Abnormal Psychology1

Coping Strategies with stressCoping Strategies with stressLect 15Lect 15

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General Principles of Coping with Stress General Principles of Coping with Stress • In reviewing certain general principles of

coping with stress, it is helpful to conceptualize three interactional levels.

• On a biological level, there are immunological defenses and damage-repair mechanisms; on a psychological and interpersonal level, there are learned coping patterns, self-defenses, and support from family and friends; and on a sociocultural level, there are group resources, such as labor unions, religious organizations, and law-enforcement agencies. 2

• The failure of coping efforts on any of these levels may seriously increase an individual's vulnerability on other levels.

• E.g., a breakdown of immunological defenses may impair not only bodily functioning, but psychological functioning as well;

• chronically poor psychological coping patterns may lead to peptic ulcers or other diseases. 3

• In coping with stress, a person is confronted with two challenges:

(a)to meet the requirements of the stressor,(b)to protect the self from psychological

damage and disorganization.

There are two types of responses a person feels uses to handle a stressful situation:

1- task-oriented response2- defense-oriented responses

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Task-oriented response• When a person feels competent to handle

a stressful situation, a task-oriented response is typical-that is, behavior is directed primarily at dealing with the requirements of the stressor.

• Typically, this response means the individual objectively appraises the situation, works out alternative solutions, decides on an appropriate strategy, takes action, and evaluates feedback.

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• The steps in a task-oriented response-whether the actions turn out to be effective or ineffective-are generally flexible enough to enable an individual to change course.

• Task-oriented responses may involve making

changes in one's self, one's surroundings, or both, depending on the situation.

• The action may be overt-as in showing one's spouse more affection -or it may be covert-as in lowering one's level of aspiration. 6

• The action may involve retreating from the problem, attacking it directly, or trying to find a workable compromise.

• Any of these actions are appropriate under certain circumstances.

• E.g., if one is faced with a situation of overwhelming physical danger, such as a forest fire, the logical task-oriented response might well be to run.

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Defense-oriented response• When a person's feelings of adequacy

are seriously threatened by a stressor, a defense-oriented response tends to prevail-that is, behavior is directed primarily at protecting the self from hurt and disorganization, rather than at resolving the situation.

• There are two common types of defense-oriented responses.

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• The first consists of responses such as crying, repetitive talking, and mourning that seem to function as psychological damage-repair mechanisms.

• The second type consists of the so-called ego- or self-defense mechanisms.

• These mechanisms, including such responses as denial and repression, They protect an individual from external threats, such as failures in work or relationships, and from internal threats, such as guilt-arousing desires or actions. They relieve tension and anxiety.9

• They appear to protect the self in one or more of the following ways:

(a)by denying, distorting, or restricting an individual's experience

(b)By reducing emotional or self-involvement(c)By counteracting threat or damage.

• Often, of course, a given defense mechanism may offer more than one kind of protection.

• We all use them to some extent for coping with the problems of living.

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• These defense mechanisms are ordinarily used in combination rather than singly, and often they are combined with task-oriented behavior.

• In fact, Gieser and Sacks (1973) have concluded that we tend to be fairly consistent in the particular mechanisms we use. Ego-defense mechanisms are considered maladaptive when they become the predominant means of coping with stressors.

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Decompensation Under Excessive Stress Decompensation Under Excessive Stress • stressors challenge a person's adaptive

resources, bringing into play both task- and defense-oriented reactions.

• Most of the time these varied reactions are successful in containing a threat. When stressors are sustained or severe, a person may not be able to adapt and may experience a breakdown.

• This lowering of adaptive functioning is referred to as decompensation. 12

• The Effects of Severe Stress Stress is a fact of life, and our reactions to stress can give us competencies we need and would not develop without being challenged to do so.

• Severe stress can exact a high cost in terms of lowered efficiency, depletion of adaptive resources, wear and tear on the system, and, in extreme cases, severe personality and physical deterioration-even death. 13

Lowering Lowering of of adaptive efficiencyadaptive efficiency :• On a physiological level, severe stress may

result in changes that can impair the body's ability to fight off bacteria and viruses.

• On a psychological level, the perception of threat leads to an increasingly narrow perceptual field and rigid cognitive processes. It thus becomes difficult or impossible for the individual to see the situation objectively or to perceive the alternatives actually available. This process often appears to be part of suicidal behavior. 14

• Our adaptive efficiency may also be impaired by the intense emotions that commonly accompany severe stress.

• Acute stage fright may disrupt our performance of a public speech; examination jitters may lead us to fail an exam despite adequate preparation.

• In fact, high levels of fear, anger, or anxiety may lead not only to impaired performance, but to behavior disorganization.

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Depletion of adaptive resources.Depletion of adaptive resources. • In using its resources to meet one severe

stressor, an organism may suffer a lowering of tolerance for other stressors.

• It appears that an organism's coping resources are limited: if they are already mobilized against one stressor, they are less available against others.

• prolonged stress may lead to either pathological over responsiveness to stressors as illustrated by the "last straw" response

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• Or to pathological insensitivity to stressors, as shown by a loss of hope or extreme apathy.

• In general, severe and sustained stress on any level leads to a serious reduction in an organism's overall adaptive capacity.

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Wear and tear on the system. • Most of us probably believe that even after a

very stressful experience, rest can completely restore us.

• In his pioneering studies of stress, however, Selye has found evidence to the contrary:

• When pressure is severe and long-lasting, adjustment problems such as excessive worry may become chronic and eventually lead to physical changes such as high blood pressure.

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Biological DecompensationBiological Decompensation• It is difficult to specify the exact biological

processes underlying an organism's response to stress.

• A model that helps explain the course of biological decompensation under excessive stress is the general adaptation syndrome, introduced by Selye (1956; 1976b).

• Selye found that the body's reaction to sustained and excessive stress typically occurs in three major phases: 19

Selye's General Adaptation Syndrome (GAS) Selye's General Adaptation Syndrome (GAS) • (a) alarm reaction in which the body's

defensive forces are "called to arms" by the activation of the autonomic nervous system; (b) stage of resistance in which biological adaptation is at the maximum level in terms of bodily resources used; (c) exhaustion in which bodily resources are depleted(exhausted) and the organism loses its ability to resist so that further exposure to stress can lead to illness and death.

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Seyle’s General Adaptation Syndrome

• Alarm• Resistance• Exhaustion

ALARM RESISTANCE EXHAUSTION

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Psychological DecompensationPsychological Decompensation

• Personality decompensation under excessive stress is somewhat easier to specify.

• It appears to follow a course resembling that of biological decompensation and may, in fact, involve specific biological responses.

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1. Alarm and mobilization. First an individual‘s resources for coping with a stressor are alerted and mobilized.

• Typically involved at this stage are emotional arousal, increased tension, heightened sensitivity, greater alertness (vigilance), and determined efforts at self-control.

• At the same time, the individual undertakes various coping measures-which may be task-oriented or defense-oriented or a combination of the two-in attempts to meet the emergency. 23

• During this stage, symptoms of maladjust-ment may appear, such as continuous anxiety and tension, gastrointestinal upset or other bodily diseases, and lowered efficiency-signs that the mobilization of adaptive resources is inadequate.

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2. Resistance. • If stress continues, an individual is often able

to find some means for dealing with it and thus to resist psychological disintegration.

• Resistance may be achieved temporarily by concerted, task-oriented coping measures; the use of ego defense mechanisms may also be intensified during this period.

• Even in the resistance stage, indications of strain may exist, including psycho- physiologic symptoms and mild reality distortions.

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• During the late phases of this stage, the individual tends to become rigid and to cling to previously developed defenses rather than trying to reevaluate the stressor situation and work out more adaptive coping patterns.

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• 3. Exhaustion. In the face of continued excessive stress, an individual's adaptive resources are depleted and the coping patterns called forth in the stage of resistance begin to fail.

• As the stage of exhaustion begins, integration is lowered and exaggerated and inappropriate defensive measures are introduced.

• The latter reactions may be characterized by psychological disorganization and a break with reality, involving delusions and hallucinations. 27

• If the excessive stress continues, the process of decompensation proceeds to a stage of complete psychological disintegration perhaps involving continuous uncontrolled violence, apathy, stupor, & eventually death.

• severe psychological decompensation may be precipitated by sudden & extreme stress; but more often, it is a gradual, long term process.

• treatment measures are used before decompensation runs its course to increase an individual's adaptive capabilities so that the process of decompensation is reversed. 28

Sociocultural Decompensation Sociocultural Decompensation • In the face of wars, economic problems, and

other internal and external stressors that surpass their adjustive capabilities, societies may undergo varying degrees of decompensation.

• At such times societies often resort to extreme measures in their attempts to maintain their organization and resist disintegration. The historian Toynbee have depicted this process to describe the decline and fall of civilizations throughout history. 29

• in a given situation -on biological, psychological, & sociocultural levels-depends on the extent to which any damage can be repaired and remaining resources reorganized.

• In some instances, an individual or group's functional level may be permanently lowered following excessive stress; in other cases, with successful problem resolution, the individual or group may attain a higher level of integration and functioning than before the episode. 30

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