Stress Management and Post

UNIT 15 STRESS MANAGEMENT AND POST Traumatic Growth

TRAUMATIC GROWTH*
Structure

15.1 Learning Objectives

15.2 Introduction
15.3 Concept of Stress
15.4 Strategies/Techniques for Management of Stress
15.4.1 Strategies Focusing on Physical Aspect and Breathing
15.4.2 Strategies Focusing on Cognitive Processes
15.4.3 Strategies Focusing on Affective Processes
15.4.4 Strategies Focusing on Behaviour
15.4.5 Stress Management Strategies at the Organizational Level
15.5 Post-traumatic Growth
15.6 Let Us Sum Up
15.7 Key Words
15.8 Answers to Self Assessment Questions
15.9 Unit End Questions
15.10 References
15.11 Suggested Readings

15.1 LEARNING OBJECTIVES

After studying this Unit, you would be able to:
 Explain the nature and types of stress;
 Describe the various strategies/techniques of managing stress; and
 Explain post-traumatic growth.

15.2 INTRODUCTION
You may be a young adult pursuing this course. You might be thinking of which career
to pursue after completion of the graduation degree. Or which further programme to
pursue? You might be feeling stressed about your higher education and career; at the
same time you might be forming relationship with opposite sex and exploring romantic
relationship. You might also be an adult already in job and/or with family; or you might
be an older person who has taken up this programme out of interest or to add to your
knowledge. Whatever age and stage of life you may be in, you must be facing stress
due to various reasons related to that particular stage. Adolescents experience stress
related to the physical and psychological changes; adults face stress related to their
job, family responsibilities, raising children, taking care of the older family members;

*Dr. Santa Misra, Professor of Psychology, Sri Sri University, Bhubaneswar, Odisha 347
Positive Psychology whereas the older people are stressed about their health, finance, and family and social
Interventions
support. Further, stress is also experienced by typical groups of population such as
children, women, people with disabilities, transgenders, people with HIV/AIDS, chronic
illness and so on. The underlying point here is that no stage of life and no group of
people are without stress. Stress is an integral part of life even though each one of us
invariably wants that their needs and desires get fulfilled and they achieve happiness in
life.
Think of it, if there were no stress, life will be simple, but may feel boring and lack
creativityalso. Stress in fact pushes us to perform to the best of our ability and stimulates
our problem solving and critical thinking. An optimum amount of stress motivates us
and enhances our performance. However, when stress goes beyond this optimum
level, which may vary from person to person, it results in stressful experience. Various
personal and environmental factors may act as barriers to reach our goals and place
adjustive demands on us leading to the experience of stress. The term ‘stress’ has
typically been used to refer both to the adjustive demand placed on an organism and to
the organism’s internal biological responses to such demands. All situations, whether
positive or negative, require adjustment, and may lead to stress.
Stress is often termed as aTwentieth Century Syndrome, born out of man’s race
towards modern progress and itsensuing complexities.
- Benjamin Franklin

15.3 CONCEPT OF STRESS

The concept of ‘stress’ was first introduced by Hans Selye in 1936. It is derived from
the Latin word “stringere” which means ‘to tighten’, denoting force, strain, or strong
efforts and pressure with reference to an object or person. According to Beck (1967),
stress refers to any force which physically or psychologically strains the coping
mechanism of an organism. Stress is defined as “nonspecific response of the body to
any demand (Selye, 1956). Hans Selye, who is known as the ‘father of stress research’,
states that when we do not get any specific response to the stimulus that creates tension
in our body and mind, it is called as stress.
Stress can be of two types – positive stress and negative stress. Positive stress is good
stress or eustress (Truxillo et al. (2015), e.g., stress arising out of job promotion,
getting married or moving to a new city; whereasnegative stress is known as distress
(Schafer (1998, p. 8), e.g., stress resulting from a cyclone which damaged your house
or suffering from a severe illness. Besides there are also other type of stresses, known
as neustress (neither harmful nor helpful stresses, Schafer, 1998); hyper stress (excessive
stresses) and hypo stress (insufficient stresses).
Stresses can also be categorized as acute, chronic and episodic acute stress. Acute
stress can occur after a very stressful life event, e.g., death or accident of a loved
one, disaster, failure/setback to reach a cherished goal, trauma, job loss [Link]
the stressor is sudden; and the symptoms are acute, but do not last long. It is also
called as short-term stress. Acute stress generally results in diabetes, headache,
rapid heart palpitation, acidity, muscle tension, body pain etc. Chronic stress, on the
other hand, involves long-lasting symptoms, for instance, stress due to bad marriages,
chronic illness, successive failures in life, and extremely taxing job/negative work
environment. Such stressis long-term and is very harmful for health. Episodic acute
348
stress involves acute stress that occurs frequently or in various episodes from time Stress Management and Post
Traumatic Growth
to time. For instance, taking up too much workload than one can handle from time to
time can result in a feeling of frequent stress. This is called as repeated stress and
becomes a way of life.
The sources of stress are considered as causes of stress that can include frustration,
conflict of motives, pressures, life events, fear, resistance, resentment, daily hassles,
interpersonal relationships, arising out of biological, psychological, and socio-cultural
factors. Generally the factors that cause stress are known as stressors. These are
the factors that challenge the adaptive capacity of the individual. Thus stressors
threaten to disrupt the organism’s optimal functioning and the stress response is the
cascade of biological processes necessary to return the system to homeostasis
(Sapolsky, 1992).
The factors influencing the severity of stresses are the nature of the stressor, the
individual’s stress tolerant behavior (relating to both physical and mental capacity),
environmental factors and social support. Whatever may be the reason, the reactions
and responses to those stresses are important that can lead to maladjustment and
maladaptive coping behavior causing stresses to the individual.
The impact of a stressor depends on its importance, duration, cumulative effects,
multiplicity, and [Link] that involve important aspects of an individual’s
life can be highly stressful. Further, prolonged exhaustion imposes a more intense stress
than does temporary fatigue. For instance, even if there are frequent arguments between
the couple, they carry on with the relationship until one day when it breaks in the face
of the “last straw”, that is, the precipitating stressor.A number of stressor at the same
time also has a greater impact, e.g., if the person gets fired from his job,faces a divorce
case, has a heart attack, – all at the same time – the resulting stress will be more severe
as compared to facing a single stressor. Finally in most difficult situations including
those involving conflict, the severity of stress increases as the need to deal with the
demand increases.
Stressors are broadly categorized into four types such as, physical or physiological,
psychological, environmental, and socio - cultural.
 Physical stressors include such stimuli as injury, infection, immobilization,
malnutrition, inadequate living space etc.
 Psychological stressors include such stimuli as threats to self esteem, failure
in an intellectual task, interaction with a hostile person, frustration, conflicts,
poor health, poor financial conditions, life crisis and so on.
 Environmental stressors include such stimuli as crowding,loud noise, extreme
temperature, air pollution, sensory deprivation, environmental overload or
under load, etc.
 Socio-cultural stressors include such stimuli as social isolation, cultural
deprivation, social disadvantages, poor socio-economic status, disturbed
family, undesired socio-cultural activities, low social status, and so on.
General Adaptation Syndrome Model of Stress
Hans Selye, the recognized father of stress research talks about General Adaptation
Syndrome (GAS) to explain the process of stress reaction.
349
Positive Psychology The GAS has three stages: Alarm, Resistance, and [Link] the alarm
Interventions
stage,the external stimulus/ stressor activates the internal stress system of the body.
There are a number of physiological and chemical reactions, such as increased pituitary
and adrenaline secretions; noticeable increases in respiration, heart rate, and blood
pressure; and a heightening of the senses. If the stressor continues, then the GAS
moves into the resistance stage, during which the body calls upon the needed organ or
system to deal with the stresses. However, while there may be a great deal of resistance
to one stressor during the second stage, there may be little, if any, resistance to, unrelated
stressors. This helps explain why a person going through an emotional string may be
particularly vulnerable to other illness or [Link], if the stressors persist over a
longer period of time, the reserves of the adaptive mechanisms during the second stage
may become drained and exhaustion sets in.

Fig. 15.1: Three Stages of General Adaptation Syndrome

Source: [Link] › medicine-and-dentistry

Besides the physiologically oriented approach to stress represented by the classic

GAS model which remains a vital dimension of modern stress research and stress
management, attention is also being given to the psychological (e.g., mood changes,
negative emotions, and feeling of helplessness), and the behavioral (e.g., directly
confronting the stressor or attempting to obtain information about the stressor)
dimensions of stress. All three dimensions (physiological, psychological and
behavioral) are important in the understanding of stress and coping strategies to
manage stress.
Diathesis-Stress Model
This model of stress (Rubinstein, 1986) explains the occurrence of stress as the
outcome of a dynamic interaction between the hereditary factors and the
environmental factors. Thus there is a biological predisposition, for instance for getting
high blood pressure or blood sugar, which makes the person vulnerable. However,
the manifestation of this will depend on the environmental factors or the stressors in
the life of the person. Similarly, the person may be prone to getting irritable/anxious,
but this will interact with the environmental stressors for the person, that will act as
the precipitating factors, to actually get anxious. Hence this is also known as the
vulnerability-stress model.
350
 Stress Management and Post
Traumatic Growth

Fig. 15.2: Diathesis-Stress Model

Source: [Link] D7%95%D7% 93%D7%[Link]

Let’s Apply
Are you Vulnerable or Resilient?
 Find out your vulnerability. What are the factors that may make you susceptible
to stress?
 Identify your strengths or protective factors that can help you manage stress.
 Make two columns on a sheet of paper and write down the above two.
 Analyze if you have more vulnerability or more resiliency.
 Reflect on how can you increase your resiliency.

15.4 STRATEGIES/TECHNIQUES FOR

MANAGEMENT OF STRESS
Management of stress requires identifying the stress and the stressors, i.e., the factors
causing stress; and also assessing the level of stress. Identification of stress requires
one to identify the various signs and symptoms of stress, which can be physical/
physiological, emotional, and behavioural.
Identification of Stress
 Physical signs: changes in heart beat, blood pressure, body weight,
diabetes, sleep problem, stomach upset, aches, headache, frequent
cold or infections, muscle tension, changes in menstrual cycle and
libido.
351
Positive Psychology  Psychological signs: difficulty in concentration, and troubles in
Interventions
remembering and recalling, worries.

 Emotional signs: being angry, moody, irritable,sad, anxious or

frustrated.

 Behavioral signs: poor self-care, not having time for the things you
enjoy or taking to drugs and alcohol to cope, smoking, overeating,
gambling, excessive internet use.

We can identify the stressors based on situations, activities, and relationships that cause
‘trauma’ to one’s physical, emotional, or psychological self. It can be from school,
work situation, family relationship, legal matters, finances, health, illness, environment
and other living situation.

Assessment of Stress

The most widely used psychological tool for measuring the perception of stress by the
individual is the ‘Perceived Stress Scale’ (PSS). It assesses the extent to which
individualsperceive their life situations/events as stressful. Other tools to measure stress
are LEDS (Life Events and Difficulty Schedule by Brown and Harris (1986), Stress
and Anxiety Inventory (STRAIN) by Slavich et. al. (2019), and Trier Social Stress
Test (TSST) by Kirschbaum, [Link]., (1993).Alongwith the various psychological tools
for measuring stress level, stress assessment also involves questionnaires, check lists
and interview with the person and significant others to understand the stress and take
appropriate measures to manage the stress.

Stress can be a short-term issue or a long-term issue. However, regular management

of stress is the key to lead a happy life. The most important point is how one perceives
the stress events and facts. This is best explained by Hans Seyle (1979) - “Stress is a
‘perception’. It is the demand that is imposed upon us because there are too many
alternatives”.The concept and principles of positive psychology can be applied to manage
our stress effectively and to promote a healthy life and a positive response to family
and society.

15.4.1 Strategies Focusing on Physical Aspect and Breathing

 Physical exercise

Regular physical exercise is beneficial for physical health as well as mental health.
Aerobics, walking, jugging, swimming, riding bicycles, playing soft balls, and
tennis etc. can help in dealing with excessive stress levels. These forms of physical
exercise increase heart capacities, lower act-rest heart rate, provide a mental
diversion from work pressures and offer a means to “Let off steam” ( Kiely &
Hadgson, 1990).

 Relaxation Technique

Jacobson Progressive Muscle Relaxation (JPMR) is a very comprehensive

relaxation technique which is based on the principle that stress and relaxation
cannot occur together as these are manifestations of sympathetic and
352
 parasympathetic nervous system respectively which reciprocally inhibit each Stress Management and Post
Traumatic Growth
other.
The technique mainly starts with breathing in, holding the breath and letting go
while contracting and relaxing 16 muscle groups such as arms, hands, shoulders,
neck, forehead-eyes-scalp, jaws - mouth, chest - trunk, stomach, lower back,
buttocks, thigh, foot-calf (Ghosh 2015).

The contracting and relaxing of muscle is to be done as follows:

 Bend the arms up to the elbow, hold for a few seconds and relax.
 Clench the hands in a fist, hold for some time and open.
 Pull the shoulders in upward direction, hold in this position for a while
and then release.
 For relaxing the neck, push back the head for a few seconds and then
bring to the original position. Similarly, bring the chin down towards the
chest, for a few seconds and then bring to the original position.
 For chest, take deep breaths, hold for a few seconds and then relax.
 Pull in the stomach for a few seconds and then relax.
 For thighs, pull the knees together for a while and then relax by drifting
them apart.
 Squeeze the buttocks together and relax.
 For feet, pull your toes up in the direction of your knees, hold this position
briefly and then relax by letting go. Heels can be pressed against the
ground for a few seconds and then relaxed by letting go.
Now, rub your palms together, place them on your eyes for sometime,
and then slowly open your eyes.

 Yoga and Meditation

Yoga:
The main aim of Yoga is self-realization (Balaji, 2012). It is a way of life which
enables one to gain inner awareness and develop a higher consciousness to attain
‘Mokshya’. Yoga as a practice originated in India and the term yoga is derived
from Sanskrit word ‘yuj’, meaning ‘to unite’, which indicates a union of
consciousness and body. At the practice level, yoga includes Asana (bodily
postures), Pranayam (breathing exercises) and Dhyana (meditation).
There are various types of yoga such as Karma yoga, Jnana yoga and Bhakti yoga
– mentioned in the Bhagvad Gita, which refer to the path of action, path of
knowledge, and the path of devotion respectively. Ashtanga yoga of Maharshi
Patanjali talks about the eight limbs or steps in the path to self-realization (you will
learn more about it in the next unit 16). Other forms of yoga include Raja yoga,
Sahaja yoga, Kriya yoga, Hatha yoga, and Kundalini yoga propounded by various
spiritual Gurus.
353
Positive Psychology
Interventions

Fig. 15.3 : Eight Steps of Ashtanga Yoga

Source: [Link]

Meditation:
Meditation (‘Dhyana’ in Sanskrit language) aims at quietening our mind to gain inner
awareness and spiritual enlightenment. It also helps manage stress and enhances one’s
health and well-being. There are various types of meditation (Villines, 2017, Welch,
2019) such as,
Mindfulness meditation refers to developing awareness about one’s thoughts and
emotions in the present moment, without any judgment. It involves shifting from our
default auto pilot mode to moment-to-moment awareness [Link] meditation
originates from Buddhist teachings. The main characteristics of mindfulness according
to Kabat-Zinn (1990) are being non-judgmental, cultivating patience, being open minded,
having trust, non-striving, acceptance and letting go.

Mindful breathing
 Sit comfortably with erect and relaxed posture and eyes closed.
 Focus on your breath as you inhale and exhale without trying to change
it.
 If any other thought comes to your mind, just notice it without any
judgement, and then gently bring back your focus on your breath.
 Mindfulness can help reduce stress and promote positive mental health.

Mantra meditationuses a repetitive sound, usually “Om” for chanting. It can also be
any other word/phrase or 1-2 lines prayer, which can be spoken loudly or quietly. It is
prevalent in Hindu and Buddhist traditions and aims at achieving a deeper consciousness.
Transcendental meditationalso involves chanting of a ‘mantra’/ or a word which is
specific toeach practitioner, and gradually intends to transcend or move beyond this
specific chanting.
Guided meditationmainly involves sitting with eyes closed and visualisation of certain
354 images that you may find relaxing.
Loving-kindness meditation, also known as ‘Metta meditation’, focuses on Stress Management and Post
Traumatic Growth
generating and spreading love and kindness to all around us. It involves feelings of
acceptance and compassion for all.
Vipasana meditation aims at self transformation by focusing and realizing the mind-
body connection.
Chakra (wheel) meditationfocuses on balancing the seven chakras – the energy
centres in our body, to reduce stress, create awareness and bring harmony in our life.
The seven chakras are Root chakra (Mooladhara), Sacral chakra (Swadhisthana),
Solar plexus chakra (Nabhi chakra), Heart chakra (Anahata), Throat chakra
(Vishuddhi), Third eye chakra (Agnya), and Crown chakra (Sahastrara).

Fig.15.4: Seven Chakras in Human Body

Source: [Link]

Focused meditation involves focusing or concentrating on something by using any of

the sense organs, e.g., focusing on your breath, or listening to music, counting ‘mala
beads’ or looking at a candle flame, flower etc. If the focus shifts, you can gently bring
back it to the object of your meditation.
Movement meditation as the name suggests, involves movement such as walking,
gardening, digging, or any other gentle forms of motion or activity.
Biofeedback:
Biofeedback provides feedback about the physiological changes that occur in stressful
situations. According to Ghosh (2015, p. 179), biofeedback is “a technique of making
unconscious or involuntary bodily processes (as heartbeat or brainwaves) perceptible
to the senses (as by the use of an oscilloscope) in order to manipulate them by conscious
mental control”.Awareness of such physiological chages as heart rate, breathing, blood 355
Positive Psychology pressure etc. will enable the individual to consciously regulate them (by engaging in
Interventions
deep breathing, relaxation exercises, changing our thoughts etc.), and reduce stressful
experience.
Biocybernaut Institute established by Dr. James V. Hardt makes use of neurofeedback
(feedback about brain activity on real-time), which enables one to regulate one’s cognitive
and affective processes([Link] thereby helping one to manage
stress.
15.4.2 Strategies Focusing on Cognitive Processes
Cognitive Restructuring:
The way we think about a particular situation/event influences the way we react to it.
Our beliefs affect the interpretation of the event, e.g., failure in an exam may lead one
student to put in more effort for the next exam, whereas the same event may lead one
to feel [Link] underlying belief here makes the difference! In the earlier case,
the student may feel sad about the result, but looks forward to perform better next
time; whereas in the latter case, the student thinks this is the end and thinks himself as
inadequate and incompetent. Thus the antecedent event results in a particular
consequence depending on the individual’s beliefs or thought process. This is explained
in the ABC triangle given below.

Fig. 15.5 : ABC Triangle

Thus cognitive restructuring requires one to restructure or modify one’s thinking patterns.
Based on this, Aaron Beck (1967) has developed the Cognitive behavior therapy
(CBT),which focuses on modifying the irrational thinking patterns of the individual,
resulting in adaptive behavior and stress reduction.

Activity1
Think of any situation/incident in your life and apply the ABC triangle. Write down
the activating stimulus, the consequences, and the your belief system. Check
whether your beliefs help or hinder the outcome.
356
Positive Attitude: Stress Management and Post
Traumatic Growth
Positive attitude refers to having an attitude that good things will happen, that one
would be able to deal with a challenge or an adverse situation. Thus it involves thinking
in a positive way, and having positive emotions towards the stressful situation. As the
proverbial question goes, “if the glass is half full or half empty”?, positive attitude involves
looking at things/situations/events/people and focusing on what positive or good is
present rather than looking at the negative or absence side. Thus it involves characteristics
of optimism, hope, divergent thinking, and resilience. Positive attitude makes one
confident, results in problem solving, reduces stress, and increases the inner strength of
the individual.
You must be thinking why don’t we have a positive attitude then?Mostly we are
attuned to negative thinking because of the ‘negativity bias’ of our brain. Our brain
easily picks up the negatives as it concerns survival from an evolutionary point of
view. However, we can easily develop a positive attitude by developing awareness
about it. Practicing positive attitude is a constructive process where you do not
negate the negative thoughts. Rather you adopt a critical approach to the situation
and think about the best possible alternatives in the situation while maintaining an
attitude of positivity. Positive thinking makes your thinking flexible and opens up
[Link] focus of thinking is contextual, not global, e.g., if you failed the job
interview, you think in the context of one interview which did not go well, and you do
not think that you will never do well in a job interview.
Positive attitude involves cognitive restructuring where we deliberately engage in thinking
in positive terms. We need to practice positive affirmations and focus on the positive
side of any challenge. Engage in positive self-talk and use visualization strategies. Create
a mental picture of what you want to achieve and how you want to see the things. This
will then help you to engage in constructive and divergent thinking regarding ways to
achieve this goal. Remember that we first create a mental picture; the physical or actual
creation follows this mental creation, for instance, when you are doing a project, or
planning a trip etc. Since we are hard-wired for negative thinking, it will require real
effort and practice to change our default mode of thinking and engage in positive thinking.
This will help to manage our stress and be effective in a situation.
Expressing Gratitude:
Gratitude refers to ‘The quality of being thankful or grateful’. It involves showing
appreciation for something. Expressing gratitude also fosters positive attitude in the
individual as it reduces our attention on the negative things in our life. If you think about
our traditions and culture, our festivals and rituals offer occasions for showing our
gratitude towards nature, other people, and our ancestors. We need to recognize and
consciously focus on cultivating an attitude of gratitude.
Gratitude not only makes you feel good by generating positive emotions, but also
boosts our physical health and psychological well-being. It releases dopamine and
serotonin which make us feel happy. Gratitude widens our thinking and perspective,
and enhances resilience. One needs to practice gratitude, e.g., by writing gratitude
letters, that is, letters that express your thankfulness to someone; gratitude visits where
you visit people to express how grateful you are for their support; counting your blessings,
i.e., focusing on the good things in your life; keeping a gratitude journal where you
write down your positive experiences during the day etc.
357
Positive Psychology
Interventions Gratitude for yourself : Be aware about yourself. Find out your strengths, focuson
what is good in you and express gratitude.
Gratitude for others : Be aware of contribution of others in your life; your
parents have given you birth, raised you, provided for your optimum development,
education and so on. Other significant people in your life have also contributed to
your life in various ways. Your friends, colleagues, neighbours have extended help
and support to you on many occasions. Think, identify, and express gratitude for
those instances.
Gratitude for everything : Be aware of this precious life, the wonders of the
nature, this vast universe, the elements of the universe; and express gratitude.

Coping Strategies :
Coping can be described as deliberate efforts directed towards decreasing the negative
effects of stressful situations. An adaptive coping style helps reduce stress whereas,
maladaptive coping has negative impacts on physical and psychological health of the
individual. Problem-focused coping tries to address the problem itself, that is, removing
the cause of the stress. For instance, you switch on the fan if you are feeling too hot.
However, emotion-focused coping deals with the emotions arising out of the stressful
experience, e.g., you felt hurt by your friend’s behaviour and you tried to manage your
hurt feeling by distracting yourself in some other activity. On the other hand, acceptance-
oriented coping focuses on developing a sense of acceptance for the stressful situation
where the things ar not under control of the individual, e.g., accepting the loss and
damage of house and other properties due to the cyclone.
Individual differences exist in the way individuals cope with stressful situations. This
couldbe due to various factors such as personality of individuals, gender, tolerance
level for stimulation, psychological hardiness, style of attribution, and learned
helplessness(Beck [Link]., 1983; [Link]., 2006; Shenellet. al.,2015, &Tang
[Link].,2015).

15.4.3 Strategies Focusing on Affective Processes

Emotional Intelligence:
Awareness of emotions in oneself and in others plays a crucial role in managing our
stress. In addition to the thinking component of stress, we need to pay attention to the
affective component of stress. Knowing about the emotions will help us in changing
our thinking and behavior so that it results in adaptive behavior. Thus thinking and
emotions need to be integrated which is called as Emotional intelligence (Goleman,
1995). The five components of EI, according to Goleman, consist of self-awareness,
empathy, self-regulation, motivation, and social [Link] intelligence basically
involves developing awareness about emotions in oneself and in others, and managing
emotions.
Positive Visualization:
Positive visualization involves the use of imagination to visualize about a future outcome
which we desire, but may not be able to achieve at the present [Link] can be
358 called as mental exercise that helps one to reach the desired goal.
It mostly has been used in the context of sports to enhance the performance and skill of Stress Management and Post
Traumatic Growth
the players. However, it can be used to enhance your performance in any aspect and
field. We can utilize our brain’s ability to think about future and create a mental pathway
to enhance our potential. As we have mentioned under positive attitude in the earlier
section, everything is created twice – first you create a mental picture of your desired
object, and then it is carried out in the reality, e.g., you plan out the project or your
itinerary, and then you carry out it. Thus thoughts precede our actual behaviour. Hence
if we can make it stronger at the thought level to begin with, it may transfer to the action
level. There are two types of visualization such as (a) Outcome visualization, where
you focus on the end goal; and (b) Process visualization, which focuses on the entire
process that leads us to our desired [Link] we engage in both outcome and process
visualization, it leads to effective results.
Visualization is not just thinking and planning about a certain thing, but it requires vivid
imagination involving all the senses. It includes the cognitive as well as affective processes
related to the desired object/thing. When we repeatedly visualize something, paying
attention to the minute details, and attaching all our senses with it, our brain gets the
signal and gets motivated to engage in selective attention, goal-directed thinking and
divergent thinking. Further, effective visualization requires us to be self-aware, knowing
our strengths, beliefs, and values so that we know what we really want to achieve.

Fig. 15.6 : Steps in the Visualization Process

15.4.4 Strategies Focusing on Behaviour

Engaging in Leisure Activities:
Activity 2: What’s your Leisure Ratio?
Examine your day’s schedule and find out how much time you are devoting to
your job-related work, family responsibilities, self-care, leisure-related, and
community support activities. Is there a proper balance between your work and
leisure? Observe and maintain a diary over a period of 1-2 weeks. At the end of
it, answer the following: 359
Positive Psychology
Interventions  How much time did you devote to each type of the above mentioned activities?
 Which type of activities added to your stress and which ones helped reduce
your stress?
 What are the reasons you engaged less or more in activities that reduced your
stress?

Leisure activities are those that we engage in to relax, reduce our stress, and feel good
about ourselves. These are pleasurable activities done voluntarily such as playing games,
drawing, pursuing one’s hobbies, socializing, being with nature, and so on. Research
focuses on leisure as a coping resource which has ample benefits for our physical as
well as mental health(Chun, Lee, Kim, & Heo, 2012; Pressman, Matthews, Cohen,
Martire, Scheier, Baum, & Schulz, 2009; Qian, Yarnal, & Almeida, 2014). Usually
leisure time is thought of as a wastage of time and/or given less time for it. However,
leisure time has manifold benefits and can help us engage in work and other activities
with new vigour.
As there are various stressors, we also have a variety of stress-busters or coping
resources. Various leisure activities depending on the individual’s preferences and
interests can help reduce stress in the individual. It is more informative to study each
leisure activity and how it helps to cope with various stressors rather than studying the
many ways of coping with certain stressors (Costa, Somerfield, & McCrae, 1996).
Connecting with People:
Connecting with people is an important tool to reduce stress. When we connect and
interact with others, it releases the stress and anxiety within. It results in catharsis which
reduces the stress in the individual. Feeling connected with others helps one to get the
necessary social support, increases their confidence, and generates a feeling of trust.
Connection with our family and relatives, friends, neighbours, and the community is a
great asset in managing our stress. It provides us the support and has a positive impact
on our physical and mental health. Even if the person is not present physically, still the
perceived social connection has lots of benefits. It provides a feeling of confidence,
comfort, and assurance that someone is there to provide you with help and support.

15.4.5 Stress Management Strategies at the Organizational

Level
 Communicating Effectively:
Communication is an important interpersonal skill at the organizational level. It
helps in conveying things clearly and avoids conflicts and misunderstanding. It can
thus reduce stress and improve relationship. Main aspects of effective
communication are : active listening, being open to feedback, paying attention to
nonverbal behavior, removing barriers to effective communication, providing
personal space, and being assertive.
 Resolving Conflicts:
Conflict resolution denotes ways in which conflict can be dealt with or resolved.
One of the conflict resolution strategies include avoiding. This denotes withdrawal
from conflict. Though, in this case the actual conflict may not resolve. But individuals
360
 may use this when they feel that confrontation or engaging in conflict is not Stress Management and Post
Traumatic Growth
worthwhile and the discomfort that they may experience while in conflict is much
more than when they avoid it. Another strategy can be competing. This is used by
individuals who engage in conflict necessarily to win. This is a win- lose situation.
Individuals using this may display assertiveness but not cooperation. Next can be
accommodating. In this case, the individual is cooperative and not assertive.
Though, this again may not be healthy as one of the parties may just give in and as
such the conflict remains unresolved. This is a lose-win strategy. Similarly
collaborating also can be one strategy where individuals are assertive as well as
cooperative and the parties may come up with an agreed solution to resolve the
conflict. This can also be termed as win-win strategy. Compromising also help in
conflict resolution, where each of the party will compromise in some way. Thus,
there is partial cooperation and assertiveness. And though, the parties may not be
completely satisfied, they are not dissatisfied as well. individuals who are able to
resolve conflicts are often excellent mediators, rational, and able to manage difficult
personalities from a place of empathy.

Let’s Apply
Next time when you have an argument or conflict, think of which conflict resolution
strategy are you using?
Note the context, is it with friends, at workplace, or family. Does the conflict
resolution strategy change depending on the situation?

 Problem Solving:
Problem solving involves finding solution to a problem at hand. It can be explained
as a mental process that includes analysis of the problem in order to find a solution
for it. Problems can be categorized into routine and non-routine problems and
well-defined and ill-defined or poorly defined problems. The steps in problem
solving include identification of problem, brainstorming for ideas and solutions,
selecting a solution and implementing the plan of action and reflecting on the
effectiveness of the solution. Strategies of problem solving include trial and error,
heuristics, algorithm and insight-oriented methods.

15.5 POST TRAUMATIC GROWTH

Post Traumatic Growth (PTG) refers to the psychological growth that occurs following
an adversity. The recent COVID 19 pandemic offers the best example of [Link]
stressful experiences and the challenges faced by people throughout the world have
been overwhelming and shocking. However, we are still persisting in our livelihood,
adapting to the situation, and trying to find meaning and happiness while undergoing a
personal process of change.
The term post-traumatic growth refers to the adaptation and accommodation of the
individual to any crisis or traumatic situation and coming out of this by coping to the
situation in a positive manner. Post-Traumatic Growth (PTG) and Post-Traumatic
Depreciation (PTD) can be defined, respectively, as positive and negative changes in
the after effects of trauma. These changes can be in the following domains such as
personal strength, relating to others, new possibilities, appreciation of life, spiritual and
361
Positive Psychology existential change (Zieba, [Link]., 2019).In other words post-traumatic growth indicates
Interventions
transformation after an intense traumatic and struggling situation that occurs mostly
automatically and naturally, without psychotherapy or any other formal intervention.
The concept of post-traumatic growth has been in existence in the teachings of our
religions, spiritual and philosophical deliberations, which talk about the elements of
potentially transformative power of suffering. In the scientific research, the term ‘Post
Traumatic Growth’ was first postulated by Richard Tedeschi and Lawrence
[Link] define PTG as positive psychological changes in the aftermath
of highly stressful and challenging unavoidable occurrences in life (Tedeschi &
Calhoun, 2004). PTG brings about a positive shift in our mindset; instead of focusing
on the negatives, the person searches out and emphasizes the positives in the adverse
situation. The cognitive restructuring in the process helps us grow as better human
beings (Fredrickson, 2004).Tedeschi and Calhoun (1996) talk about five indicators
of PTG in their Post-Traumatic Growth Inventory (PTGI): Appreciation,
Relationships, New possibilities and opportunities, Personal strength, and Spiritual
enhancement.
The process of PTG may differ based on the types of trauma, personality characteristics
of the person, nature of social support received and experiences afterwards. Further,
positive attitude, gender, cultural factors, and socio-economic status may also affect
the PTG(Arpawong,2013; Cordova. 2001; Jaehee,[Link]., 2015; Wang, 2014; Yi &
Kim, 2014, & Zebrack, 2012).
Post-traumatic growth is an important positive psychology construct that needs to be
differentiated from resilience that is much talked about in the field of positive psychology.
Differences between PTG and Resilience
Post-traumatic Growth (PTG) Resilience
Occurs only after exposure to trauma Can be present before trauma also,
available as part of one’s personality
An outcome of highly stressful situation/ May not occur after exposure to trauma.
trauma But if a person shows PTG, s/he
develops resilience in the process
PTG always involves resilience Resilience may or may not lead to PTG
Involves transformation in the personality – May not involve any change unless the
changes in one’s thinking, beliefs, attitude person is required to show resilient
and behaviour behaviour in any situation

Post-traumatic growth can be a significant phenomenon creating growth, balance, and

continuing our life with renewed vigour and positivity. PTG includes aspects/ constructs
related to positive psychology such as positive attitude, resilience, emotional strength,
emotional competence, heightened gratitude towards life, spirituality, and finding meaning
in [Link], one needs to take note of the post-traumatic growth syndrome,
which refers to the perceived happiness reported by the individual after the trauma
rather than real joy and actual well-being. So it can be called as a positive illusion
(Lommen, Engelhard, van de Schoot, & van den Hout, 2014), which is for a short
duration only rather than the PTG which is more stable in nature.
362
PTG can be assessed through the Post-traumatic Growth Inventory (PTGI) developed Stress Management and Post
Traumatic Growth
by Tedeschi and Calhoun (1996). It consists of 21 items in five areas such asappreciation,
new possibilitiesin life, reationship with others, personal strength, and spiritual enhancement,
which measure positive growth after adversity. A short form of this with 10 items was
later developed by Cann et al. (2010); and modified version by Kaur et. al. (2017). PTG
can also be measured with questionnaires, checklist and interview methods.

15.6 LET US SUM UP

Stress is like the salt and pepper of our life, presence of which makes our life lively,
energetic, varied and dynamic. However, one needs to ensure that the stress does not
go overboard and is within the stress tolerance level of the individual. Optimum level of
stress will motivate the individual and enhance their performance. In the present unit,
you learned about the meaning of stress and the various types of stressors in our life. It
is important to identify the stress so that proper steps can be taken to manage it.
Various techniques of stress management were described focusing on physical, cognitive,
affective, and behavioural aspects. You also learned about post-traumatic growth, an
important concept in positive psychology. Post-traumatic growth helps one to go beyond
the stress and turn the adversity into opportunity or positive learning experience.

15.7 KEY WORDS

Stress : refers to any force, which physically or psychologically
strains the coping mechanism of an organism.
Diathesis-Stress Model : explains the occurrence of stress as the outcome of a
dynamic interaction between the hereditary factors and
the environmental factors.
Biofeedback : provides feedback about the physiological changes that
occur in stressful situations so as to regulate them
consciously.
Gratitude : refers to the quality of being thankful or grateful by
showing appreciation for something.
Positive visualization : involves the use of imagination to visualize about a future
outcome which we desire, but may not be able to
achieve at the present moment.
Post-traumatic growth : refers to the adaptation and accommodation of the
individual to any crisis or traumatic situation and coming
out of this by coping to the situation in a positive manner.

15.8 ANSWERS TO SELF ASSESSMENT QUESTIONS

Self Assessment Questions 1
1. ‘stringere’
2. Acute stress is short-term stress which occurs suddenly, and the synptoms are
acute, and do not last long.
363
Positive Psychology 3. Stressors are the factors that cause stress.
Interventions
4. physical or physiological, psychological, environmental, and socio - cultural.
5. Alarm, Resistance, and Exhaustion
Self Assessment Questions 2
1. Mindfulness meditation refers to developing awareness about one’s thoughts and
emotions in the present moment, without any judgment.
2. Cognitive restructuring requires one to restructure or modify one’s thinking patterns.
3. Some of the components involved in positive attitudeare optimism, hope, divergent
thinking, and resilience.
4. ‘Negativity bias’ refers to the fact that our brain easily picks up the negatives as it
concerns survival from an evolutionary point of view.
5. Problem-focused coping tries to address the problem itself, that is, removing the
cause of the stress whereas emotion-focused coping deals with the emotions arising
out of the stressful experience.
6. Gratitude letters, counting your blessings, gratitude visit, and gratitude journal
Self Assessment Questions 3
1. Daniel Goleman
2. Outcome visualization, which focuses on the end goal; and Process visualization,
which focuses on the entire process that leads us to our desired goal.
3. Avoiding, competing, accomodating, collaborating, and compromising
4. Appreciation, Relationships, New possibilities and opportunities, Personal strength,
and Spiritual enhancement.

15.9 UNIT END QUESTIONS

1. Explain the concept of stress and describe the types of stressors.
2. Discuss the General Adaptation Syndrome model of stress.
3. Describe yoga and meditation as strategies for delig with stress.
4. Explain the stress management strategies focusing on the affective processes.
5. Define post-traumatic growth (PTG). Differentiate between PTG and resilience.

15.10 REFERENCES
Arpawong, T.E., Oland, A., Milam, J.E., Ruccione, K., & Meeske, K.A. (2013).
Post-traumatic growth among an ethnically diverse sample of adolescent and young
adult cancer survivors, Psychooncology, 22(10): 2235-44.
Balaji, D. P. V. (2012). Stress and yoga. Journal of Yoga and Physical Therapy, 2,
109. doi:10.4172/2157-7595.1000109.
364
Beck, A. T. (1967). Depression: Causes and treatment. Philadelphia: University of Stress Management and Post
Traumatic Growth
Pennsylvania Press.
Beck, A. T., Epstein, N., & Harrison, R. (1983). Cognitions, attitudes and personality
dimensions in depression. British Journal of Cognitive Psychotherapy.
Brown, G.W.& Harris, T. (1986). Stressor, vulnerability and depression: A question of
replication. PsycholMed, 16(4):739-744.
Cann, A., Calhoun, L.G., Tedeschi, R.G., Taku, K., Vishnevsky, T., Triplett, K.N.,
&Danhauer, S.C. (2010). A short form of the Posttraumatic Growth Inventory. Anxiety
Stress Coping, 23(2):127-37. doi: 10.1080/10615800903094273. PMID: 19582640.
Chesney, M.A.,Neilands, T.B.,Chambers, D.B., Taylor,J.M. & Folkman, S. (2006).
A validity and reliability of the coping self-efficacy scale, Br J Health Psychol., Page
11Author manuscript; available in PMC October [Link]-PA Author Manuscript.
Chun, S., Lee, Y., Kim, B., & Heo, J. (2012). The contribution of leisure participation
and leisure satisfaction to stress-related growth. Leisure Sciences,34:436–449.
Cordova, M.J., Cunningham, L.L., Carlson, C.R., & Andrykowski, M.A.
(2001).Posttraumatic growth following breast cancer: a controlled comparison study.
Health Psychol, 20(3):176-85.
Costa, P., Jr., Somerfield, M., & McCrae, R. (1996). Personality and coping: A
reconceptualization. In M. Zeidner, and N. Endler (Eds.) Handbook of coping: Theory,
research, applications. pp. 44-61. New York: Wiley.
Fredrickson, B. L. (2004). The broaden–and–build theory of positive
emotions. Philosophical Transactions of the Royal Society of London. Series B:
Biological Sciences, 359(1449), 1367-1377.
Ghosh, M. (2015). Health psychology: Concepts in health and wellbeing. New
Delhi: Dorling Kindersley (India) Pvt. Ltd.
Goleman, D. (1995). Emotional Intelligence. New York: Bantam Books.
Jaehee, Y.i., Zebrack, B., Kim, M.A. & Cousino, M. (2015). Posttraumatic growth
outcomes and their correlates among young adult survivors of childhood cancer,J
Pediatr Psychol.40(9): 981–991. doi: 10.1093/jpepsy/jsv075
Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body
and mind to face stress, pain and illness. New York.
Kaur, N., Porter, B., LeardMann, C., Tobin, L., Lemus, H., & Luxton, D. (2017).
Evaluation of a modified version of the Posttraumatic Growth Inventory-Short Form.
BMC Medical Research Methodology,17. 10.1186/s12874-017-0344-2.
Kiely, J. & Hodgson, G. (1990). Stress in the prison service: The benefits of exercise
programs, Human Relations Journal. p. 551-572.
Kirschbaum, C., Pirke, K.M., &Hellhammer, D.H. (1993). The ‘Trier Social Stress
Test’—a tool for investigating psychobiological stress responses in a laboratory
setting. Neuropsychobiology, 28(1–2):76–81.
Klosky, J.L., Krull, K.R., Kawashima, T., Leisenring, W., Randolph, M.E., Zebrack,
B.,Stuber,M.L.,Robison,L.L.&Phipps,S.(2014).Relationsbetweenposttraumatic stress
365
Positive Psychology and posttraumatic growth in long-term survivors of childhood cancer: a report from
Interventions
the Childhood Cancer [Link] Psychol.,33(8):878-82.
Lommen, M. J., Engelhard, I. M., van de Schoot, R., & van den Hout, M. A. (2014).
Anger: cause or consequence of posttraumatic stress? A prospective study of Dutch
soldiers. Journal of Traumatic Stress, 27(2), 200-207.
Pressman, S.D., Matthews, K.A., Cohen, S., Martire, L.M., Scheier, M., Baum, A.,
& Schulz, R. (2009). Association of enjoyable leisure activities with psychological and
physical [Link] Med., 71(7):725-32.
Qian, X. L., Yarnal, C. M., & Almeida, D. M. (2014). Does leisure time moderate or
mediate the effect of daily stress on positive affect? An examination using eight-day
diary data. Journal of leisure research, 46(1), 106–124. [Link]
00222216.2014.11950315
Schafer, W. (1998). Stress management for wellness. United States: Thomson
Wadsworth.
Selye, H. (1956). The stress of life. New York: McGraw-Hill
Slavich, G. M., Stewart, J. G., Esposito, E. C., Shields, G. S., & Auerbach, R. P.
(2019). The Stress and Adversity Inventory for Adolescents (Adolescent STRAIN):
associations with mental and physical health, risky behaviors, and psychiatric
diagnoses in youth seeking treatment. Journal of Child Psychology and Psychiatry,
60, 998-1009. doi: 10.1111/jcpp.13038
Tang, S.T., Lin, K.C. Chen, J.S. Chang, W.C. Hsieh, C.H. & Chou, W.C. (2015).
Threatened with death but growing: changes in and determinants of posttraumatic growth
over the dying process for Taiwanese terminally ill cancer [Link],
24(2):147-54.
Tedeschi, R. G., & Calhoun, L. G. (1995). Trauma and transformation. Thousand
Oaks, CA: Sage.
Tedeschi, R. G., & Calhoun, L. G. (1996). The Posttraumatic Growth Inventory:
Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3),
455-471.
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations
and empirical evidence. Psychological Inquiry, 15(1), 1-18.
Truxillo, D. M., Cadiz, D. M., & Hammer, L. B. (2015). Supporting the aging
workforce: a research review and recommendations for workplace intervention
research. Annu. Rev. Organ. Psychol. Organ. Behav. 2, 351–381. doi: 10.1146/
annurev-orgpsych-032414-111435.
Wang, M.L., Liu, J.E., Wang, H.Y., Chen, J., & Li, Y.Y. (2014). Posttraumatic growth
and associated socio-demographic and clinical factors in Chinese breast cancer
survivors. Eur J Oncol Nurs. 18(5):478-83
Welch, A (2019). A guide to 7 different types of meditation. https://
[Link]/meditation/types/ Accessed on 25th December 2021 at 6.32
p.m.
366
Yi, J. & Kim, M.A. (2014). Postcancer experiences of childhood cancer survivors: Stress Management and Post
Traumatic Growth
how is posttraumatic stress related to posttraumatic growth? J Trauma Stress.,
27(4):461-7.
Zebrack, B.J., Stuber, M.L., Meeske, K.A., Phipps, S., Krull, K.R., Liu, Q., Yasui,
Y., Parry, C., Hamilton, R., Robison, L.L., & Zeltzer, L.K. (2012). Perceived positive
impact of cancer among long-term survivors of childhood cancer: A report from the
childhood cancer survivor study. Psychooncology, 21(6):630-9.
Ziêba, M., Wiecheæ, K.,Biegañska-Banaœ, J., & Mieleszczenko-Kowszewicz, W.
(2019). Coexistence of post-traumatic growth and post-traumatic depreciation in the
aftermath of trauma: Qualitative and quantitative narrative analysis. Frontiers in
Psychology, 10: 687. DOI=10.3389/fpsyg.2019.00687

15.11 SUGGESTED READINGS

Goyal, P., & Chakrawal, A. (2016). Stress management. New Delhi: Studera Press
Niemiec, R.M. (2019). The strengths-based workbook for stress relief: A character
strengths approach to finding calm in the chaos of daily life. Oaklands, CA: New
Harbinger Publications.
Schachter, R. (2019). Mindfulness for stress management: 50 ways to improve
your mood and cultivate calmness. California: Althea Press.
Selhub, E. (2019). The stress management handbook: A practical guide to staying
calm, keeping cool, and avoiding blow-ups. NY: Skyhorse publishing.
Stahl, B., & Goldstein, E. (2019). A mindfulness-based stress reduction workbook.
2nd edition. Oaklands, CA: New Harbinger Publications.

367