RELIEVING

STRESS &
ANXIETY
 DR. GUIDE BOOK SERIES

The Doctor’s Guide to:

RELIEVING STRESS
By
Wendy Martin and Dr. Ken Young

in consultation with the Canadian Mental Health Association, Mental

Health America, The Physicians Association for Patient Education,
Canadian Pharmacists Association.

ISBN 987- 55040-068-1

Relieving Stress. Patient manual for Relieving Stress. Self-help Relieving Stress
©2007 Mediscript Communications Inc.
11th edition. All rights reserved.

The publisher, Mediscript Communications Inc. acknowledges the financial support

of the Government of Canada through the Book Publishing Industry Development
Program (BPIDP) for our publishing activities.

No part of this publication may be reproduced, stored in a retrieval system or

transmitted in any form by any means electronic, mechanical, photocopying,

recording or otherwise, without prior permission of Mediscript Communications Inc.

www.mediscript.net

Printed in Canada.
IMPORTANT MESSAGE FROM THE PUBLISHER
The purpose of this book is to help you help yourself. Understanding stress is a step
towards helping you on the path towards conquering the negative aspects of that
feeling.

By including self-awareness exercises throughout this book, we are hoping you will
gain greater awareness of your emotions and what motivates you.

It must be emphasized that there is nothing controversial or harmful in the

suggestions offered here. This book is not intended to replace your physician’s
advice or treatment. Each person’s treatment needs are different; if your doctor has
prescribed medication, the information in this book is not meant to replace it.

A Doctor’s Guide to Relieving Stress is a down-to-earth, common sense approach to

handling the pressures of everyday life. Always consult your doctor on any major
changes linked to your treatment.

This book advocates physical exercise as a way to control stress and anxiety. Always
check with your physician regarding acceptable levels of exercise, especially if you
haven’t exercised for a long time or if you suffer from a medical condition that may
be worsened by too much physical activity.

Neither the authors nor the publisher accept responsibility for any possible
consequences of any course of action suggested in this book. Always call your
doctor if you have questions or concerns.

For further information (websites):

There are few reputable websites concerning this topic but our professional editors
are pleased to recommend the following:
Canadian Mental Health Association www.chma.ca
Mental health America www.mentalhealthamerica.net
Work Life Canada www.worklifecanada.ca.
Work Life Balances in Canadian Workplaces. www.hrsdc.gc.ca

Bibliography:
For a complete listing of the bibliography for this book go to www.mediscript.net and
navigate to the Dr. Guide book: Relieving stress.

Ordering this book

Health care professionals wishing to order more copies of this book may contact us
at mediscript@rogers.com, or by calling 1-800 -773-5088 or visit www.mediscript.
net
 TABLE OF CONTENTS
INTRODUCTION ....................................................................... 1

WHAT IS STRESS? ................................................................... 2

KNOW YOUR STRESSORS.................................................... 11

STRESS AND OUR HEALTH .................................................. 16

PERSONALITY AND STRESS................................................ 24

MARITAL STRESS .................................................................. 30

STRESS AND THE WORKPLACE .......................................... 32

CHILDREN AND STRESS ...................................................... 36

MANAGING STRESS ............................................................. 38

DEVELOPING ASSERTIVENESS SKILLS ............................. 47

MANAGING YOUR TIME ..................................................... 61

CONCLUSION......................................................................... 67
 INTRODUCTION

I
n today’s fast paced world stress are common. The statistics
are revealing: at $160 billion a year, stress related problems
constitute the number one health cost. The average North
American loses 16 working days a year due to stress, and “gradual
mental stress” accounts for 11% of worker compensation claims.
Although chronic stress can contribute to other medical problems,
for most people it merely makes getting through the day more
difficult. Many do not se ek help; they simply weather the storms
and carry on. The good news is that stress can be prevented.

Stress is created by changes and challenges in life, and it is not

always a bad thing. In fact, we cannot live without it; the right
amounts of stress can help us perform better. Extreme changes,
such as a death in the family, can bring on intense feelings of
stress, and adjustment and adaptation becomes difficult. There’s
a fine line between stress that is normal and stimulating, and the
kind that leads to hea lth problems. In order to handle stress
it’s important to recognize the situations in your life that are
causing problems, adjust your attitude towards a more positive
outlook, and learn coping mechanisms like time management and
assertiveness.

The good news is that stress for the most part is not regarded as
a mental illness requiring medication. Anxiety, on the other hand,
can be a chronic situation where you may not know why you are
anxious which may require medication from your physician. It is
important to know this difference.

This book is aimed at those of you who are experiencing stress

that is interfering with your quality of life. Its purpose is to help
you attain a more enlightened outlook on stress and anxiety. It is
not meant as a substitute for your physician’s advice or treatment.
Consider it an adjunct to your health care regimen, a common
sense manual of self-assessment techniques that will help you
understand yourself better and help you cope with the challenges
of everyday life. 1
 WHAT IS STRESS?
“The world is too much with us; late and soon,
Getting and spending, we lay waste our powers.”
– Wordsworth, Miscellaneous Sonnets

T
he word “stress” has become an all-too-familiar part of our
modern vocabulary. We’ve only to turn on the radio, flip
open a magazine or switch on the TV to hear about stress
and its adverse effects on our work, our health and our personal
relationships. It’s become the bugaboo of the 21st century, and
there would seem to be no escaping it.

There exists, in fact, a multibillion-dollar industry aimed at

eliminating stress from our lives, or helping us deal with its effects.
In North America alone, more than 100 million prescriptions for
mood elevators are written each year. There are biofeedback
machines to train us to relax, anti-stress courses and seminars
for working men and women, and gimmicks and gadgets of every
description. And yet, with all this high-priced advice bombarding
us from every direction, for many of us, the situation seems to be
getting worse.

The purpose of this book is to help us realize that stress can be

both good and bad, helpful and destructive. Once recognized,
stress can be controlled and channeled in positive, life-enhancing
directions. First, though, we must understand the nature of stress
and how it works in our lives.

One hundred years ago, the highest social prestige was attached
to people and institutions that had nothing whatever to do with
industry or trade. The English country gentleman, for example,
was a respected figure among his neighbours, precisely because
he didn’t have to work. He had comfort, social position and a great

2
deal of personal leisure time. The idea of taking on a profession,
for someone who didn’t need the money, was considered eccentric
at best, and often frowned upon. If a man had ambition, he could
satisfy it in politics, the military or even the Church. He could
afford to be scornful of the middle-classes and their desire to
“better themselves”, and concentrate his energies on his estate,
his family life and his peer group.

Today, of course, all that has changed. In our fast-paced society,

“busy” is the status symbol. (Look around at the number of
people attached to their cell phones while in their cars or grabbing
a mid-morning coffee.) Leisure time – what there is of it – has
become serious business. Although the number of paid working
hours per week is declining and technology continues to advance
at an unprecedented pace, most of us have less free time than our
parents did.

Women are a good example of this trend. Most of them work

far longer hours than their grandmothers may have, because they
work outside the home as well as taking care of their families. All
of this is at the expense of sleep, personal care and free time.

Students aren’t exempt from the rigors of stress. In these days of

intense competition for good grades, the schools themselves teach
children at a very young age to measure themselves in terms of
tests, grades and how they rate with their peer group. Charles
Reich, the author of The Greening of America, makes the claim that
today’s student is actually motivated by external values: “He often
seems to keep pushing beyond rational limits,” he writes. “The
exterior goals consume the inner ones, and he has little time left
for more intimate personal values.”

As society progresses, so do our expectations. We want more

from life and we want it faster. Faster food, quicker weight loss,

3
instant pain relief. And we expect more of ourselves. We take
adult education courses and management training courses and
positive parenting courses, always trying to be one step ahead of
the next person, pushing ourselves to be better and better.

We’re proud of our achievements, and we should be – we should

feel good about our lives. And yet, instead of reaping the benefits
of the good life, many of us feel we are on a treadmill. We’re afraid
if we don’t stop we won’t get going again, that if we look too closely
at who we are, we may not like what we see. We miss the overall
picture and our own very important and unique place in it.

DEFINING STRESS
Stress has been defined as the interaction between the coping
skills of the individual and the demands of his or her environment.
In other words, it’s how we react to what is happening around and
within us, depending on our ability to deal with it.

Generally, when we refer to stress, we’re talking about the stressors

in our lives – the events, often harmful or unpleasant, which put
extra demands on our ability to cope. We see stress as a synonym
for distress, and when we say we’re under stress we’re referring
to the symptoms of our distress – fatigue, insomnia, difficulty in
concentrating, headaches, depression and so on. We may feel
overwhelmed, unable to cope with what is happening or what we
imagine might happen, uncertain about the situation.

4
The stress process includes four components that interact
and influence each other:
1. Stressors
2. Physical responses
3. Psychological responses
4. Behavioral responses

Each of these components plays a part in how we react to stress.

For example, if you’re already in a bad mood, an upsetting event
at work will be more likely to put you under stress than if you’re
feeling happy and confident. We can all remember times when,
suffering from a cold or a bad case of the ‘flu, we felt depressed
and unable to cope with even the simplest of situations.

Let’s look at the components of stress to get a further understanding

of how they work, both individually and together.

STRESSORS
These are the events or situations in our lives that put demands on
our coping skills. Some of them are obvious. There are the daily
occurrences we all deal with – a flat tire, a glass of milk spilled on
the carpet, the morning we get up late, the car doesn’t start, a
100 e mails waiting for you at work, and we miss that important
business appointment. Such events are disagreeable but not
catastrophic. A cup of coffee, a friendly word or a good laugh can
usually clear the air and put the event behind us.

More serious are the stressors we can’t control or find relief

from, and the more prolonged they are the more harm they can
do. Struggling to keep a failing business afloat, dealing with the
breakup of a marriage, working under an obstinate or incompetent
superior – these are hidden stressors that build up over a period

5
of years. If they aren’t recognized and managed they can result
in chronic stress and cause physical, psychological and behavioral
disorders.

PHYSICAL RESPONSES
If you were to make a checklist of yourself during any given stressful
moment, you might find that some or all of the following things
were happening: your stomach, arm and leg muscles might be
tense and rigid; your pulse rate might be increased and your heart
pounding; you might feel yourself perspiring and find that you were
unable to sit still and concentrate, and even your digestive system
might be upset.

These are all physical responses to stress, the results of our bodies’
efforts to adapt to stressful conditions. They come under the
heading of the “fight or flight” response and they can be extremely
useful. In Stop Killing Yourself, Susan Seliger relates several true
stories of people whose physical responses to stress gave them
almost super-human powers:
● A mother in Dorset, England, who weighed only 112 lbs.,
moved a 2000 lb. car and saved her son who was pinned
under it.
● A weight lifter in Georgia was lying on his back, bench-
pressing 250 lbs. in his basement, when the weight slipped
and dropped on to his neck and began choking him. He was
helpless, unable to shift the weight. His 60-lb., 11-year-old
daughter – the only one at home at the time – managed to
lift the weight off her father so that he could catch his breath
and lift it the rest of the way off.
● A 70-year-old man saw the car in which his 12-year-old
granddaughter was riding go over an embankment. He
managed to get down the slope to her, pick her up and carry
6
 her up a hill so steep that a 35-year-old relative who visited
the scene said he could barely make it up alone and believed
it was impossible to do so carrying an unconscious, 70-lb.
weight.

Stress, as a temporary element, can prod us to greater heights. But

on a day-to-day level, it merely causes us headaches, backaches
and muscle pain. When it’s chronic – that is, when it continues
for a long time without relief – it can lead to high blood pressure,
insomnia and even, in some cases, sudden heart attacks.

To understand how that can happen, let’s look at the three stages
of the “fight or flight” response:

Alarm
When your brain perceives a stressor, it sends a message to your
pituitary gland, which secretes hormones to stimulate the adrenal
gland to release adrenals into the bloodstream. The body is now
ready to deal with any real or imagined dangers or challenges.

Resistance
This occurs when the stressor persists. The body adapts to
running in high gear, a situation that drains a good deal of the
body’s energy as the high levels of hormones continue. If the
immediate threat is overcome, the body’s reverse mechanism
comes into play and things return to normal. If, however, this
stage continues for too long, the body’s resources become
depleted and the next stage sets in.

Exhaustion
At this point your body is telling you it is running out of steam.
Your blood vessels may start to tighten up, making it harder for
the blood to flow through them. Chronic stress also changes the
chemistry of the blood, making it more lily to clot. This means
there’s a greater chance that a clot will form and lodge in a
7
narrow artery in the heart, and cause a heart attack. So chronic
stress can be hard on the heart.

PSYCHOLOGICAL RESPONSES
In the first place, it’s important to understand that an event or
situation becomes a stressor simply because you see it as one.
Policemen, for instance, report that they feel more under stress
when they have to deal with the boring paperwork of a desk job
than when they are out making arrests and intervening in crimes.
They have been trained to act, and when they perceive themselves
to not be acting, they feel stress.

Also, how you coped with a similar experience in the past will
determine your expectations about whether or not you are going
to be able to deal with a stressful situation in the present. Simply
knowing that this has happened before, and you were fine, can
relax any fears or anxieties you might have about the event. On
the other hand, if this is an entirely new event, or if a similar
situation occurred in the past and you were unable to handle it, you
are probably going to be apprehensive about your ability to cope.

To complicate matters, many of us believe there is something

inherently wrong with feeling anxious or depressed, and that
attitude in itself increases our levels of stress. We may try to
eliminate those feelings by smoking, drinking alcohol, overeating
or keeping ourselves so busy there’s no time to dwell on our
anxieties.

When we’re having difficulty managing stress, we may find we can’t

concentrate at work, or have difficulty making even the simplest
decision. We may become irritable and quick to anger, or find
that we’re developing irrational fears about everyday situations.
Feelings of stress can chip away at our self-confidence.
8
BEHAVIORAL RESPONSES
The “fight or flight” response can be a constructive attempt to
solve a problem or an inappropriate reaction to a difficult situation,
depending on the circumstances. In wartime, a soldier may be
called on to fight for his country; punching an antagonistic co-
worker, however, doesn’t solve anything. It makes sense to flee
a dangerous animal; running away from a traffic jam is neither
appropriate nor, in most cases, possible. And it is because we
cannot attack our coworkers or immediately disentangle ourselves
from traffic jams that stress has such an impact on our behavior.

The “fight” response can be aggressive, such as losing your temper

and lashing out at your partner. It can also be passive, where you
sulk and ignore people. The “flight” response, in which you walk
away or avoid stressful situations, generally reduces stress in the
short term. But it can restrict the way you live your life and cause
further stress because of that. And of course, you cannot always flee
a stressful situation. Nervous tics, nail biting, absent-mindedness
and foot tapping are all forms of escape and are pretty harmless.
But other means of escaping stress – increased use of alcohol,
smoking, taking drugs, using tranquilizers – bring with them a host
of other problems, which in turn lead to further stress.

It’s not the event or situation in itself that harms us; it’s our
reaction, our perception of the event, how we think and feel about
it, that can either hurt us or motivate us to achieve our goals.
Stress can actually be a positive force in our life. Symphony
conductors are good examples of this. The average conductor has
what to many would seem a stressful life. He or she travels a
good deal, consistently has to meet deadlines, deals with often
temperamental musicians, and works continually in the glare of
public scrutiny. And yet these men and women live longer than
the rest of us. Why? Well, they take pride in their achievements,
9
receive applause for their work, are respected in the world of music
and the community at large, and receive a great amount of creative
fulfillment from their jobs. These factors would seem to outweigh
any negative by-products of stress.

We can’t all be symphony conductors, nor would we wish to be.

But we do need, each of us in our own way, to find balance and
equilibrium in our lives and our work. What may be a negative
stressor to one person can be a challenge to someone else. Thrill-
seekers see sky-diving as exhilarating; most of the rest of us break
out in a cold sweat at the thought. We need to find jobs and
lifestyles that are compatible with our abilities and our individual
levels of stress tolerance. And we need to learn to manage the
stressors we cannot change.

The Canadian Mental Health Association has an excellent on line

quiz, “work life balance Quiz” –simply go to www.chma.ca , click
on “your mental Health” and then click on “work life balance” and
complete the quiz , then submit. An objective response will indicate
whether your life is balanced or problematic.

10
 KNOW YOUR STRESSORS
“To conquer oneself is a greater victory
than to conquer thousands in battle.” – Zen saying

In Chapter One we talked about the need to identify events or

situations in your life that are causing you stress. The difference
between a “flat tire” stressor and a “failing marriage” stressor is
obvious. The flat tire stress is acute but, after half an hour or so,
there is a sense of relief in solving the problem and you carry on
with your life – perhaps with a greater sense of achievement. A
failing marriage is a chronic (no relief) stressor; it can wear you
down physically and mentally.

The following Stress Awareness Checklist can help pinpoint

negative stressors in your life. There are two aspects:
● Your physical response to stress (how your body changes to
meet the stress challenge) and,
● Your stress cycle (do you relax or stay all wound up after the
stressful event?)

STRESS AWARENESS CHECKLIST

Your Physical Response Yes No

Does your heart pound? ....................................... ❑ ❑

Do your muscles tense? ....................................... ❑ ❑
Do your hands become cold and clammy? .............. ❑ ❑
Do you perspire? ................................................. ❑ ❑
Does your stomach get “knotted”? ........................ ❑ ❑
Do you get a headache? ....................................... ❑ ❑
If you respond “Yes” to at least three of these symptoms, then your
body is experiencing stress.
11
YOUR STRESS CYCLE

Positive Stress Yes No

Do you feel a period of rest and

renewal after the stress event? ............................. ❑ ❑
Does your body return to a relaxed,
pre-stress state? ................................................. ❑ ❑
If you answer “Yes” to these questions, you’re experiencing positive
stress: a good mix of arousal and relaxation that helps you perform
better through greater concentration and effort.

Negative Stress Yes No

Do you feel you can’t turn off your stress response? ❑ ❑

Does your body stay “wound up”
in the so-called state of flight? .............................. ❑ ❑
If you answer “Yes” to these questions, you can be experiencing
negative stress: constant arousal that can lead to all kinds of
debilitating health conditions. This is the stress you must try to
eradicate from your life.

12
At this stage in your self-help program you should identify the
negative stressors in your life. Think carefully about events and
situations that generate negative stress; recognizing these can be
the first step in relieving your stress and anxiety. We’ll deal with
the “how-to” in overcoming negative stress later. The main thing is
that you are documenting the problem areas you will be tackling.

Recurring events, situations, relationships or behavior that drain

your sense of physical or psychological well-being are all indicators
of stress that may show up as health problems.

To diagnose the negative elements in your life, write out the details
of events that bothered you. Describe the event, the circumstances,
your behavior and the outcome.

Using this technique may help put the situation into better
perspective and help you interpret more objectively why it was
stressful for you. Looking at the event in hindsight may reduce
your stress and anxiety and set you on a positive path. It may also
teach you to cope better if and when such a situation recurs.

The bottom line for changing these negative stressors is that if

you choose to mentally process the experience in a different
way, stress and anxiety can be reduced or eliminated. It’s all in
the mind.

13
STRESS EVENT EVALUATION (S.E.E.)
This next exercise involves writing down your feelings as if you
were writing a letter to yourself. It can help you put an issue
or event into perspective. Often the solution unfolds before your
eyes. You may find that discussing a problem with a friend or
health professional provides a clearer focus.

Rate yourself on a scale of 1 – 10 where the descriptions are: 1

– No Stress, 4 maximum positive stress (you are motivated) to 10
Maximum intense negative stress. This is a subjective rating but
the events and situations are all relative so you will get an objective
appreciation of the more serious stressors in your life.

The following example is included to help you understand how

to complete this exercise. Photocopy the form if you need more
copies.

S.E.E. (Example)
Describe the event or situation being called into the office from
the production room
Who is involved? My boss & 2 office secretaries
How do I behave/react? Nervously, being very submissive - I
always agree to anythng just to get out.
Do I have control? no Stress/Anxiety feelings (1-10) 9
Why is this stressing me? I always feel I have done something
wrong because my boss talks “down” to me.
What could be changed to solve the problem? I do a good job. I
guess I’ll have to learn to be more confident and to communicate
better.

14
S.E.E.
Describe the event or situation

Who is involved?

How do I behave/react?

Do I have control? Stress/Anxiety feelings (1-10)

Why is this stressing me?

What could be changed to solve the problem?

15
 STRESS AND OUR HEALTH
“Oh health! health! the blessing of the rich! the riches of the poor!
Who can buy thee at too dear a rate, since there is no enjoying
this world without thee?” – Ben Jonson, Volpone

In a time of fiscal restraint and budget cutbacks, it was probably

just a matter of time before the health care workers at the hospital
were affected. Still, the announcement, when it came, that six
contracts would not be renewed was devastating news to some of
the workers.

Roseanne, in particular, was extremely upset. She left the office

in tears and returned home, unable to work for the rest of the day.
She had worked at the clinic for almost six years; where on earth
was she going to find another job like that.

When her contract ended, Roseanne gradually stopped going out

and began spending more and more time at home in front of the
television. She felt too embarrassed to go out for lunch with her
friends, who were all working, and instead ate more than usual
and put on weight. She began to experience heart palpitations and
finally, under pressure from her family, went to see a doctor who
prescribed tranquilizers.

Jennifer was also laid off, but she reacted differently. During the
four weeks she had left until the end of her contract, she used her
free time to contact friends and acquaintances that might have job
leads.

After her layoff, she decided to treat herself to a trip to Arizona

to visit an old high school chum. While she was there, she had
some time to think and re-evaluate her priorities. She decided
that the desert climate agreed with her and within a few weeks had
established a catering business there with her girlfriend.
16
Here we have two women with similar backgrounds, dealing with
stress in very different ways. Why does that happen? Why does
stress cause some people to get sick, while providing others with
the incentive to make major positive changes in their lives?

Obviously, some people have a higher tolerance for stress than

others. The key to success in today’s changing world is learning
to adapt successfully to the stresses you meet. Failure to do
so will mean depression, sickness, loss of self-esteem and low
achievement.

Psychologists say that people who withstand a lot of stress and

stay healthy – even though they may have a family history of
disease – feel in control of their lives, are committed to themselves
and to others, and see stressful events as challenges, rather than
insurmountable problems.

It seems, then, that there is a mind/body connection that comes

into play here. Our health depends to a great degree not only on
our physiological but also our psychological resistance to disease.
There’s a new field of medicine that looks at this particular subject
– why some of us become sick and others remain symptom-free.
It’s called psychoneuroimmunology, or PNI.

PNI is based on the idea that the brain, endocrine and immune
systems form an intricate communication network. They interact
in ways that can make us sick or keep us well and, when we are
sick, boost our chances of recovery.

Researchers at the National Institute of Mental Health in Maryland

have suggested that when we feel helpless and out of control,
our bodies send out chemical messengers which slow down the
movement of white blood cells that fight disease.

It is increasingly clear that your ability to handle stress is the single

17
most important asset you can have in fighting illness. Fear, anxiety,
frustration, confusion and insecurity are beginning to be seen as
the causes of more disease than bacteria and viruses.

Three-quarters of all complaints in the practice of general medicine

are stress-related. Almost a quarter of prescriptions written by
North American doctors are for tranquilizers, sleeping pills or
anti-depressants. Unfortunately, there seems to be a growing
acceptance that this is an unavoidable fact of modern life – that
with our faster, more hectic pace with the inescapable technology of
cell phones, text messaging, blackberries, webcam, emails, voice
mail and more….can lead to tension headaches, ulcers, depression
and general ill health.

PROLONGED STRESS AND DISEASE

Constant tension is linked to a number of diseases. The evidence
clearly shows that prolonged stress – or the body’s constant
readiness for action over a period of time – is an important part of
the trigger that sets off many diseases.

When your blood pressure stays high for a long period, the blood
vessels are constricted. This means it’s harder for the blood to flow
through them. Also, chronic stress changes the chemistry of the
blood, making it more likely to clot. All of this can result in a heart
attack or stroke.

Stress can lead to digestive disorders such as constipation or

diarrhea, duodenal and stomach ulcers, and colitis. The constant
effort of the lungs to get more air can lead to problems for
asthmatics. The skin changes associated with stress can cause
allergies and rashes, and a continued state of tension may result in
headaches, backaches and muscle pain.

18
Keep in mind that we’re talking about keeping the body in a state
of readiness for a prolonged period of time. Momentary crises
which are coped with quickly cause no problems, because the body
returns to its normal state very rapidly.

Stress and your heart

If your heart starts beating harder and faster than usual, it
means it has increased its output. Exercise can do this; so can
stress. When we’re stressed, we may feel that nothing is going
right, that we’re always racing around and accomplishing nothing.
When this happens, the brain stimulates the sympathetic nervous
system which causes your body to pump out adrenaline-like
substances. These increase your heart rate, which leads to
higher blood pressure.

Diabetes
Recent research has shown that emotional stress is a factor in the
management of diabetes. A diabetic can follow his diet strictly,
monitoring every dose of insulin or oral medication and yet still
find that his system is “out of whack” thanks to an argument with
his partner or pressure at the office.

In an experiment at Duke University Medical Center, a group of

diabetics admitted to hospital with poor blood sugar control were
put on medication and taught a technique called “progressive
relaxation.” Starting with their toes and working their way up,
they tensed and relaxed various muscles, learning to recognize and
reduce muscle tension when they found it. After the training, they
were better able to tolerate a dose of sugar than a similar group of
patients who received medication but no relaxation training.

Researchers also introduced biofeedback into relaxation exercises

for insulin-dependent diabetics. In these sessions, the patients

19
were hooked up to electronic equipment that detected muscle
tension, perspiration and temperature and let the patients know
when they were relaxing properly. After a year of using these
techniques whenever they were feeling tense, the patients had the
same overall need for insulin. Relaxation, however, allowed them
to keep their blood glucose swings under control.

Cancer and stress

There is some evidence that the stress of repressing emotions
can lead to some kinds of cancers. A study by researchers at
the Johns Hopkins University School of Medicine found that the
highest incidence of cancer in a group of male medical students
was among the “Lone” cluster, a group of men who felt lonely and
faced the world with bland, unemotional exteriors. They were 16
times more likely to develop cancer than were members of the
“Acting Out/Emotional” cluster, people who were anxious, easily
upset and prone to depression. According to the study, people
with the highest cancer rates were likely to hide their real feelings,
particularly negative ones.

Of course, there is still no real proof that people’s emotions affect

their chances of getting cancer, or surviving it. But while the debate
continues, one New Haven surgeon who is convinced there is a
connection treats his patients with what he calls “a healthy dose of
self-responsibility.” He suggests that we should be turning victims
into fighters, teaching them to take care of their own needs.

When it comes to the idea of personal responsibility, the other side

of the coin is that it can lead some patients to feel guilty about
their disease, believing that they are somehow to blame because
of some personal inadequacies. It can also direct them away from
medical treatment to unproven, potentially harmful therapies.
Remember: stress management is an aid to conventional medical
treatment, not a deterrent.
20
GRIEF
Widows and widowers have much higher rates of sickness and death
than their peers. One group of researchers found that intense
grieving during the eight weeks following the death of a spouse
lowered the immune responses of the bereaved persons, rendering
them much more vulnerable to infection and cancer.

Does this mean you shouldn’t grieve for your loved ones? Of course
not. It does mean, though, that you should realize that you are at
a heightened health risk at times like these, and take measures to
lessen that risk.

POSITIVE STRESS
Years ago, the US National Institute of Mental Health built a veritable
paradise for laboratory mice, stocked with every conceivable
comfort and food. You would think the mice would have thrived
under those conditions. The fact of the matter was, however, that
the younger mice became listless and lethargic; reproductivity
declined and the older rodent population showed increasing signs
of stress. With no challenge, nothing to strive for, the mice soon
lost their zest for life.

Human beings are no different. As Donald Norfolk has written in

The Stress Factor, “A regular shot of adrenaline is also a wonderful
cure for lethargy and boredom…we need the stimulus of occasional
anxiety and fear to keep us alert and alive.”

The secret is to find your own optimum stress level, the point at
which you are performing at peak efficiency. Beyond that level,
performance deteriorates and harmful consequences of stress set
in.

21
STRESS EVALUATION
For many years, Drs. Thomas Holmes and Richard Rahe have
studied the effects of change on our physical well-being. They
have discovered that: “Four out of every five people who have
experienced many dramatic changes in their lives over the past
year can expect a major illness within the next two years.” They
devised a list of life events and assigned a numerical rating called
Life Change Units (LCU) to each one. Death of a spouse has the
highest Life Change rating of 100; minor violations of the law, such
as parking tickets, were given the lowest LCU rating.

They found that while 80% of people with scores over 300, and
53% of people with scores in the 150 – 300 range, became
seriously depressed, had heart attacks or suffered other forms of
illness, these disorders occurred in only 33 of people with scores
under 150.

22
HOLMES-RAHE STRESS EVALUATION
Add up the point values of the events that have occurred in your
life in the past year.
EVENT LCU
Death of a spouse ...........100
Marital separation............. 65
Death of a close family
member .......................... 63
Personal injury or illness ... 53
Marriage ......................... 50
Loss of a job .................... 47
Marital reconciliation ......... 45
Retirement ...................... 45
Change in health of a family
member .......................... 44
Pregnancy ....................... 40
Sex difficulties ................. 39
Gaining a new family member
...................................... 39
Change in financial status.. 38
Death of a close friend ...... 37
Change to a different kind of
work ............................... 36
Increase or decrease in
arguments with spouse ..... 35
Taking out a big mortgage on a
home .............................. 31
Foreclosure of mortgage or
loan ................................ 30
Total Life Change Units (LCU) _________
EVENT LCU
Change in work responsibilities
...................................... 30
Son or daughter leaving home
...................................... 29
Trouble with in-laws.......... 29
Spouse beginning or stopping
work ............................... 29
Outstanding personal
achievement .................... 28
Revision of personal habits 24
Trouble with business superior
...................................... 23
Change in work house or
conditions ....................... 20
Change in residence ......... 20
Change in social activities.. 18
Taking out a small mortgage on
your home ...................... 17
Change in sleeping habits .. 16
Change in number of family
get-togethers................... 15
Change in eating habits..... 15
Vacation .......................... 13
Minor violation of the law .. 11
23
 PERSONALITY AND STRESS
“The fault, dear Brutus, is not in our stars,
But in ourselves, that we are underlings.”
– Shakespeare, Julius Caesar

G
reg is always in a hurry. At 37, married and working
as a commission-only salesman, he forever seems to be
in two places at once. He has to be the best, whether
it’s receiving his company’s most valuable player award three
years in a row, or soundly beating his racquetball partner during
a “friendly” match at lunch. At parties, Greg tends to drink a little
more than he should, and gets into arguments with the people
around him.

During his last medical checkup, his doctor suggested he learn

to slow down a little, quit pushing himself all the time, leave the
blackberry at home during the weekend. Greg shrugs off that kind
of advice – his wife has been telling him that for years.

Greg is a “Type A” personality, a prime candidate for a heart attack,

ulcer, stroke or other stress-related problem. And he’s not alone.

TYPE A BEHAVIOR
A 10-year study of healthy business executives, carried out by two
American cardiologists, found that the stress-prone individuals in
the group – or Type A personalities – were three times more likely
to experience heart attacks than their more relaxed colleagues.

Their study theorizes that it is more than your cholesterol level,

your blood pressure or even the number of cigarettes you smoke
that predisposes you to heart disease. Your personality and
temperament are also determining factors.

24
This makes particular sense when you realize that the age range for
heart attacks is dropping. Younger people, who seem vigorous and
healthy and should be carrying on until a ripe old age, are having
trouble with their cardiac systems. One-third of all heart attacks
occur between the ages of 30 and 45. An inability to handle stress
is the culprit, and some of us are more at risk than others.

Nobody possesses all the characteristics of a stress-prone

personality. But you may find that you have certain behavior traits
that fit into the patterns below. Use this as a guide to working on
changing those aspects that are likely to prove troublesome.

Hostility and anger

If you’re under constant low-level stress, you’re likely to feel
hostile towards those around you, not very trusting – even a little
paranoid. You’re also likely to feel angry more often than someone
who is feeling more relaxed and less pressured. A Minnesota
study found that people who feel hostile a great deal of the time
have a death rate from all causes that is six times higher than the
average person. They are also six times more likely to contract
heart disease.

This is not to say that you should never get angry. But you should
realize that getting yourself angry and worked up on a regular
basis is not only likely to alienate you from those around you – it
may also be harmful for your health.

Overplanning
Type A personalities tend to overplan each day. They impose an
unrealistic schedule upon themselves, with goals that are often
impossible to reach, utilizing all the technology from laptops,
blackberries, cell phones and so on. They are perfectionists,
whose tight programs leave no room for unforeseen problems.
With no time to do things properly, unable to relax without feeling

25
guilty, the Type A person is constantly frustrated and unhappy, and
usually behind in his self-imposed schedule.

Multiple thoughts and actions

The impatient, over-programmed person doesn’t live in the here-
and-now. She reads while she eats, cell phones while driving
to work, works on reports while watching television. This is the
person at the party who tends to finish other people’s sentences,
rushes them along, appears to be listening when she’s thinking of
something else. This sort of person will seem to have many friends
but the truth of the matter is that she usually has few meaningful
relationships.

Need to win
Do you have to win to be happy? The classic Type A becomes
agitated and unhappy when he loses, whether it’s an account at
the office or a tennis match. His behavior goes well beyond the
realms of healthy competition; instead, it’s obsessive. For such a
person, playing the game isn’t the important thing – winning is an
end in itself, at all costs.

Need for recognition

We all like to be commended on a job well done, but for the Type
A person this need for recognition supercedes everything. Work
takes on an importance completely out of proportion to the rest
of her life. She may amass enormous wealth and possessions as
proof of her success, but finds that somehow she doesn’t enjoy
them as much as she should. And that no matter how much she
has, it’s never enough.

Inability to relax
It probably goes without saying that a true Type A personality can’t
relax without feeling guilty about it. This is the workaholic who is
the first to arrive at the office in the morning and the last to leave

26
at night, the laptop at home, keeping him or her connected at all
times.

The Type A person will seldom – perhaps never – take holidays, and
when he does, will be texting or e mailing into the office every day
to see what’s going on. What leisure activities he does have will
be planned and programmed to the nth degree, and so recreation
becomes just as tedious and stressful as work.

TYPE B PERSONALITY
As you may have guessed, the Type B person is very different from
her Type A counterpart. Type B tends to be confident of what she
can do and pretty much accepting of what she cannot. This is not
to suggest that the Type B person does not have drive or ambition.
It simply means that she can work without feeling wound up and
agitated, and her work is generally more productive in the long
run because she feels good about doing it. The Type B person is
much more likely to relax and take a vacation without feeling guilty
about it.

HOW TO TELL IF YOU ARE A TYPE A

PERSONALITY
Although Type A behavior may run in your family, it is not a genetic
factor – Type A’s are made, not born. Type A fathers and mothers
teach their children to respond to the stresses of life with Type
A behavior. It’s something that has been learned, and it can be
unlearned, or at least modified, if the desire to do so is there.

It’s important to remember that we are all individuals. Some of

us truly do thrive on stress and would not be nearly as productive
without it. For those stress-seekers, life would loose much of its

27
flavor if those frequent challenges were taken away. The problem
is not the stress itself, but a person’s temperament and ability to
cope.

In her book Life Stress, Rosalind Forbes suggests you rate yourself
as to how you typically react in each of the situations listed in
the following chart. Remember – there are no right or wrong
answers.

28
PERSONALITY TEST
Ratings: 4-Always 3-Frequently 2-Sometimes 1-Never

❑ Do you try to do as much as possible in the least time?

❑ Do you become impatient with delays or interruptions?
❑ Do you always have to win at games to enjoy yourself?
❑ Do you find yourself speeding up the car to beat the red light?
❑ Are you unlikely to ask for help with a problem?
❑ Do you constantly seek the respect and admiration of others?
❑ Are you overly critical of the way others do their work?
❑ Do you have the habit of looking at your watch or clock often?
❑ Do you always strive to better your position and achievements?
❑ Do you spread yourself “too thin” in terms of your time?
❑ Do you have the habit of doing more than one thing at a time?
❑ Do you frequently get angry or irritable?
❑ Do you have little time for hobbies or time by yourself?
❑ Do you have a tendency to talk quickly or hasten conversations?
❑ When traveling do you always open your laptop for work?
❑ When traveling do you feel the need to cell phone all the time?
❑ Do you have a tendency to get involved in multiple projects?
❑ Do you have a lot of deadlines in your work?
❑ Do you feel guilty if you relax and do nothing during leisure?
❑ Do you take on too many responsibilities?
___ TOTAL

TOTAL – If you score between 20 and 30, the chances are that you
are non-productive, or your life lacks stimulation. A score of 31-50
designates a good balance in your ability to handle and control stress.
If you score between 51 and 60, your stress level is marginal and you
border on being excessively tense. Learning relaxation techniques
will lower your risk of developing stress-related problems. If your
total number of points is greater than 60, your stress could seriously
affect your health. It’s time for a change! 29
 MARITAL STRESS
“One was never married, and that’s his hell; another is,
and that’s his plague.”
Robert Burdon, The Anatomy of Melancholy

T
oday’s high divorce rate and the resulting growth of single
parent families and blended family situations have created
many more stressors in society. One wonders whether
these statistics could be reduced if people were more aware of
the nature of stress and the skills and changed attitudes required
to eliminate it.

Awareness of the problem and an improved ability to communicate

can relieve negative stressors. Through it is not the intention of this
book to address the complex issue of relationships, the following
Marital/Relationship Scale can serve as a basis for discussion
between you and your partner, or with the help of a counselor.

Rate on the numerical scale how you feel today. Try to exclude
all feelings of yesterday. As you rate each area of your marriage,
ask yourself this question: “If my partner continues to act in the
future as he/she is acting today with respect to our relationship,
how happy will I be with this aspect of our relationship?”

30
MARITAL/RELATIONSHIP SCALE
< UNHAPPY/HAPPY >
1 2 3 4 5 6 7 8 9 10 Raising the children
1 2 3 4 5 6 7 8 9 10 Social activities
1 2 3 4 5 6 7 8 9 10 Financial arrangements (sufficient income & sharing)
1 2 3 4 5 6 7 8 9 10 Household responsibilities
1 2 3 4 5 6 7 8 9 10 Sexual satisfaction
1 2 3 4 5 6 7 8 9 10 Personal independence
1 2 3 4 5 6 7 8 9 10 Partner’s independence
1 2 3 4 5 6 7 8 9 10 Career progress
1 2 3 4 5 6 7 8 9 10 Self development (Am I growing as a person?)
1 2 3 4 5 6 7 8 9 10 Communication effectiveness

This is an interesting exercise; you may be surprised at the findings. Often

there are just one or two aspects with a low score causing the negative
stress. A step towards solving the problem occurs when you realize that
one aspect of the relationship is disproportionately causing so much of a
problem.

Relationships usually start off romantically, somewhat self-indulgent and

focused on caring for one another without too many distractions. Then the
“baggage” accumulates: money problems, disagreements about raising
children, career conflicts and so on. Sooner or later the pleasure of those
early days is tinged with stress.

Effective communication means keeping an open mind to the needs

and wants of your partner and seeking solutions to problem areas. It’s
important to avoid emotional states that can immobilize you to the point
where you’re unable to find a way out. Anger, guilt, worry, fear – even
not sticking up for yourself – can ruin the chances of eliminating those
negative stressors. One of the classic range of books on the market aimed
on helping people rid themselves of these destructive emotions are Wayne
Dyer’s books which started with “Your Erroneous Zones”. His books have
sold over 60 million copies and helped countless relationships.
31
 STRESS AND THE WORKPLACE
“Men, for the sake of getting a living, forget to live.”
– Margaret Fuller, Summer on the Lakes

I
n North America, many large corporations promote the idea
of the “healthy” company. Healthy, fit individuals are seen
as more productive, less prone to absenteeism and better
employees. Many of these companies spend large amounts of
money each year on programs encouraging smoking cessation,
weight loss and stress management.

Johnson & Johnson, for instance, has a health promotion program

called Live for Life; it’s free of charge, voluntary and available to
33,000 US employees. It offers a health screening service that lets
employees know how healthy they are – or not – and then offers a
series of 8-week courses designed to improve their weakest areas.
The company also holds one-hour lunchtime seminars on subjects
like biofeedback. Not every company is taking the idea of healthy
employees as seriously as Johnson & Johnson, but many company
sites have fitness facilities open during working hours.

Businesses that offer such services are experiencing dramatic

reductions in absentee rates, lower hospital costs and a substantial
boost in morale. Some even find that happier, healthier employees
mean fewer union grievances.

BURN-OUT
This is a term you hear a lot these days, generally referring to an
individual who has collapsed, emotionally or physically or both, in
the course of dealing with the pressures of work and has lost the
motivation to work. But there are some misconceptions about
burnout; let’s look at them before we go on to talk about how it can
be dealt with, or avoided altogether.
32
Misconception #1: As long as you really enjoy your work,
you can work as long and as hard as you want and you
won’t burn out.

This is like saying as long as you really enjoy eating and drinking,
you can eat and drink as much as you want forever without getting
sick.

Whenever a job entails a great deal of frustration, conflict and

pressure without periodic breaks from stress and strain, there is
the potential for burnout no matter how much you might love your
work.

Misconception #2: People know when they’re burning out;

all they need to do is take a few days or even weeks off
work to rest and relax and they’ll be fine again.

It’s rare for anyone to know when he’s burning out. In fact,
the individual who’s burning out is often the last one to realize
there’s a problem. He may ignore the signals or dismiss them as
unimportant, until the problem has progressed to the point where
he may never again be able to be as productive as he once was.

Misconception #3: If you’re psychologically and physically

strong, you probably won’t experience burnout.

Just the opposite seems to be true. Physically strong people can probably
take on double the amount of work, but if they don’t have proper stress
management skills, that extra workload can wreak havoc.

It works the same for people who are psychologically strong. If

you’re seen as especially competent and tough-minded, you’re
likely to be handed an overabundance of duties and responsibilities,
leaving you less time and energy for the kind of psychological
refueling that’s necessary to handle it all. Without proper stress
skills, that kind of strength can actually be a liability.
33
Misconception #4: Burnout is always job-related.

Actually, burnout is almost never solely connected to work. Usually

what happens is that stressors from other areas of one’s life –
family, friends or personal life – bring pressures to bear that can
affect a person’s performance at work.

An individual, for example, is experiencing overwhelming pressures

at work, feels dissatisfied with her social life, and is having marital
or parenting conflicts at home. When she burns out, the factors
are considered job-related, when in fact she has a disordered life in
general. The job may be the least of her problems.

PREVENTING BURN-OUT
There are usually 4 major issues in work situation that contribute
to burnout, these are listed and some ‘what you can do” solutions
are suggested.

Too much demand / not enough time.

You should establish objectives and goals, prioritize, analyze
problems and practice good communication skills with the relevant
people

Lack of control
When you have no control in your job, this is regarded as the
number one reason for stress and burnout. People always telling
you what to do, not allowed to make suggestions, these are some
of the comments you hear.

34
Why not volunteer for different tasks you feel offer more independent
actions, try to be more assertive in getting your suggestions and
demands on the table, schedule your work tasks to accommodate
the peaks and valleys of your energy. This is a tough issue to solve
sometimes because of the rigid nature of certain jobs, so consider
changing jobs!

Too much caring

It may well be in your personality that you care more than you should
and taking the worries home may create stress and burnout. You
may also want to disproportionately please people at work.

You should try to develop more of a detached concern, appreciating

your quality of life at home is more important. You should realize
that perfection can rarely be achieved in any task and you have to
settle for less to make sure you do your job properly. Discuss issues
with colleagues, which can be a great leveler for you because you
see perhaps a lower level of caring.

Stressors of long duration.

Any of the issues creating stress for you that last for a long time
can eventually cause burnout. You have to be proactive to not let
the issue continue for a long time. It is always good to care about
yourself at this time: do exercise, reward yourself, cut down on
negative lifestyles like drinking or fast food and try to see humour in
the situation.

35
 CHILDREN AND STRESS
“Children need models more than they need critics.”
– Joseph Joubert, Pensées

I
n spite of everything we now know about childhood, there are
still people who believe that kids have it easy, that childhood
is one endless, golden summer holiday, and a child’s toughest
decisions are whether to buy gum balls or licorice sticks. If only
it were true!

Children are often pressured to perform. In adolescence youngsters

are pressured to date, often long before they’re ready. There are
pressures to go out for the team, wear the “right” clothes, smoke,
drink and take drugs, and hang out with the “right” people – who
are too often absolutely the “wrong” people, unfortunately. And of
course there is pressure from parents for them to get good grades
and fulfill family expectations. Considering this, it’s no wonder that
young people are often confused, moody and despairing.

College and university provide further challenges, with students

pressured to make important career choices. Dr. Harold M.
Visotsky, director of the Institute of Psychology at Northwestern
Memorial Hospital in Chicago, says students are under extraordinary
pressure: “We’re seeing things in young people we never saw
before. They have stomach disorders, ulcers, hypertension, colitis,
even rheumatoid arthritis. All of these are related to high levels
of stress.”

As Dr. Visotsky points out, young people today are subject to

unprecedented amounts of stress. How they cope with it will have
a lot to do with the stress-coping techniques they have learned at
home.

36
WHAT PARENTS CAN DO
Especially in the younger stages of childhood, parents can do a great
deal to help a child cope with stress. First of all, it’s important tat
you accept that your children are responsible for their own actions.
This means letting them have the freedom to make mistakes and
to learn from them. You can’t live their lives for them.

As a parent, you have the right to live your own life as well. You
need a certain amount of freedom and independence as much as
your children do.

Accept the fact that you’re not the perfect parent and you probably
do not have perfect children. Your child has to learn that people
and life situations are not perfect; if he learns to deal with that fact
at home, he’ll be much better equipped for what life has to offer
him.

You cannot live through your children. You may always have
wanted to play the piano of be the captain of the football team, but
forcing your child to take piano lessons or go out for the team is
only going to be harmful in the long run.

Let your children share their problems and experiences with you,
without giving in to the urge to say, “I told you so.” Parental
guidance is more than simply telling your children what to do;
practice effective listening, and you’ll find that they’ll talk to you
more than they would if the conversation was always one-sided.

Instill confidence in your child by encouraging positive achievements

and avoiding unconstructive criticism. Let your child know you’re
on her side, even though you may not always agree with her.

37
 MANAGING STRESS
“A journey of a thousand miles must begin with a single step.”
– Lao-Tzu, The Way of Lao-Tzu

Janet is a chronic worrier. Although she has a good job, a loving

husband, a pleasant home and two children, she tends to concentrate
on the negative aspects of her life – a problem at work, a neighbor
who was rude, her mother’s failing health. Janet is not completely
aware of it, but she gives herself negative messages all day long.
She has conditioned herself to be tense, miserable and depressed,
rather than relaxed, joyful and optimistic.

Janet needs to put the small problems into perspective – she needs
to learn to “roll with the punches.” How she does that will be
unique to her. There are, however, some coping skills that can help
everyone. They involve attitude adjustment, improving behavioral
skills and changing lifestyles to counteract negative stressors.

Information search
In many situations, lack of knowledge is a main source of stress
– what you don’t know can hurt you. When faced with a crisis, get
adequate and accurate information as soon as possible.

Positive reappraisal
Learn to make the best of a bad situation. People who cope
effectively look back on stressful periods and say, “I’m a better
person because of that – I learned from that experience.” An
approach like this can encourage feelings of pride and satisfaction,
rather than anger and depression.

Problem-solving
Confront the situation head-on. Devise a plan of action and follow
it step by step.
38
Exercise
The benefits of exercise, are wide ranging. A University of
Wisconsin study had subjects de-stress in one of two ways: one
group engaged in 40 minutes of moderate aerobic activity such as
jogging and swimming, while the other group rested quietly for
40 minutes. It was found that for the group involved in physical
exercise, signs of stress were significantly reduced for up to three
hours, while those who had rested were “de-stressed” for only 20
minutes.

Regular aerobic exercise – where the heart rate stays elevated to

70% of its maximum for 20 to 30 minutes at least three times a week
– not only improves a person’s physiological state by conditioning
the heart and lowering blood pressure, but also relieves depression
and fatigue.

Physical activity has a similar effect on muscular tension as a

tranquilizer. A person who is aerobically fit is more relaxed and
less prone to getting sick when under stress.

This is no secret to many successful business people. Most of

them have long been aware of the benefits of a regular exercise
program. When you have to make dozens of decisions every day,
it’s important to be as alert at 7:00 or 8:00 at night as you were
first thing in the morning. An early morning walk or run, or a
workout at lunchtime, will give you extra energy for the rest of
the day, and provide temporary relief from the pressures of a busy
life.

It has been found that exercise, along with laughter, tears, music
and pregnancy, releases endorphins, those magical, morphine-like
brain chemicals. Research on endorphins has shown they not only
play a large part in making us feel happy, optimistic and healthy,
but also bolster the activity of our bodies’ immune systems.

39
It’s not even necessary to engage in strenuous activities such as
biking, running and swimming to reap the benefits of exercise.
Walking can produce the same effect. Robert E. Thayer, a Professor
of Psychology at California State University, has been doing research
for years on the mood changes that occur with short, rapid walks.
He has found that brisk walks increase people’s feelings of energy
– sometimes for several hours. They can reduce tension, make
personal problems appear less overwhelming and may even make
it easier to quit smoking.

Professor Thayer compared the effects of walking to those brought

on by eating a sugary snack; he found that the immediate mood
change from the snack was similar – increased energy. But one
hour after snacking, some negative changes began to show up,
such as fatigue and tension. The people who walked enjoyed an
energy boost without experiencing these negative effects.

Not all exercise has the same beneficial effects, however. Playing
a competitive game of tennis or racquetball will help condition the
body, but if you’re tense about winning or upset about losing you
won’t find the experience very relaxing.

Get involved
The “high” that people get from a physical workout can also be
produced from an activity requiring less exertion – helping others.

A US study looked at more than 1,700 women who were regularly

involved in helping others. A large percentage of them reported
feeling physically stimulated during the act of helping. Many of
them mentioned increased strength and energy, which may once
again be linked to the release of endorphins, the body’s natural
pain-reducing chemicals.

One of the helpers, a woman who counseled abusive parents,

compared her sense of fitness and well being to what she felt
40
while swimming. Another, a nursing home volunteer, noted that
although the work left her feeling tired, it was the kind of fatigue
she experienced after a good game of tennis.

The benefits of getting involved with other people appear to work

on a social basis as well. Researchers have found that business
executives who are alienated from their friends, family and co-
workers tend to have a high incidence of stress-related illnesses.
Active relationships with other people enhance our feelings of self-
worth and our ability to cope.

Avoid hassles
If rush hour traffic gets you tense and upset, try car pooling or
using public transit, or even changing your work hours, if that’s
possible. For many people, one of the benefits of working from
home has been cutting out the daily commute – a frequent source
of stress and frustration.

Smell the flowers

Take a few minutes for yourself every day to take a break and
enjoy nature. If you have the time to do it, drive out into the heart
of the country away from the lights of the city and contemplate
the Milky Way. The humble nature of our existence in the grand
scheme of things can put your problems into perspective and help
you begin to sort out your priorities.

Talk it out
When you feel depressed, overwhelmed or unable to deal with
stress, talk to someone you trust. Remember: “A trouble shared is a
trouble halved.” Just talking things through can help enormously.

Love a pet
Many people find the unconditional affection of a dog or cat truly
therapeutic and better than all the relaxation techniques under
the sun. It has been shown that people who own pets tend to
41
be healthier than those who do not. One study of heart attack
victims showed that those with pets were five times more likely to
survive for a year afterward than those without pets. It’s just one
more link in the network that bonds us with other living creatures,
bringing us out of ourselves and enlarging our perspective on life.

Deal with life’s changes

Changes in your life, whether they’re unexpected or planned, can
be a great source of stress and anxiety – a new baby, a promotion,
retirement, moving house, an ill or aging parent, and so on. Sit
down and work out how you are going to cope with the increased
demands. Admitting that you’re having some difficulty adapting is
nothing to be ashamed of – it’s simply taking a sensible approach
and benefiting yourself, your family and your co-workers.

Develop a positive attitude

Is the glass half full or half empty? Dr. Seligman, a psychologist
at the University of Pennsylvania, challenged his patients with
their negative beliefs about themselves. He had them put forward
evidence to back up their negative attitudes, and then encouraged
them to come up with evidence that would contradict those beliefs.
He found that as his patients were encouraged to make positive
statements about themselves they were less likely to blame
themselves and their negative thoughts diminished. In other
words, optimism can be learned.

Don’t embrace a “victim” mentality. Make every experience or

setback a learning situation in which you resolve to do better next
time. Look at life as a series of exams – if you don’t pass, you get
a chance for a retake.

Eliminate the “quick fixes” in your life

Alcohol, cigarettes, junk food and drugs are temporary refuges
from daily tension and anxiety. Unfortunately, they bring with
42
them their own stressors in the form of depression, hangovers
and physical illnesses. Rid yourself of these debilitating addictions
and you will dramatically increase your resistance to stress and
anxiety. When the time is right and you’re sufficiently motivated,
you’ll find all kinds of help through books, audiotapes and CDs and
your physician.

Work at a healthy lifestyle

Stress and anxiety can be counteracted by eating the proper foods,
getting the right amount of sleep, exercising regularly, setting goals
and having regular checkups. Respect your body and appreciate
the importance of maintaining it. Set a goal: for one week cut out
alcohol, junk snacks, staying up late – whatever your nemesis is,
try to eliminate it just for a week. You’ll find yourself thinking more
clearly and having much more energy than before.

Laughter – the best medicine

Humor is a terrific stress reliever. There are consultants who earn
money making executives laugh to ease tension in the corporate
corridors. Take time to find the humor in your own situation. You’ll
be happier – and healthier.

Talk or write to yourself

Putting things down on paper or talking to yourself with a view to
improving your situation is a good way to clarify matters and put
them into perspective.

Reward yourself
Treat yourself as special. If you’re going to be effective in dealing
with others, you need to love yourself and treat yourself well. Do
something special for yourself, at least once a week. By liking
yourself you’ll adopt a positive, achievement-oriented outlook on
life.

43
 Here’s a quick overview of how to relax, ranked by our panel of
physicians in order of popularity and effectiveness.

Deep breathing
This basic technique can be done anywhere, anytime. Simply sit or
stand with your hands on our stomach. Inhale slowly through your
nose, feeling your stomach expand. Then inhale slowly through
pursed lips, and repeat a half dozen times. You are tricking your
body into relaxing by simulating sleep.

Stretching
This loosens the muscle tension that often occurs with a stress
response. Again, it can be done almost anywhere, anytime. Most
of the stretching can be done in a chair, concentrating on the back,
neck and upper body.

Clearing the mind

This can take as little as 5 – 10 minutes. Find a quiet environment
with no distractions. Close your eyes and focus on a peaceful image
(lying on a beach, perhaps). A peaceful thought or a symbolic word
will also work. It takes some preparation but you’ll feel refreshed
afterwards and more relaxed.

Progressive muscle relaxation

This takes about 15 minutes to complete. The principle is simple:
progressively tighten and then relax each of your several muscle
groups, beginning with your toes, feet and leg muscles and working
your way up to your chest, arms, neck and face. With your body
and mind joined in relaxed harmony, you will notice how much
lighter a relaxed muscle feels.

44
Self hypnosis
This approach to relaxation is underrated, probably because of all
the show-biz overtones. However, the mind is a powerful factor in
getting you to relax and hypnosis has been proven to help many
medical conditions. You can purchase self-hypnosis tapes and CDs
or, with proper instruction, you can make your own tape appropriate
to your needs.

Meditation
Focus your attention on one particular thing at a time – a picture,
a word, the flame of a candle. (This is more difficult than you may
think – the mind tends to wander.) By disciplining your mind to
concentrate, you can temporarily eliminate negative stressors.

Biofeedback
This has proven to be useful for migraines and a number of stress
related illnesses. Although this approach often needs specialized
equipment and professional instruction, there are inexpensive
biofeedback machines available that can help you relax with self-
training.

Counselling
Discussing the causes of your stress with a professional can be
a very useful exercise of sharing your concerns and realizing the
truth of your situation. In recent years a highly effective program
called Cognitive Behavioral Therapy (CBT) has proven to be highly
effective, and is strongly recommended by our editors. CBT is
where skilled therapists encompass interactive techniques for you
to discover the truth of your situation and helps you change your
thinking and behavior patterns in order to relieve the stress in your
life.

45
A FINAL NOTE
In this chapter, we have included a lot of tips and suggestions. You
may be interested to know that we carried out a survey among
physicians, asking them to assess the most effective ways (apart
from medication) to reduce stress. Here are their answers, in order
of effectiveness:
1. EXERCISE – whatever’s right for you.
2. COUNSELING with a professional.
3. KEEP HEALTHY – eliminate the quick fixes in your life, such
as drugs, alcohol and cigarettes. Get plenty of sleep and eat
right.
4. LEARN TO RELAX – whichever method suits you.
5. SEEK SUPPORT – a trouble shared is a trouble halved.
6. COMMUNICATE – don’t bottle up your problems.
7. BE ASSERTIVE – stick up for yourself while respecting others.
8. SET OBJECTIVES – decide what’s important in your life.
9. MANAGE YOUR TIME – avoid putting yourself under pressure.

46
 DEVELOPING
ASSERTIVENESS SKILLS
“As you think so shall you be.”
– The Book of Proverbs

S
amantha is a 49-year-old mother of three who works as a
medical secretary. Her husband is a project engineer whose
work assignments constantly take him away from home.
Besides her duties to her family, Samantha is burdened with a
sense of guilt towards her elderly, widowed mother. Although
she has been a loving and sensitive daughter, Samantha feels she
should have visited her mother and father more, when he was
alive, and helped them out to a greater extent. This guilt creates
a constant low level of anxiety within her, and as a result she is
generally overly submissive towards her mother, trying always to
comply enthusiastically with her wishes. She visits her mother
often to help with the housework tasks of a large house and to
keep her mother company.

Jane, her mother, is 81 and has been a widow for two years. She
lives alone in the same large house where she raised Samantha
and her brothers and sisters. Although she doesn’t like to admit
it, Jane’s beginning to find the housework too much for her, and
she feels tired more often than she used to. Yet she remains a
bit of a perfectionist and wants to see the house kept to the same
standards she set when she was raising her family.

The Scene
It’s a Saturday morning and Samantha has just finished cleaning
the kitchen while Jane vacuumed upstairs. Jane comes into the
family room to find her daughter resting on the couch, writing a
shopping list for the upcoming long weekend.

47
Jane: “Well, it must be nice to put your feet up and relax. I’d
like to do the same but of course I can’t, with this place to keep
clean.”

Samantha: “Mom, I’ve just sat down this minute. I cleaned the
whole kitchen, you know. I’m doing my best.”

Jane: “Never mind, dear. If it’s too much trouble, just tell me. I
thought you liked to help out, that’s all. But if it’s too much for
you, don’t bother.”

Samantha: “It’s not too much, Mom. I’m happy to do it. Here, let
me finish vacuuming the hallway.”

Jane: “That’s all right, I’ll do it later. Do you know who I should
call about my television?”

Samantha: “The television? What’s wrong with it?”

Jane: “Oh, it hasn’t been working all week. And my favorite

program’s on tonight, wouldn’t you just know it?”

Samantha: “I’ll call somebody to come and fix it. Although it’ll
cost more if they come on the weekend. I wish you’d told me
earlier in the week.”

Jane: “I didn’t want to bother you, dear. Never mind, I’ll just read
a book.”

Samantha’s feelings
The conversation has reinforced Samantha’s guilt that she’s not
doing enough to help her mother. She resents the implication that
she’s not willing to help her mother with the housework, yet she’s
only too aware of the growing vulnerability of the older woman.
Whatever Samantha does, it just never seems to be enough. And
now there’s the problem of the television to deal with.

48
THE PROBLEM AND THE SOLUTION
The fundamental problem here is Samantha’s lack of assertiveness
in dealing with her mother. This has its roots in the history of
their relationship: Samantha always adopted this submissive role
and she simply can’t imagine dealing with her mother any other
way. As for Jane, she’s not trying to be malicious or hurtful. She
sees her physical abilities diminishing and along with them her one
source of power and pride: her ability to manage her household.

Things will not change until Samantha manages to take a more

assertive stance with her mother. This doesn’t mean arguing with
the older woman or refusing to help her. It does mean finding
an opportunity to appropriately state her own case, and allow
both her and her mother a chance to take an objective look at the
situation.

Let’s replay the situation and see how Samantha might have
responded more effectively:

Jane: “Well, it must be nice to put your feet up and relax. I’d
like to do the same but of course I can’t, with this place to keep
clean.”

Samantha: “Mom, I’m just taking a minute to jot down the things
I need to pick up for the weekend. Anyway, I’m done now, so why
don’t you sit down and have a cup of tea while I finish vacuuming
the hallway?”

Jane: “That’s all right, I’ll do it later. Do you know who I should
call about my television?”

Samantha: “The television? What’s wrong with it?”

49
Jane: “Oh, it hasn’t been working all week. And my favorite
program’s on tonight, wouldn’t you just know it?”

Samantha: “I’ll call somebody to come and fix it on Monday. But I

don’t want you to miss your program. Why don’t you come watch
it with us tonight? Or I can tape it for you.”

Jane: “Thank you, dear, I’d like that. Let’s have that cup of tea.”

Over tea might be a good time for Samantha to bring up some of

the larger issues: Should Jane move to a smaller place? Is it time
to spend a little money and get somebody in to help her mother
– say one day a week? Perhaps the reason the upkeep of the
house is so important to Jane is that she has little else in her life to
occupy her. Maybe she should join a club, or get out and exercise
a couple of times a week.

Of course, this doesn’t resolve that persistent anxiety Samantha

feels on the subject of her mother. She needs to talk this through,
perhaps with her husband or a friend. Samantha has to learn – as
we all do – to live in the present. What happened in the past is
over; it can’t be changed. Whether or not Samantha visited her
parents enough in times past is no longer an issue – what matters
is how she deals with the here and now.

Samantha might also consider what control she has over her
feelings of guilt. She is not responsible for her mother’s television
not working, but she can do something about it. She can help
her find a repairman, tape the show for her or invite her home to
watch her program there. By making any of these suggestions,
Samantha is taking control of the situation and eliminating her
feelings of guilt.

50
Assertiveness consists of appropriately expressing your own rights
and feelings, without infringing on the rights and feelings of others.
It might include learning to say “no” to someone, expressing
an unpopular opinion within a group, or providing constructive
feedback to someone.

Two destructive tendencies exist at the opposite ends of

assertiveness. They are submissiveness (as in Samantha’s case)
and aggression, or hostility.

Submissive Assertive Aggressive

It’s very common for people to confuse being assertive with being
aggressive. There are three criteria that determine whether or not
an assertive exchange has taken place:
1. The event has created the desired results, i.e. Samantha feels
less stress and her mother has solved one of her problems.
2. The event is relatively satisfying for the person being
assertive, i.e. Samantha feels a sense of accomplishment and
the seeds are sown for a more honest relationship with her
mother in future.
3. The event is relatively satisfying for the target of the
assertiveness, i.e. Jane feels her daughter is strong and
appreciates her solving the problem and putting things into a
more sensible perspective.

Take a few moments now to complete the following exercise and

evaluate where you stand on the submissive/assertive/aggressive
scale.

51
SUBMISSIVE/ASSERTIVE/AGGRESSIVE
EVALUATION
Evaluate whether you tend to be more submissive, assertive or
aggressive by completing the questionnaire below.

I have the right to: Strongly Strongly

Agree Agree Neutral Disagree Disagree

Hold and express my

own opinions ❑ ❑ ❑ ❑ ❑
Express my feelings if
I wish ❑ ❑ ❑ ❑ ❑
Be listened to
❑ ❑ ❑ ❑ ❑
Say no without feeling
guilty ❑ ❑ ❑ ❑ ❑
State my own needs if
I wish ❑ ❑ ❑ ❑ ❑
Be treated with respect
❑ ❑ ❑ ❑ ❑
Decline responsibility
for other people’s
problems
❑ ❑ ❑ ❑ ❑
Not be dependent on
others for approval ❑ ❑ ❑ ❑ ❑
Request explanations
for others’ actions ❑ ❑ ❑ ❑ ❑
Not express myself if I
so choose ❑ ❑ ❑ ❑ ❑
The more answers you give towards “Strongly agree” the more
you tend to be aggressive. The more answers you give towards
“Strongly disagree” the more you tend towards being submissive.

52
If you are either strongly submissive or strongly aggressive you should read fu
on assertiveness training, or take hints from this book and practice adopting a m
approach. The good news is that you can change. It’s only learned behavior, b
to practice and work at it. Let’s look at the body language signs and words tha
submissive, aggressive and assertive behavior:

SUBMISSIVE BEHAVIOR
Verbal signals
“It’s only my opinion, but…”
“If that’s the way you want it…”
“I don’t want to cause any problems…”
“I can change my plans if you insist.”

Non-verbal signals
Quiet voice
Hesitant speech
Lack of eye contact
Nervous hand movements
Protective body stance (crossed arms or legs, hunched up)

AGGRESSIVE BEHAVIOR
Verbal signals
“You must be crazy if you think…”
“No way will I accept…”
“That’s ridiculous.”
“That’s your problem, not mine.”

Non-verbal signals
Loud or dominating voice
Rapid speech
Strong, dominating eye contact
Forward-leaning body positions
53
ASSERTIVE BEHAVIOR
Verbal signals
“I would like to…”
“How can we resolve this to meet both our needs?”
“I can’t do that, but I can…”

Non-verbal signals
Straight eye contact, but non-threatening
Firm, steady, non-dominating voice
An “open” body stance – neutral rather than threatening or
submissive

THE HOW-TO OF DEVELOPING ASSERTIVENESS

There’s no magical formula that can change you overnight into an
assertive person. The following points, however, will help you to
become more assertive. Keep in mind that assertiveness is a habit,
a learned behavior. It’s like losing weight or quitting smoking – it
takes a focused effort and time.

Attitude
Believe in your right to stand up for your needs while respecting
the rights of others. It can help to talk this through with family
members, friends and co-workers. For a comprehensive look at
learning to become more assertive, we recommend Your Erroneous
Zones, by Dr. Wayne Dyer.

Be specific, relevant and honest

Try not to use generalities. Phrases such as, “You always leave
things to the last minute”, or “You never look at things my way”
don’t lead to establishing good relationships or solving a problem.
Be prepared to be honest about what is relevant and specific.

54
Focus on the problem, not the personality
Don’t get drawn into slinging matches, even if the other person
gets angry. Stay calm. Listen to what the other person is
saying. You can empathize with someone else’s feelings without
necessarily agreeing with him or giving in to the other point of
view. Concentrate of the finding a solution to the problem rather
than trying to “win” the argument.

Negotiate as equals
Taking the point of view that you each have rights, discuss the
situation calmly. Look for solutions where you can both get what
you need – which may not necessarily be what you both want.
Ideally, both parties should feel positive about the outcome even
though it was not exactly what each of them wanted.

Choose your words carefully

Your goal is to maintain receptivity. The other person should be
listening to your message or point of view. Once receptivity is lost,
resentment, hostility and other negative emotions creep in, and
the chance of a solution evaporates.

For example:

“Yes, but…” This is a combative phrase, not a conciliatory one. An

alternative might be, “I just wonder if there are any alternatives
you might consider?”

“No, I won’t.” This is an absolute rejection of someone’s idea or

suggestion. You are not demonstrating a willingness to cooperate.
Simply changing “no” to “if” offers alternatives and keeps the
communication door open.

“You made the same mistake before…” This is a failure-based

comment. You’re saying to the person, “You’ve failed and I’m
superior to you.”

55
Stick up for yourself
Decide what is negotiable and what’s not. Make sure you know
how far you will go in conceding and go no further.

WAYS OF SAYING “NO”

There are a number of constructive ways to refuse a request and
not create ill will. Here are some of them:

Reflective
Listen very attentively and show that you’re listening before making
an understanding response.

Reasoned
Explain factually why you cannot do something, making it clear
that you understand why the request has been made.

Pre-emptive
Let it be clearly known beforehand that you cannot do it or are not
willing to do it.

Rain check
Express enthusiasm for the request, and offer to think about doing
it the next time.

Broken record
When people simply won’t take “no” for an answer, stick with your
original answer – don’t give “better” reasons. Give the same reason
over and over again, perhaps slightly re-worded. The message will
get through eventually.

56
ASSERTIVENESS INVENTORY
As a final comprehensive self help check, fill out the Assertiveness
Inventory on the next page. It consists of 30 interpersonal
situations that require you to assert yourself in some way. The
exercise will provide you with three pieces of information:
1. Your degree of discomfort with the situation;
2. The probability of actually carrying out that sort of behavior,
and
3. Situations you would like to handle more assertively.

INSTRUCTIONS
Indicate your Degree of Discomfort in the space provided on the
left-hand side before each situation listed. Use the following
scale:
1. None
2. A little
3. A fair amount
4. Much
5. Very much

Go over the list a second time and indicate your Response Probability
(the likelihood of your displaying the behavior if presented with the
situation.)
1. Always do it
2. Usually do it
3. Do it about half the time
4. Rarely do it
5. Never do it

57
Circle the situations that you would like to learn to handle more
assertively. If there are situations not listed which occur to you,
write them in.

NOTE: It is very important to take a piece of paper and cover up

your discomfort ratings on the left as you complete your response
probability ratings. If you don’t do this, you may be influenced
by what you set down as your level of discomfort and won’t get a
realistic assessment of your behavior.

58
ASSERTIVENESS INVENTORY
Degree of discomfort Situation Response probability
❑ .......................... Compliment your friends ..................... ❑
❑ .......................... Ask a favor of someone ..................... ❑
❑ ................Turn down a request to borrow your car........... ❑
❑ ..................... Apologize when you are at fault ................ ❑
❑ .............. Admit you are frightened about something ......... ❑
❑ .......................... Ask for a salary increase ..................... ❑
❑ .......................Admit ignorance in some area.................. ❑
❑ ..... Tell a person you are intimate with he/she irritates you ❑
❑ .................... Resist unwanted sexual overtures ............... ❑
❑ ......................... Express a differing opinion .................... ❑
❑ ......... Tell someone he/she has behaved unfairly to you .... ❑
❑ .....................Return defective items to a store................ ❑
❑ ............................Ask personal questions ...................... ❑
❑ ................. Initiate a conversation with a stranger ............ ❑
❑ ...... Admit confusion about a point and ask for clarification . ❑
❑ ................................. Apply for a job ............................ ❑
❑ .................Ask whether you’ve offended someone ........... ❑
❑ .......................Tell someone you like him/her.................. ❑
❑ ........ Request service in a restaurant when it’s not being given ... ❑
❑ ..... Tell a waiter of your dissatisfaction with a meal when he asks ❑
❑ ................ Tell someone good news about yourself ........... ❑
❑ .............. Resist an authority figure’s unfair demand ......... ❑
❑ .....................................Quit a job................................ ❑
❑ ................. Request the return of borrowed items ............ ❑
❑ ............................. Receive compliments ........................ ❑
❑ ........ Ask a person who is annoying you in public to stop ... ❑
❑ ....... Discuss with someone his/her criticism of your work .. ❑
❑ ..... Continue to talk to someone who strongly disagrees with you ❑
❑ ..................... Resist persuasive sales pressure ................ ❑
____ TOTAL TOTAL ____
59
ANALYSIS: The essence of this exercise is to pinpoint situations
where you’d like to be more assertive. Normal assertiveness scores
fall in the 50 – 70 range. If you score over 100 in either, you need
to examine ways you can improve your assertiveness skills.

CONCLUSION
Assertiveness is the most important learned behavioral skill in
helping to overcome stress and anxiety in everyday life. Many
books have been written on the topic and they’re available at
bookstores and libraries. Keep in mind hat most of us prefer to
deal with people who are straightforward without being obnoxious.
In the long run, sticking up for yourself can only benefit you and
everybody you deal with.

NOTES (HOW CAN I IMPROVE MY ASSERTIVENESS)

60
 MANAGING YOUR TIME
“Do not dwell on the past, do not dream of the future,
concentrate the mind on the present moment.”
– Zen saying

O
ne of the biggest causes of stress, both at home and at
work, is what you do with your time. Many people have
had their lives completely turned around by learning time
management skills. Understanding the nature of time and using
it to your advantage can greatly enhance your quality of life.

THREE GOLDEN RULES OF TIME MANAGEMENT

Rule 1: Establish priorities

In order to fulfill the true purposes of your life, you have to decide
on the activities you need to carry out. For example: your job may
be to make sure that products get shipped out to customers. Every
other activity you carry out in a day – filling out a survey for your
boss, reading a trade journal, tidying up your desk, attending a
meeting about the new car park – is secondary. Your first priority,
then, has to be whatever action it takes to get your product to the
customer.

At home, your priorities may be to help your children with their

education, see that your family eats well, and enjoy a loving,
constructive relationship with your partner. Everything else is
secondary – looking after your neighbor’s pets, visiting friends and
co-workers and renovating the basement are all less important
than the purposes you’ve pinpointed for your home life.

One of the biggest sources of stress in life can be people asking

you to carry out activities that are urgent but not important – not

61
to you, anyway. Take a look at the grid below. How much of your
day is spent carrying out tasks in Category #2 or #4?

IMPORTANT NOT IMPORTANT

URGENT URGENT
1 2

3 4
IMPORTANT NOT IMPORTANT
NOT URGENT NOT URGENT

Let’s take a hypothetical example: You’re busy finishing a proposal

aimed at acquiring a new account, which will boost your sales by
15%. This is what you’re paid to do – it’s an activity (key area) for
achieving your job purpose.

Suddenly your boss comes in and requests that you attend a

meeting on an idea she has for streamlining the internal reporting
system. It has to be submitted to the senior manager by tomorrow
because he’s going on holiday. This is something which is important
to your boss, not you. It’s what she’s paid to do – it’s an activity
(key area) for achieving her job purpose. But because she’s been
procrastinating, she now has an urgent task for you to carry out,
which could prevent you from completing your important task – the
proposal for the new account.

The task you were carrying out was Category 1 (important and
urgent). The task your boss wants you to carry out is Category
2 (not important but urgent). Your focus should always be on
Category 1 and Category 3 tasks. Category 2 tasks should be
minimized through assertive behavior on your part.

62
Review the urgent tasks that are demanded of you in a day. How
many of them fit into Categories 2 and 4? How can you resolve
this?

Rule 2: Identify time wasters

Demands are continually made on you at work and at home that

can be considered key areas, activities which are necessary to
achieve your goals and purposes. Because of this, you are only
ever going to have a limited amount of time that you can control to
give you that important “time management” edge. It’s estimated
that, on average, most people have less than 20% of controllable
time in their jobs. The nature of most jobs dictates a certain work
pattern.

Pinpoint the time wasters in your life, both at home and at

work, which are causing you stress. Your goal is to eliminate or
drastically reduce them. They might be unnecessary phone calls,
drop-in interruptions, or unreasonable demands from colleagues
or neighbors. The best way to identify these time wasters is to
complete a time log.

63
Rule 3: Practice self-discipline

Time management is all about developing better habits. Although

not as difficult, achieving better time management skills is similar
to losing weight or quitting smoking. Poor time management
habits, like anything else, can only be changed through a concerted,
sustained and focused effort.

The things you need to change are as individual as you are.

Determine problem areas by completing the previous exercises
and then work to resolve them.

You must be committed to change. If you go to work in the morning

and spend the first hour drinking coffee and surfing the internet,
you’re probably wasting time – unless, of course, this is part of
your job. In order to get rid of this time-wasting behavior, you
need to replace it with new habits, like going through the e - mail,
phoning key customers, or making that first hour the time when
you set your priorities for the day. Allow yourself that cup of coffee
as a reward for a productive first hour.

The following are the top 10 areas where people, by applying a

little self-discipline, can improve their time management skills.
See if any of these apply to you:

64
Procrastination
People put things off for one or more of the following reasons:
fear of failure; lack of enjoyment in carrying out the task; seeking
perfection; getting distracted, or failing to set clear priorities. If
you find that you’re procrastinating, here’s a simple tip: Do just
one thing towards completing the task – the first line of a report,
the first box emptied, the first line of a letter you need to write.
Ninety-nine times out of 100 you’ll go on to complete the task,
simply because you started it. Highly successful people often do
the unpleasant tasks first. Having an unpleasant task hanging
over your head drains your energy. So go ahead: JUST DO IT.

Don’t try to be perfect

Winston Churchill once said, “The maxim that nothing avails but
perfection spells paralysis.” Aim for excellence – or as good as is
possible – and go ahead and do it.

Take time to plan

By setting out a plan that is both realistic and achievable, you
give yourself a target for self-discipline. With a plan, you know
what your should be concentrating on and can identify potential
distractions.

Aim to be proactive rather than reactive

Some jobs are by nature reactive, and you have to live with that.
And some people love a crisis and thrive on urgent deadlines.
Your personality plays a big part in whether you prefer to be a
“firefighter” type or an “administrator” type. Learn how proactive
activities can help your ability to manage your time.

Avoid unnecessary tasks

Refer to your Key Areas and Key Activities, and decide what are
the things you do that don’t really need doing. Ask yourself the
following question: “What would happen if I didn’t do this? Do I

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really need to do it? If so, do I really need to do it now?”

Group similar tasks

If you can manage to do it, it’s often more efficient to carry out a
number of similar tasks at once. Making six telephone calls within
a half-hour period takes less time out of your day than making
those calls at intervals spread out throughout your workday.

Be tidy
Knowing where everything is can be a real time saver. How often
during a day do you waste time searching for something?

Practice active listening

You stand a better chance of getting your job done right – or
delegating a project to someone else – if you listen carefully and
check for mutual understanding.

Be assertive
Go back and re-read Chapter 9. Sticking up for yourself when
it comes to completing important tasks can be the single most
important aspect of improving your time management skills. If
you know what’s important – not necessarily urgent – and are not
afraid to say it, you’ll be much more productive in the long run.

Set objectives
A common trait of highly successful people is that they continually
set goals and objectives. Do this for yourself. Set long-term goals
(“I’m going to improve my golf handicap”; “In 5 years I want to
be at such-and-such a level in my career”) and short term goals
(“By the end of this week I’ll have written this report”; “Tonight
I’ll sit down with the kids and make up a household chore roster.”)
Remember: If you don’t know where you’re going, any road will
take you there!

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CONCLUSION
We are all responsible for our own health and happiness. By completing
the exercises in this book, you can learn to alter your behavior and create
a healthier, more productive mental outlook. Learning to handle stress
related problems will set you on the path to better health, both mentally
and physically.

Many illnesses are related to substance abuse, inadequate nutrition or

stress. It has been estimated that three-quarters of all medical complaints
– ulcers, stomach disorders, migraines, insomnia, high blood pressure,
backaches and heart attacks – can be traced to stress and anxiety.

A study carried out at the University of Tennessee showed that more than
half of all hospital admissions could be prevented by changes in lifestyle.
In order to contain skyrocketing health care costs, and prevent stress
related diseases, we need to adopt preventive health measures related
to lifestyles. Many types of surgery, medication and medical procedures
could be dramatically reduced, if not eliminated altogether.

The modern physician’s workload is enormous. Add to that an aging

population and it’s clear that we will have to make a wholehearted effort
toward promoting healthier lifestyles if we’re going to limit the demands
made on health care. We believe that stress and anxiety relieving
techniques could become part of the most important health care revolution
in decades.

This book is a basic introduction to the skills involved in taking control of

your life and minimizing the risk of stress related illnesses. By reading
this book and completing the exercises within it, you’ve taken one step to
becoming a person who is comfortable in any situation, fulfilled and yet
unhurried, relaxed, confident, physically fit and seldom tired – the kind
of person who projects a quiet strength and inspires friends, family and
colleagues.

The next step is up to you, to translate understanding and acceptance into

positive stress relieving behaviors and attitudes that will lead, ultimately,
to a better life. Good luck!
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