Heal2BHuman

“Whether you think you can or can’t, you’re right.”

–Henry Ford

I am proud to announce that this article was entirely written by a human.

Although I’d recommend reading the entire article, skip to “section 6” for actionable strategies to have less stress.

1. How To Have Less Stress For A Better Life
2. How To Have Less Stress- Mindset Matters
3. Stress Mindset Theory
4. Stress is Enhancing Mindset
5. Cultivating A Positive Relationship With Stress- 3 Step Process
6. How To Have Less Stress- 6 Actionable Strategies

Imagine that you are in a very high-stakes meeting at work. The meeting is stuffed full of stakeholders, your job is on the line, and you feel a palpable rise in heart rate as you begin to feel the mounting pressure of “stress” overcome your thoughts and impact your physiology.

You notice the room is full of loud, boisterous voices- everyone wanting to be heard and direct each other about what is right, what is wrong, and if your recent project is a success or a complete dumpster fire.

The voices, noises, yelling, and commotion are being interpreted by your ears as they convert waves of auditory information into tiny and repetitive electrical signals that eventually lead to your auditory cortex from which you begin to assign meaning, value, and merit to.

But what if the noise you heard was not a stressful work meeting, but of noise, yelling, and constant commotion at your favorite concert?

Chances are that you would experience radically different sensations- joy, happiness, glee, and fulfillment.

This example helps us understand how stress, very much like our sense of hearing depends on context and our interpretation of what is going on around us.

We briefly discussed stress, perception, and mindset in THIS article, but we are going to dive deeper into the rabbit hole today.

There is a lot of chatter on social media and news outlets regarding the topic of how “mindset matters,” and to be honest the first time I heard of this concept I wrote it off without a second thought.

But little did I know, our mindsets play a critical role in how we perceive, and interact with the countless demands in life.

This concept of “mindset matters” may seem like a “woo-woo” concept to many (at least it did for me), but the science and ideas surrounding experiencing less stress date back to the mid-1980s. Lazarus and Folkman (1984) were trailblazers in the field of psychology as they helped to lay the groundwork for understanding the importance of cognitive appraisal in experiencing and responding to a potential stressor.

What Were The Results?

Folkman and Lazarus proposed that our interpretation, or “appraisal” of a given stressor lies at the epicenter of the stress experience and forms the stress response itself.

Primary Appraisal

During the “primary appraisal stage,” of stress assessment, individuals assess whether a given demand is threatening to their immediate or future well-being. Throughout this stage people ask themselves questions like “What will this stress do to me in the next few days,” and “is it significant enough to disturb my life?”

During this stage, we are answering one primary question…..

“Is this threatening to my immediate or future safety?“

Typically we answer this question with 3 types of answers….

• This is stressful
• I welcome this stress (IE: it is good challenge)
• This is negligible and not important

What is a real life example of primary appraisal?

Let’s imagine for just a moment that you are prone to excessive neck and low back pain that is ALWAYS made worse with thermal stimuli, and specifically cold. Throughout your life, you notice that every time the weather shifts, and the temperatures plummet, you feel crummy, whole-body joint stiffness, and often times experience muscle spasms.

Let’s just say that you have a strong, and unrelenting hate for the cold.

Now imagine, that one day you wake up to a bone-curling snow storm with temperatures at -10 F. And as you are trying to get ready for work- you “appraise” the weather conditions as highly stressful and a potential threat to your safety.

You have made this determination in the past because your back always hurts more during the winter, and you are worried that muscle spasms and a significant pain experience is in your near future.

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^This is an example of how “primary appraisal” shares a common thread with what we know about chronic pain and how it fluctuates, or often worsens with extreme temperatures, such as the cold.

If we determine that extreme cold is threatening to our safety, our stress response is more readily triggered, and little “danger” sensors in our body called nociceptors are activated, and you may be more prone to experience both stress and physical pain.

Secondary Appraisal

In many theories about psychology and science, stages are laid out in chronological order, meaning that one stage must precede the other before it progresses. In the cognitive appraisal process, each stage is thought to occur simultaneously meaning that we can swing in and out of primary and secondary appraisal when making a determination about a given life demand.

Throughout this stage, individuals evaluate the resources and coping strategies at his or her disposal for addressing perceived threats.

For example, we may ask ourselves-

• “Have I encountered this demand before?”
• “What have I done that has helped me in the past?”
• “I can try my best and see what happens”

This is in sharp contrast, to more maladaptive thoughts such as –

• “There is no way I can change this”
• “I won’t even try because nothing will ever change”
• “Everyone is already doing this, why should I even make an attempt?”

These thoughts about appraisals came out of the 80s, are they really still relevant?

In more updated research on the topic of understanding stress, researchers redefined stress as the balance of perceived resources (knowledge, action, experience) with perceived demands such as danger or uncertainty about the future.

For a deeper dive on this topic…..

• The Robust Nature of the Biopsychosocial Model Challenge and Threat: A Reply to Wright and Kirby

• Resilience and Vulnerability to Daily Stressors Assessed via Diary Methods

All this talk about “perceived” demands and resources may make many of us call “bullSh**” on the entire topic. But if we step back from our initial emotional reaction and start getting curious about how our perception drives most of our reality- we can find freedom, joy, and even opportunity.

We’ve established that Stress is not black and white.

Instead of stress simply being “one thing,” in actuality, it is a complex puzzle that creates widespread brain activity and is tightly correlated with our thoughts and emotions about the past, present, and future. In an article titled “The Role of stress mindset in shaping cognitive, emotional, and physiological responses to Challenging and threatening stress,” Dr. Alia Crumb dives into how changing our thoughts directly modifies our physical and mental health.

The results of Dr. Crum’s study?

In a study with 113 participants, Dr. Crum and colleagues compared two individual mindsets and observed how these mindsets impacted our physiology. The study found that those who adopted a “Stress is enhancing mindset” produced larger increases in anabolic growth hormone levels compared to those who adopted a “stress is debilitating mindset.”

This is remarkable because this means that when two different people encounter the exact same stressor, our interpretation or “lens” in which we experience the stressor can be wildly different.

How Cool Is That?

This means that if we can adopt an evolved method of observing, experiencing, and responding to stress, we will experience less “distress” associated with the experience.

Is There A Simple Solution To Stress?

I vividly remember a professor of mine at a local community college saying “Stress is simple, it is a mismatch between our demands and resources.” Her solution to decreasing negative stress was pretty cut and dry- “either decrease your demands or increase your resources.”

This concept seems simple to talk about but in reality, life throws many more curve-balls that make it nearly impossible to always accurately adjust demands or resources. For example, what if your roof fell in and you immediately feel financial pressure threatening your ability to have a roof over your head?

This would invariably skyrocket your life demands and you would have very little to say about it.

What About Unmodifiable Resources?

Our current or future resources are mostly modifiable, but in the case of our roof falling in, our resources are may be very limited to solve the problem at hand- we either pay for a new roof, and well…… that is pretty much it.

The example of the roof falling in brings us to our next point of why mindset is crucial to answering the question “how to have less stress.” 

Is Stress is Challenging or Threatening?

An experience of potential stress is “challenging” when we perceive that our pool of resources is adequate to meet the demands.

In contrast, an experience of stress that is “threatening” occurs when we perceive that our demands and resources are drastically disproportionate to the demands at hand. This often leads to detriments to both our physical and mental health in the short and long term.

Threatening vs. Challenging Stressor-

Is it black and white?

Many of us like simple answers to complex questions, and we enjoy finding correlations and obvious solutions in most domains of life- love, politics, religion, finance, etc., but when you peek under the hood of many of these concepts, we realize that most things in life are not simple.

Life is full of potential stressors, some modifiable, and other immovable but the methods we choose to intake, process, and react to stimuli is a powerful undertaking that any one of us can harness to optimize health, happiness, and resiliency.

Take a moment and think about the things in life that impose physiological and psychological stress on the brain and body-

• Exercise
• Problem-solving
• Cognitive challenges
• Learning a new skill
• New financial obligations

To many of us, these items create some type of stress- whether it is in the form of physical stress from exercise or cognitive stress from learning, or failing to learn a new skill. Stress is often the nervous system’s trigger to adapt and evolve or inadvertently maladapt and devolve. The idea that stress and failure is required to stimulate growth may seem like a novel idea to some, but scientists have known for years that failure, and the generation of “errors” is the exact trigger the nervous system needs to rewire and change. We explored this in our last titled “Change your life with neuroscience.”

Stress Mindset Defined

Stress mindset is defined by what core values and beliefs we hold true regarding the experience of stress. Put another way, it is the extent to which one believes stress is either beneficial or debilitating.

Believing stress is good or bad matters. Preliminary studies suggest that the way we perceive the idea of stress plays a significant role on psychological health, performance, and behavioral outcomes.

I remember hearing a statistic about small business owners and failure rates- it was something like “90% of new small businesses fail within the first year.” 

Why do you think this is?

I think a lot has to do with how our thoughts, emotions, and mindsets directly influence life and business decisions.

Think about it- starting a new business is full of failures, fears, and uncertainty. Over time this can lead many of us to generate negative self-talk, poor emotional states, and limited coping strategies which often leads to failure.

What if these small business owners adopted the mindset that stress is enhancing?

Chances are many of them would continue to seek opportunities, be open to failure, and welcome both negative and positive feedback about their efforts.

Stress is Enhancing–

Business & Personal Stress

Adopting a mindset that recognizes stress as adaptive, both in our careers and personal lives is a critical step to improving emotional health, and feeling less overwhelmed over time.

Emerging evidence suggests that a “stress is enhancing” mindset positively impacts aging, personalities, and levels of intelligence. Additionally, research studies suggest that this mindset positively impacts the endocrine system by controlling the amount of cortisol secreted during a given stressful event.

To put it simply- our mindset gives us the tools to meet, exceed, and adapt to current and unforeseen future demands.

Stress is Enhancing Mindset

Is Arthritis a disease?

I remember working with a 38 year old patient who presented with chronic right knee pain that was worsening over the last few months and was beginning to limit many aspects of her life-  career, sports, and enjoying her life with her kids. When I asked her “why do you think your knee hurts,” she responded much in the same way that ~90% of people do- “Ah it is probably just old age and arthritis.”

But is arthritis really causative to pain?

There are countless studies looking at arthritis and knee pain which address the topic of using MRIs to identify why someone with knee pathology may be experiencing pain. One such article had this to say “no single MRI or radiographic finding performed well in discriminating between painful and nonpainful knees. “

What does this have to do with mindsets?

It means that most of our core beliefs surrounding arthritis, much like stress, might be incomplete. But what this also means is that arthritis and the experience of functional loss and pain is not guaranteed as we age.

In fact, what we know about mindsets, pain, and arthritis is that if we hold negative core beliefs regarding our body’s ability to function, it directly impacts how we perceive our body’s functional integrity.

Our thoughts, beliefs, and experiences associated with how we view our body is known, as body schema.

Crazy right?

Mindsets are intertwined in how we interact with friends, family, how we think about our body, and how we view it as we age.

Stress is Enhancing Mindset

Aging

Two studies investigated whether there was any connection between our mindset and aging and found a correlation between poor participation in preventive health behaviors and the belief that health problems are an inevitable consequence of aging.

Resources:

Preventive health behaviors influenced by self-perceptions of aging

Can Personality Be Changed? The Role of Beliefs in Personality and Change

In one study, participants aged 75 years and older, who considered arthritis, difficulty sleeping, and heart disease to be aspects of normal aging were less likely to see a physician regularly and to seek preventive care, such as blood-pressure screening or flu vaccines.

It’s almost like this matters. 🙂

Whether you are 75 years old, or a 38 year old patient with knee pain in physical therapy, the idea is the same- our thoughts and perceptions about health and aging sets the stage for either positive or negative health consequences.

Stress is Enhancing Mindset

How To Have Less Pain

It seems like every time you hop on social media or see an ad about pain, someone is trying to sell a magic fix, pill, or just ONE EXERCISE that will instantly reduce your experience of pain.

^An example of a “magic bullet fix” on social media

Modern research into pain, and specifically chronic pain has shown promise in identifying that our thoughts and mindsets surrounding pain directly impact the frequency and intensity of pain, as well as quality of life.

A cross-sectional study comprised of 1240 participants asked a very similar question related to mindsets and social behavior and how it impacted their experience of pain.

Here is what they found-

• Chronic pain patients had a more negative stress mindset and a lower level of social identification than people without chronic pain.
• A positive stress mindset was linked to better well-being and fewer depressive symptoms.
• Adaptive coping behaviors such as positive reframing and active coping was linked to very depressive episodes.

Patients and Their Relationship to Coping, Well-Being & Depression

“We only stress about things that are meaningful and valuable to us in life. Once we understand this, stress becomes adaptive and transformative.“

-Dr. Alia Cum

How To Decrease Stress- Adopting A Positive Mindset

According to much of the psychological literature, and Dr. Crum herself, it appears that stress itself is not inherently bad, in fact, at it’s core, stress is the stimulus required to grow, change, and adapt.

Without stress, the human brain and body has no reason to change, learn, and adapt over time.

But how do we start shifting our mindset?

I really like how Dr. Crum and her team lay this out in the following 3-step process:

1. Acknowledge that you are stressed
2. Welcome Your Stress
3. Harness the stress response to achieve what you care about

Let’s break this “having less stress” process into more manageable bits…..

1. Acknowledge That You Are Stressed

Life is full of crazy shit, and many of us get so wrapped up in to-do lists, responsibilities, and tasks that is is very easy to be on autopilot and simply keep going on with our lives.

Here‘s the problem with that.

Many of us don’t realize we have reached the upper limit of our available resources and stress until it is to late. Sometimes this “it is to late” phenomenon occurs and we experience a mental break down, some reach for pharmaceuticals, and others reach for things like alcohol or smoking to temporarily ease their pain.

After nearly a decade of clinical experience, I have come to realize that this “reactionary” approach to stress simply doesn’t work. In fact, it often makes us worse after the effect of the drug of choice wears off.

^Cheers to more or less stress?

Much of the psychological literature, and what health coaches, physical therapists, and other health providers have identified is helpful is the concept of “mindfulness.”

According to an article titled “The benefits of simply observing: mindful attention modulates the link between motivation and behavior,” they explore this in great detail.

In short- when we experience stress, give yourself the opportunity to simply take a step back and give yourself a “head nod” acknowledging that the demands you are under are becoming potentially stressful.

This internal “head nod” can be the first step towards recognizing how we feel physically and emotionally when stress begins to build.

The recognition itself, gives us the ability to transform our nervous by becoming the “observer of our thoughts” and maybe even detach our thoughts from our self-identity.

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Additional Resource-

Your Best Life: Mindfulness – The End of Suffering

^How can you begin to simply observe your thoughts?

2. Welcome Your Stress

The common message we receive from news outlets and social media is that stress is “bad” and is something we need to always fight against. Heck, I have even written posts about how to destress, breath, and meditate your way to destressing.

Imagine what our life would look like and how it would change our thoughts and emotions about stress if we cultivated a “welcoming attitude” geared towards growth?

• Would you finally reach your goals?
• Could you begin to feel more at peace with yourself?
• Would it free you from assumptions and negative self expectations?

If we allow ourselves to welcome stress, we can begin to understand where the popular idea of “growth mindset” originates from.

Harvard School of Business says this about mindsets-

A growth mindset views intelligence, abilities, and talents as learnable and capable of improvement through effort.

A fixed mindset views those same traits as inherently stable and unchangeable over time.

Look at the image below- would you rather grow and evolve like the tree or feel “stuck” and overwhelmed like the office worker?

Here is step #3 in changing our mindset with stress….

3. Harness Your Stress Response

We stress about what we care about.

Much of the information on the internet that discusses the stress response talks all about the negative aspects of stress such as cognitive and physical decline. To be honest, prior to writing this article, I applied much of what I knew about the stress response to chronic pain.

The experience of pain is complex, but on the surface it makes complete sense to equate a “chronic stress response” to something like ongoing pain because of the resources needed to mount the physiological effect of this response.

To further illustrate the idea that “we stress about what we care about,” here are a few things in life that you may stress about-

• Money?
• Career?
• Children?
• Relationships?
• Pain?
• The Environment?

A quick glance at these images above helps us realize that most things we worry and stress about are related to aspects of our lives that bring us joy, sustenance, and meaning.

Challenge yourself about how you can use this knowledge to fine tune how you react both cognitively and physically to the demands and stressors in your life.

1. Level Up Your Awareness

Knowledge is only potential power, it is only when we create action surrounding knowledge that true transformation occurs.

Scientific evidence suggests that mindsets can be changed simply by presenting novel information which orients them us to a new mode of thinking.

This “presentation of new information” is essentially what all health providers interested in created behavioral change in patients are well-versed in

Resource- Mind-Set Interventions Are a Scalable Treatment for Academic Underachievement

2. Zero In On Your Stress Mindset

When we improve our understanding of how a “stress is enhancing” mindset works, we can begin to get curious about how it may function when we undergo challenging and threatening situations. We can use this understanding to improve our response to stress without changing either the demands or resources.

“By showing that the stress response can be altered independent of the specific situation, we can change individuals’ general beliefs and advance existing literature and lay the foundation for an integrated theory that can apply to any type of stressful situation.”

— Dr. Ali Crum

3. Intentionally Create Stress

Our mindset, and in turn our mental and physical health responds to demanding situations through the stress response. Emerging psychological data suggests that the lens through which we view stress does not discriminate between types of stressors. 

For example, physical exercise is a stressor that is known to positively impact our ability to handle a whole host of other life demands. The evidence is clear- the correlation between physical activity and mental health is known to improve self-esteem, cognitive function, mood, depression, and quality of life. According to this study, and many like it, exercise enhances mood and self-esteem while decreasing stress tendencies, a factor known to aggravate mental and physical diseases.

Put another way- doing hard things on a consistent basis has the potential to dramatically impact our mood, stress response, and quality of life.

Examples of intentionally creating stress may include:

• Exercising
• Learning a new skill
• Intentional exposure to heat
• Having difficult conversations
• Being honest with a friend or family member
• Intentional cold exposure

4. Identify Your Assumptions & Let Go

How we interact with the world and our perception of reality is molded by past experiences, current resources, and our future worries. Assumptions are something that we hold in absolute truth and we have a very difficult time letting go of our own “version” of the truth. Personally, I’ve found that letting of assumptions and operating under the more realistic viewpoint of “we don’t really know” helps create more emotional freedom and curiosity about life and those around me.

Challenge yourself to think of one assumption that you hold as “absolute truth.”

From there, think about how holding that assumption as truth may impact your actions, behaviors, as well as your relationship with stress.

Below is a list of assumptions that many of my patients have shared with me:

• “My boss doesn’t like me, I just know it.”
• “Everyone at the party probably just thinks I am awkward.”
• “Everybody else is doing this, why would I ever start?”
• “Everything changes after you get married, trust me.”
• “My industry is only getting worse, there is nowhere I can work and feel happy.”
• “I am not good enough.”

5. Use This “Perceived Stress” Scale

This 10-question survey is extremely helpful to guide people in the journey through mental and physical health. It validates much of what many of us are thinking and presents “novel” information that may help us consider a different point of view.

There is something very therapeutic and eye-opening to observing similarities between the way we think and a well validated scientific tool that identifies potentially unhelpful thought processes.

In fact, using this tool can be a gateway intro rewiring the brain and shares a common thread with what many psychologists do to help patients rethink how they view and interact with stress.

Here are my thoughts- If you are curious and open to the idea of shifting your mindset regarding stress, we know that the presentation of novel ideas about how we think can modify the brain’s “internal chatter.”

This curiosity, paired with learning can help to set our mind free.

Here are a few example questions from the questionnaire-

• In the last month, how often have you been upset because of something that happened unexpectedly?
• In the last month, how often have you been able to control irritations in your life?
• In the last month, how often have you been angered because of things that happened that were outside of your control?
• In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?
• In the last month, how often have you felt that things were going your way?

6. Use Dr. Crum’s 3 Step Process

1. Acknowledge that you are stressed.
   • Becoming an observer of our thoughts and physiological reaction to stress is often the first and last step towards a happier and more fulfilled life.
2. Welcome Your Stress.
   • Give your stressor an unrelenting hug and invite it with open arms. Remember, we only stress about things that bring true value and meaning to our life.
3. Harness the stress response to achieve what you care about.
   • We know that stress can be a VERY good thing. Start to get curious about how you can utilize the physiological and psychological reactions to help find more balance and meaning.

Cheers to a more fulfilled life, -Dr. Chad Shafer, PT ✌️✌️

• Stress and Coping with Discrimination and Stigmatization
• Principles of Pain Nociceptors
• The Robust Nature of the Biopsychosocial Model Challenge and Threat: A Reply to Wright and Kirby
• Resilience and Vulnerability to Daily Stressors Assessed via Diary Methods
• The role of stress mindset in shaping cognitive, emotional, and physiological responses to challenging and threatening stress
• Neuroplasticity Promoted by Task Complexity
• The Stress Mindset
• Individual magnetic resonance imaging and radiographic features of knee osteoarthritis in subjects with unilateral knee pain: the health, aging, and body composition study
• Revisiting the body-schema concept in the context of whole-body postural-focal dynamics
• Preventive health behaviors influenced by self-perceptions of aging
• Can Personality Be Changed? The Role of Beliefs in Personality and Change
• Stress Mindset and Social Identification in Chronic Pain Patients and Their Relationship to Coping, Well-Being & Depression
• The benefits of simply observing: mindful attention modulates the link between motivation and behavior
• Your Best Life: Mindfulness – The End of Suffering
• Mind-Set Interventions Are a Scalable Treatment for Academic Underachievement
• Physical activity and mental health: evidence is growing
• Functional improvement and social participation through sports activity for children with mental retardation: a field study from a developing nation
• Perceived Stress Scale