed his or her capabilities and resources. The situation can be a major event such as the death of a loved one, an interaction with another person such as a disagreement with a coworker, or even an internal event such as a realization that one is aging but has not accomplished important life goals. Stress, especially if experienced chronically, can have serious negative physical and psychological consequences. Coping consists of the individual’s thoughts and behaviors aimed at eliminating the source of the stress, reducing the negative emotions associated with the stress, or increasing positive emotion in the context of stress. The study of coping is important because adaptive coping can be taught, which can help short-circuit the potentially harmful effects of stress on mental and physical health.

Stress History and Background

Stress is a ubiquitous term that is commonly used to describe a wide range of situations, experiences, and states of being. Practically everyone has had personal, often daily, experience with stress, and the idea that stress is harmful to mental and physical well being is well ensconced in popular culture. Empirical studies of stress began early in the 20th century with research focused on the biological aspects of the stress response. In 1932, Walter Cannon outlined the fight-or-flight response in which the organism reacts to a threat by releasing catecholamines that ready the organism physically to respond to the stressor. Increased heart rate, blood pressure, blood sugar, and respiration are among the physiological results of catecholamine release. The fight-or-flight response is adaptive in the sense that it provides the necessary physical resources for the organism to react to acute stress. When the fight-or-flight response is repeatedly or chronically triggered, there are likely to be harmful physical consequences. Hans Selye discovered that a variety of stressors such as extreme cold or fatigue caused enlarged adrenal glands, shrinking of the thymus, and bleeding ulcers in rats. Selye outlined a three-stage process called the General Adaptation Syndrome in which prolonged stress leads to a breakdown of bodily resistance leaving the organism vulnerable to what he called diseases of adaptation such as cardiovascular disease, kidney disease, or arthritis.

Early biological theories of stress led researchers to investigate the types of occurrences or events that resulted in biological changes. A natural outgrowth of the research of Cannon and Selye was stressful life events research. Researchers in this tradition were interested in quantifying the impact of various life events by their effects on psychological and physical well-being. Initially, the idea was that those individuals who experienced life events that required some sort of adjustment (such as marriage, death of a close family member, pregnancy, or changing to a different line of work) would be more likely to experience distress, depression, and physical illness than would those who experienced fewer life events. Results of these studies indicated that although there is a significant association between life events and well-being, the link is not particularly strong. Even among those individuals who are categorized as high risk for deleterious effects based on the number of stressful life events they experience, a substantial number do not show increased illness. Thus, the research focus in stressful life events turned from an emphasis on the stressful events per se to the study of other factors that play a role in the association between stressful events and physical or psychological well-being. Coping is one such factor. Two people who experience the same objectively stressful event can have very different psychological and physical outcomes depending on how they cope with the event.

The concept of coping was born out of the psychodynamic work on defenses. The theory developed by Sigmund Freud in the late 1800s and early 1900s was that each form of psychopathology stemmed from unconscious reliance on a particular defense mechanism in response to uncomfortable thoughts or feelings. For example, paranoia was thought to stem from the defense mechanism of projection—attributing one’s own unacceptable thoughts and feelings to someone else. Subsequent theorists classified defense mechanisms into adaptive (mature) and maladaptive (immature) with responses such as humor, suppression, and sublimation considered mature and responses such as projection and passive aggression considered immature.

One of the hallmarks of defense mechanisms is that they are relatively unconscious and trait-like. Although research on defenses continues, in the 1960s, researchers set a new course for the study of stress and coping by conceptualizing coping as a context-dependent, conscious process of thoughts and behaviors that ordinary people use in response to the events in their lives that they perceive as stressful.

Stress and Coping Theory

The stress and coping theory developed by Richard Lazarus and Susan Folkman has served as the foundation for decades of coping research in several different samples experiencing a vast variety of types of stress. The key components of the theory are appraisal and coping, along with emotion, which is central to both components.

Appraisal

Appraisal is the evaluation of an event in terms of its significance for well-being. Whether the individual appraises the event as stressful depends on characteristics of the individual (such as personality, goals, and beliefs) as well as characteristics of the event. Appraisal is an assessment that focuses on the meaning of an event or situation for the individual and occurs on a continuous basis. Humans naturally appraise or evaluate their surroundings and experiences constantly in relation to their own well-being. Primary appraisal addresses the question of whether anything is at stake for the individual in the context of the event. Secondary appraisal indicates what, if anything, can be done in response to the event and involves the assessment of available coping resources (e.g., money, time, social support, self-esteem) and options for coping and whether these are likely to be effective in the particular situation. For example, imagine you have an exam coming up in your most difficult class and you must do well on it to pass the class and graduate. If graduation is something you value, your primary appraisal is likely to be one of threat—there is a lot at stake in the situation for you. As part of the secondary appraisal process you inventory the resources at your disposal for addressing the stressor/upcoming exam. Your coping resources may include textbooks and other reading materials on the test topic, notes taken by other students in the class, the willingness of the teaching assistant to spend time helping you prepare for the exam, and perhaps your own confidence in your test-taking ability. Upon reflection on your coping resources, you may reappraise the upcoming test as more of a challenge than a threat. Together, primary and secondary appraisal determine the extent to which the event is perceived as stressful.

Appraisals are associated with emotional responses. Those stressful events appraised as threatening are usually associated with negative emotions such as anxiety. Events appraised as harmful are associated with negative emotions such as sadness or anger. A challenge appraisal—the evaluation of a situation as having the potential for gain—is usually associated with both positive and negative emotions. Whereas an appraisal of challenge is likely to prompt feelings such as excitement and enthusiasm, there is also the potential for anxiety and fear because the outcome is uncertain.

Early stress and coping research focused almost exclusively on negative emotions. However, several studies have now documented that positive emotion can occur with relative high frequency, even in the most dire stressful context, even during periods when depression and distress are significantly elevated. Positive emotion in the stress process is thought to sustain coping, restore depleted resources, and provide a respite from negative emotions, particularly under conditions of chronic stress. Furthermore, positive and negative emotions are associated with different types of coping. Therefore, it is important to consider the role of positive as well as negative emotion in the coping process.

Coping

The appraisal of the event as a harm, threat, or challenge prompts a coping response. This coping response may influence the event itself, the individual’s appraisal of the event, or the emotions associated with the event. In the context of a given stressful event, appraisal produces emotion and prompts coping, which, in turn, influences emotion and subsequent reappraisal of the situation. This appraisal-emotion-coping-emotion-reappraisal process continues until the situation is resolved or the appraisals are such that the event is no longer viewed as stressful.

Although there are potentially an infinite number of ways of coping (e.g., making a plan of action, fantasizing about an ideal outcome, reminding oneself of the good that will come out of the situation, pretending the stressful event didn’t happen), on a theoretical level, there are two major functions of coping. Problem-focused coping involves taking steps to deal with the problem directly, whereas emotion-focused coping is aimed at reducing the negative emotions associated with the problem. Some examples of problem-focused coping are making a plan of action or concentrating on the next step. Some examples of emotion-focused forms of coping are engaging in distracting activities or using alcohol or drugs. Getting drunk doesn’t really solve the problem, but people often think it will help them feel better.

The theoretical distinction between problem- and emotion-focused types of coping is useful for classifying and discussing the many types of coping, and it is used extensively in the coping literature. In practice, however, the distinction between coping aimed at addressing the problem and coping aimed at addressing the emotion isn’t always clear. Problem-focused coping can also serve an emotion-focused function because by addressing the problem itself, the individual is also addressing the source of his or her negative emotions. Thus, if the problem-focused efforts are successful, the negative emotions associated with the problem will also be reduced. For example, a problem-focused response to having a car that repeatedly breaks down would be to buy a new car. Buying a new car effectively eliminates the negative emotions associated with the repeated breakdowns of the old car. Thus, the problem-focused coping response has also served an emotion-focused function. Sometimes, emotion-focused types of coping can ultimately serve a problem-focused function. Studying in response to an upcoming exam is a form of problem-focused coping. However, high levels of anxiety may prohibit effective studying. Therefore, doing something to reduce the anxiety such as going to the gym or getting a massage may facilitate subsequent problem-focused coping. People rarely rely on just problem-focused or just emotion-focused types of coping. Usually, in response to a given stressful event, they employ a mix of problem- and emotion-focused responses.

Although many stressful events are short-lived and require only an abbreviated coping response, many types of life stress are ongoing. These chronically stressful situations call for repeated and continued coping efforts over a long period. Examples of such ongoing stressors include one’s own or a loved one’s chronic illness, a dysfunctional work environment, or living in the aftermath of traumatic life events such as a major natural disaster. Because it calls for sustained coping efforts over a long period, chronic stress can deplete an individual’s coping resources. In this context, meaning-focused coping becomes important. Meaning-focused coping responses draw on deeply held values, goals, and beliefs and help motivate and sustain coping efforts and bolster coping resources over the long term. These responses are linked to positive emotion, which reinforces their motivational and sustaining qualities. Meaning-focused coping, for example, includes identifying realistic coping outcomes that are valued by the person. For example, a husband providing care to his wife in the terminal stages of cancer who ensures that his wife is cleaned up and dressed every day because that helps her retain a sense of normalcy even though she is unable to leave the house is engaging in meaning-based coping. The pursuit of these outcomes creates a sense of control, which produces positive emotion, which, in turn, helps reinforce coping effort. Meaning-focused coping is used when a person reorders priorities so that they are in alignment with his or her underlying values, goals, and beliefs. The reordering helps the person allocate attention, resources, and efforts according to what matters. Benefit-reminding, a form of positive reappraisal in which the individual appraises benefit in a stressful situation (e.g., improved personal relationships, appreciation of the little things in life, greater sense of self-worth), is also considered a form of meaning-focused coping.

What Is Effective Coping?

A central tenet of stress and coping theory is that coping is not inherently adaptive or maladaptive. Instead, coping effectiveness must be judged in the context of the stressful situation. A given form of coping may be effective in one situation but not in another. For example, in a situation in which the individual has some control, problem-focused forms of coping are likely to be beneficial. But in situations that are completely out of the individual’s control, problem-focused coping is less likely to be effective. Furthermore, the effectiveness of a given coping strategy will depend on the outcome of interest. A given coping response can be beneficial in terms of one outcome but detrimental in terms of another. For example, increasing the amount of time you spend on a project at work may be effective for your career success but damaging to your relationship with your spouse. Another consideration in judging coping effectiveness is proximity of the outcome. A particular coping strategy may be beneficial in the short run (e.g., confronting the person responsible for the problem may make you feel better) but detrimental in the long run (damage the potential for working with the person you confronted in the future). Thus, in judging coping effectiveness, it is important to identify the outcome, the time point (proximal vs. distal), and the context.

Can Coping Be Changed?

Part of the appeal of studying coping is that because it is a conscious response, it is potentially amenable to change. A growing body of evidence indicates that coping can be changed and people can be taught to cope more effectively with a variety of stressors. One approach to improving coping effectiveness is to help individuals identify whether a situation is changeable or not and then to match the form of coping to the situation (problem-focused types of coping for changeable situations, emotion-focused types of coping for unchangeable situations, meaning-focused coping in chronic situations). Another type of coping intervention targets the individual’s appraisals of the stress and works to enhance confidence in his or her coping skills. Traditional stress management interventions can be viewed as training in emotion-focused coping, and problem-solving interventions can be thought of as training in problem-focused coping. In addition, coping training can take the form of enhancing coping resources such as social support.

References:

  1. Cannon, W. B. (1939). The wisdom of the body (Rev. ed.). New York: W. W. Norton.
  2. Folkman, S., & Moskowitz, J. T. (2004). Coping: Pitfalls and promise. Annual Review of Psychology, 55, 745-774.
  3. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
  4. Park, C. L., & Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1, 115-144.
  5. Selye, H. (1956). The stress of life. New York: McGraw-Hill. Zeidner, M., & Endler, N. S. (1996). Handbook of coping. New York: Wiley.
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