Introduction (Book Excerpt)Imagine a prehistoric man walking across a grassy savannah. Out of the corner of his eye, he sees a saber-toothed tiger stalking him. Boom! Instantly, hormones are released in the man’s body that make his heart pound faster, his breath quicken, his pupils dilate, and his blood rush from his gut to his muscles. For the next few moments, as his body is flooded with extra oxygen and energy, he is stronger, faster, and sharper than normal. This reaction may well make the difference if he chooses to fight or (smarter still) flee the tiger. If the man is walking with a friend, and his friend’s body does not have this “stress response,” the friend is more likely to become lunch. But our prehistoric man wins the 50-yard dash and survives to pass his genes—and stress response—to future generations.
Today, we all have inherited this “fight-or-flight” response, which used to serve us so well. But we live in a vastly different world from that of our ancestors. The stress response evolved as a physical solution to a physical threat. Our world is still full of threats, but they are rarely physical ones, and physical responses are rarely appropriate. If your boss yells at you and you punch him in the nose, you’ll get a pink slip. If you feel your blood pressure rising as you endure a traffic jam, and you respond by veering into the breakdown lane and flooring the gas pedal, you risk a ticket or even an accident. The reality of the modern world is that, most of the time, the appropriate response to a stressful situation is simply to grin and bear it. And that’s a problem. Because those stress hormones, triggered by ancient genes, still scream at us to do something physical. They cause real chemical and physical changes in the body as they shift all our systems to Code Red. The stressful tension created by that inner urgency, and the inability to act on it, isn’t just uncomfortable. It exacerbates almost every type of illness you can think of. It can even kill. In one four-year study, caregivers with high levels of stress had a 63 percent greater risk of dying than people with normal stress. Another study showed that women under stress suffered actual changes in their DNA—the equivalent of aging 9 to 17 years. Still another found that men who had high surges in blood pressure due to stress had a 72 percent increased risk of stroke. Stress is implicated in everything from headaches and obesity to fibromyalgia, depression, and infertility. It erodes relationships and productivity. It will shorten your life and ruin your days. It is no laughing matter. The bad news? There is no way to escape stress entirely. If you are an American adult, chances are almost 50/50 that you are feeling the debilitating effects of stress as you read these words. The chances are overwhelming that you will suffer from stress at some point in the future. Stress goes hand in hand with contemporary life. A small sampling of other illnesses it causes, or exacerbates, include heart disease, acne, eczema, psoriasis, irritable bowel syndrome, and heartburn. Stress may also affect the treatment of diabetes, high blood pressure, chronic pain, and asthma. The good news? Probably no area of your health can be improved more easily, and with more beneficial impact, than stress. Manage your stress and you will worry less, live longer, and laugh more. Despite what you may have been led to believe, managing stress does not require years of study or learning any difficult or esoteric techniques. It is amazing how small changes in our thought patterns can cause large improvements in our ability to handle stress. Likewise, taking a few minutes to learn a basic 10- minute relaxation technique can pay off again and again. Even simple lifestyle changes will have a profound impact on stress. There is no single answer for dealing with stress, but there are numerous opportunities to control it. That’s what this book is about. Simply put, it is a stress management tool kit. Just as replacing a rock with a sledgehammer can turn an unworkable problem into a simple fix, having the right tools on hand for tackling stress can dispel what felt like an impossible burden. Not all tools will work for everyone. Depending on your personality and circumstances, you will find certain ideas and techniques that fit you best. Even if one chapter isn’t helpful to you, please keep reading. One patient told me that the chapter on mindfulness changed her life, and another found that the chapter on communication skills made all the difference. But no matter who you are, you will find some techniques in this book that work. I know, because I’ve taught these techniques to thousands of people over the past fifteen years as director of the Stress Management Program at one of the largest medical clinics in California. I’ve even taught it to the staff at the clinic. I’ve seen firsthand the changes in how people enjoy their day and in how they get stuff done when they are relaxed and focused. The funny thing is I didn’t set out to become a stress specialist. I began my career doing regular family practice, but after less than a year of seeing patients, I saw in graphic detail that America had a major problem on its hands. My patients had physical ailments, sure, and they needed specific treatments for them, but in family practice I mostly treated people who were incredibly stressed-out. The more I talked with my patients—and I try to talk a lot with my patients, because I believe in treating the whole person—the more I realized that stress either was their primary problem or was aggravating their other concerns. These people didn’t need more pills; they needed to learn how to unwind. I wasn’t the first doctor to recognize this problem. A recent survey showed that 97 percent of physicians are aware that stress often triggers or compounds patients’ ailments. However, most doctors are too busy and stressed themselves to take the time to treat stress properly. It isn’t unusual for a doctor to have all of 15 minutes to handle three different problems. Many doctors see 25 or 35 patients in one day. This isn’t their choice, but they have to do the best they can under the circumstances. When a patient says, “My work is getting very stressful and now I have headaches every evening,” the doctor may want to take two hours to do some stress management training and teach the patient some basic relaxation exercises, but that isn’t an option. The patient wants fast relief, so the doctor says, “Here, take this medicine the next time you have a headache.” Unfortunately, the basic problem has not been addressed. Given the time constraints of a typical office visit, what alternatives does a family doctor have? In 1992, I decided to come up with a solution. There was no shortage of information. The questions of how to deal with stress and how to be happy have been around for thousands of years, and so have some of the best answers. From early in my training, I was aware of them and have been researching the answers for the past 30 years. I organized and led seminars in stress management for my patients and for other doctors’ patients. I might not be able to do much for my patients’ stress levels in one office visit, but if I could get them to take the stress management course, I could give them skills that would last a lifetime. The first class was so well received that I scheduled another, then another. The written notes that I handed out kept getting more extensive. Soon, I realized that they needed to be accompanied by guided audio relaxation meditations. Then, the psychology department at my clinic asked to see what I’d created, so I put it all together for them. Eventually, as I taught and lectured more and more to groups and businesses about stress, the written materials evolved into a full book, especially for those people who were “too stressed to take a stress management course”! The book and CD package you now hold in your hands is the final result of those 30 years of studying stress and 15 years of teaching people how to manage theirs. I’ve changed, refined, and, usually, simplified the techniques I teach over the years, after seeing what works and what doesn’t. I have tried to make the book neither gimmicky nor esoteric. When people are stressed, they don’t have time for a 600-page tome. Therefore, this book is concise and to the point. I give you just the information you need to get proactive about stress relief as quickly as possible. If one of the topics strikes a chord with you, I encourage you to consult the reading list for more extensive study. I have included the points that people who have already taken my classes found most useful in dealing with stress, as well as a variety of pertinent quotations that add perspective and make for an entertaining and sometimes humorous read.
The first step in our journey will be to discover a technique that will help you effectively relax whenever you have a few free minutes. You can start using it right away while you learn more about stress in Chapter 2 and explore the in-depth relaxation techniques in Chapter 3. However, you don’t always have a few free minutes. When your boss yells, “Get in here now!” it’s best not to say, “I’ll be there after my 10-minute relaxation break.” If you did, you might end up with an extended relaxation break! Therefore, Chapters 4 and 5 explore a technique called mindfulness and show how it can be used to deal with stressful situations as they happen and can even alter their outcome. This deceptively simple technique is the heart of the book, and you may find, as I have, that its benefits go far beyond stress relief. In fact, it may help you discover greater happiness in every passing moment. Closely connected to mindfulness, in Chapter 6, is the concept of changing your thoughts by reframing your mental context. Then, we will look at how slowing down can help with stress, and we will learn ways of putting our lives in perspective. Your physical health, and the amount you exercise, has a tremendous impact on stress levels, so we will investigate basic lifestyle changes that can minimize stress. Much stress revolves around relationships, so a discussion of communication skills is important. We will learn to deal with feelings of anger and frustration, take the stress out of decisions, and improve sleep. Occasionally, even if you do all the right things to help yourself deal with stress, your surroundings are so stressful that internal solutions are insufficient. If your spouse regularly physically abuses you, exercise and meditation are going to get you only so far. Chapter 14 discusses when external changes are necessary and guides you in making those changes—but also cautions against the temptation to use your environment as an excuse. Chapter 15 teaches how best to combine all these strategies for maximum effect. Finally, in Chapter 16, I’ll help you decide if your problems represent more than stress and, if so, what to do about it. You will see that this book draws on a wide mixture of teachings, ranging from those of Albert Ellis and the Dalai Lama to those of Meyer Friedman and Jon Kabat-Zinn. Many of the techniques I created myself for my classes. The stories and anecdotes, which help illustrate concepts throughout the book, are drawn from my own life and from my patients and students. Their names and occupations have been changed to ensure their anonymity. This is a hands-on book. It’s here for your benefit. To get the most out of it, I encourage you to make it your own. Take notes in the book, underline meaningful parts, and consider the questions and exercises in each chapter. Instead of just reading the general techniques, actively tweak them so that they apply to your personal situation. Even if you feel as if you already know some of these techniques, it is important to be reminded of the principles. I’ve taught well over a hundred stress management classes, yet every time I teach a class, I’m reminded of ways to handle my own stress more effectively. In the same way, if you are already familiar with some of the concepts presented in this book, ''Take the Stress out of Your Life'' should serve as an important reminder of common sense that is often forgotten.
In addition, you do not have to have severe problems with anxiety to benefit from Take the Stress out of Your Life. Just because you aren’t suffering from psoriasis or high blood pressure doesn’t mean stress isn’t sapping some of the pleasure from your life. Even people with low levels of stress find that the skills taught in this book improve their day-to-day lives. In fact, you can think of them as basic training for a rewarding and productive life. After all, learning to fully experience every moment is something from which we can all benefit. You would not expect to run a marathon without training your body. You would not expect to work at almost any professional occupation without instruction. In order to live the most joyful life possible, you must have some basic instruction and must train your mind. My students have ranged from people with minimal stress to people with full-blown anxiety disorders. Virtually all of them came away with useful information. There is no ultimate, quick fix for stress. Learning to manage it well is a lifelong pursuit. However, completing this book and trying the exercises in it and on the CD set will be a very healthy start to the endeavor. Congratulate yourself for starting the journey to a healthier and happier life. If you make the commitment to finish the book and follow through with the recommendations, your life may never be the same.
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