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Running head: BIOFEEDBACK & STRESS MANAGEMENT 1

Biofeedback & Stress Management

An Experiential Project Paper

Presented to

The Faculty of the Adler Graduate School

________________

In Partial Fulfillment of the Requirements for

the Degree of Master of Arts in

Adlerian Counseling and Psychotherapy

________________

By:

Latonya Renee Rainwater

August 2010

BIOFEEDBACK & STRESS MANAGEMENT 2

Table of Contents

Abstract………………………………………………………………………………………..…..3

Introduction……………….……………………………………………………………….……....4

Objective………………………………………………………………………………………..... 4

What is stress……………………………………………….……………………………….......4-6

Stress Burnout & Statistics ……………………………………………………………………....6

Causes of Stress……………………………………………………………..……………...….. 6-7

Signs & Symptoms of Stress…...……………………………………………………..…….. …7-8

Anxiety & Depression……….……………………………………………………………..……...8

Affects of stress…………………………………………...…………………………………….8-9

Ways to deal with stress……………………………………………………………….………9-13

Specific Techniques that manage stress ……………………………………………...……...13-14

The program presentation…………………………………………...………………….…….15-17

Responses…………………………………………………………………………………...…....17

Conclusion ……………………………………………………………………………………... 18

Reference…………………………………………………………………………………..…20-24


Abstract

The debilitating affects of stress on the mind and body are wide spread and can be devastating.

Many Americans disregard the signs and symptoms of stress that their bodies are telling them.

This paper will deal with stress, what it is, cause, symptom, affects and ways of dealing with it.

It will also explore the different kinds of techniques that are used to relieve stress. The paper will

then explain what was done in the presentation and what the project was about.


Introduction

Stress-related and stress exacerbated disorders continue to devastate all levels of our

society. From the corporate boardroom working on million-dollar deals to the housewife

working on a household budget, none are immune. How people view life is going to tell them

how healthy they are now and how healthy they may be in the future. Billions of dollars are

spent each year on both allopathic and alternative medicine trying to find a solution to the all-

elusive feeling of health and well being. Most attempts made to obtain a balance in life often fall

way short of the desired outcome-- All except Biofeedback Therapy and self-regulation

techniques. Biofeedback Therapy started in the 1930s as a technique teaching people how to

relax. It has, through the decades, evolved into a major adjunctive therapy to modern medicine

dealing with everything from anxiety, panic attacks, headache, chronic pain, essential

hypertension, digestive distress, insomnia, and chronic fatigue syndrome; just to name a few.

Objective

A stress management program was designed to teach participants how to identify stress in

their lives. The aim of the program was to help participants understand the impact that stress has

on all of them. Not only understanding the kind of stress that impacts them, but how it may

present itself differently in individuals. The goal was to show the participants how to use self-

regulation techniques and how the success of the aforementioned can be taught measured, and

directed using various techniques, to ensure the success of the participants.

What is Stress?

Stress is part of life (Health & Wellness, 2010). It is something that can’t be avoided.

However, people can change the way they react towards stress. Not handling stress in a healthy


way, a person is more likely to have health problems (Health & Wellness, 2010). Stress is a

feeling of tension that can be caused by many different things.

Having a deadline at work to encourage employees to work harder to succeed can be

stressful. People create stress internally and externally. In externalized stress people are unable

to mange stress, they have to manage everything that is around them. There is no control over

externalized stress. Internalized stress deals with how a person feels. The amount of stress that a

person can take is different for each person (Health & Wellness, 2010). The body passes through

three universal stages of coping (Gabriel, 2010). First, there is an alarm reaction that prepares a

person to recognize a challenge or threat that goes into a fight or flight (Gabriel, 2010). In the

second stage, a resistance to stress is being built. The body tends to adapt to a challenging

situation. The coping tends to require physiological resources that eventually get exhausted

(Gabriel, 2010). Finally, if the exhaustion stage occurs it usually means that the stressful

challenge has gone too long. (Gabriel, 2010). Changes in life can be stressful. Losing a loved

one or a job can cause a person to be very stressed. Happy events can cause stress, such as

buying a house (Health & Wellness, 2010).

Health problems can also increase a person’s stress (Health & Wellness, 2010) Stress is

any life change that puts wear and tear on the body. Techniques come and techniques go. What

might be popular one year might not be the next year. It is important to practice techniques that

have long history of success. The longest successful technique is biofeedback, which will be

discussed later. It is important to deal with stress before it results in a mental breakdown. Minor

mental symptoms lead to major ones unless they are stopped early.

Stress affects people at different times of their lives. Everyone has a different way of

coping with stress. As people continue to go through life their stressors will change. Distress


has a negative impact on a person. Distress is caused when changes people feel upset them

(Gabriel, 2010). Eustress has a positive impact on people. It is also, considered as the changes

people feel good about (Gabriel, 2010). Gabriel (2010) states that it is the way a person takes

things that shows whether they are able to adapt to change or not. By accepting change it

reduces the impact of stress on a person (Gabriel, 2010). Stress can be bad as well as good for a

person. Eustress keeps people active and productive in life (Health & Wellness, 2010). It is a

part of life, and even the smallest amount of stress is not bad.

Unfortunately, stress is everywhere from the home and to the job. This involves setting

priorities and working on simple tasks first. Many people believe that stress comes from work,

children, and finances. About half of the stress comes from all people (Health & Wellness,

2010) People tend to worry about things they can’t control.

Dealing with all inner stress can be more difficult to handle than stress coming from the

outside. Inner stress requires individuals to admit they have a problem, identify the source of

their stress, and work to get rid of it (Health & Wellness, 2010). Sadly, if not managed inner

stress can continue to grow in anxiety if not properly treated. This kind of stress can lead to

taking over a person’s life (Health & Wellness, 2010).

Stress & Burnout Statistics

According to the American Psychological Association (2006) most Americans are

experiencing symptoms related of stress. About 77% of people state that they are experiencing

physical symptoms and 73% are experiencing psychological symptoms of stress in one month

(APA, 2006). Some physical symptoms of distress include: general fatigue, stomach upset,

headaches, grinding of the teeth, dizziness, muscle tension, loss of appetite (APA, 2006).

Psychological stress symptoms include: irritability, nervousness, and lack of energy, feeling as


though you could cry, and lying awake at night (APA, 2006). About one third of Americans feel

as though they are living with extreme stress (APA, 2006). The American Psychological

Association (2006) reports that about half Americans feel that their stress has increased over the

past five years.

Causes of Stress

The American Psychological Association study (2007) indicates that work and money are

on the rise as stressors. Another significant source of stress is housing costs, such as mortgage

payments or rent. Americans report that stress has a negative impact on both their personal and

professional lives (APA, 2007). Managing work and family responsibilities is about how a

person feels about these in stress or not that makes it significant source of stress. Some other

sources of stress are workload, children, health concerns, health problems affecting other family

members or parents, and intimate relationships.

It is important to note that not all stress is from external factors. It is an inside job that

equals out to how people feel. Such as, work, relationship difficulties, children and family, being

too busy, and financial problems (Smith, Gill, & Segal, 2009). Stress can also be self-generated

by pessimism, negative self-talk, and inability to accept uncertainty, unrealistic expectations, and

perfectionism (Smith, Gill, & Segal, 2009). Individuals might show these things by worrying

too much, or not trusting themselves and others. A person can prevent these things from

happening if they pay closer attention to the signals their body is trying to tell them (Smith, Gill,

& Segal, 2009). The signals will indicate to the person that they may need to change some

things in their life (Smith, Gill, & Segal, 2009). For instance, the way people work or how they

think about certain situations in their life can cause stress.


Human beings like things to be consistent. If they think bad things are going to happen

they probably will, because people attract in their lives what they think. It is more difficult to rise

above things in their lives if they say they can’t. This is where the old adage “don’t bite off more

than you chew” comes to mind. It is okay to strive to do good work but it is just as important to

know when something is good enough. Having to work long hours on the job and balance family

life can be stressful to any individual. Wanting to please the family and employer it is hard

sometimes to say no.

Signs & Symptoms of Stress

Too much stress can cause many physical or emotional changes within an individual.

Some common effects of stress include: feelings of anxiousness may occur when stressed

(Health & Wellness, 2010). People may begin to feel tense, and their minds may feel like they

having racing thoughts. Forgetfulness and having trouble concentrating may happen to those

who are stressed. Mood changes can occur (Health & Wellness, 2010). One minute they may be

happy and the next sad. Feelings of frustration can also occur. Depression can also take place and

the person may not know why. Substance abuse may take place when individuals are stressed

(Health & Wellness, 2010). All diseases are stress generated and long term consistent stress

breakdown the immune system (Health & Wellness, 2010).

Some physical symptoms that indicate a person is having too much stress may include:

breathing problems (Riley, 2010). People may breathe too quickly or feel like they are not

getting enough air. Dizziness can be experienced when a person has breathing problems (Health

& Wellness, 2010). If this occurs, chest pain may be another sign that a person is having too

much stress. Feeling like their heart is beating harder or faster than usual may occur (Riley,

2010). Headaches, backaches, or stiffness in their neck, shoulders, or other muscles can take


place (Riley, 2010). Most diseases and health problems can become worse if people are overly

stressed. They run the risk of high blood pressure. If they have heart problems they may

experience more chest pains than usual.

Anxiety & Depression

Even though people deal with high levels of stress on a daily basis, the consequences of

poorly managing stress becomes serious. When people are stressed they tend to overeat or not eat

enough (Scholten, 2010). If they do overeat it is likely that they eat unhealthy foods to manage

their stress at the time (Scholten, 2010). Some may even skip meals due to the amount of stress

that is placed on them. Those who smoke or drink engage in self-destructive behaviors when

they are under stress (Scholten, 2010). Shopping, sex, gambling, is addiction and stress reducers

as is exercise.

Watching TV or Internet surfing is used as we’ll to relieve stress (Scholten, 2010). Some

other things people do when under stress are sleeping too much, constant worrying, withdrawing

from loved ones, angry outbursts, and doing too much to avoid stress (Scholten, 2010). The

feeling of anxiety and depression occurs when people are not managing their stress level.

Affect of Stress

Stress affects all areas in life. Adler believed that there are three basic life tasks that

everyone must master work, friendship, and love. In order to be mentally healthy it is important

that an individual master each of the tasks (Carlson, Watts, & Maniacci, 2006, p.13). Adler

believed that the work task was mastered when what the individual did for work was meaningful

and satisfying (Carlson, Watts, & Maniacci, 2006, p.13).

Adler believed that the friendship task was mastered when caring for and contributing to

the welfare of others being family, community, or society (Carlson, Watts, & Maniacci, 2006,


p.13). The love or intimacy task was mastered when people learned to love themselves as well

as others (Carlson, Watts, & Maniacci, 2006, p.13). A majority of the participants stress was

caused by work and love. In all three tasks an individual could have experienced stress.

Lifestyle reflects how a person functions, thinks, and how they identify with the world

and things taking place around them (Oberst & Stewart, 2003, p. 19). Financial threats can lead

to a person feeling stressed all of the time. Going through a divorce can place strain on an

individual. People often tend to base their lifestyles on living up to other people’s expectations.

Meeting the demands of a job can cause people to overwork themselves to please the boss.

An individual’s action serves a basic purpose (Carlson, Watts, & Maniacci, 2006, p12). For

example, being expected to be too many things for too many people can cause stress. Human

beings have many choices and are capable of reasoning. On the other hand, if individuals had no

choice, they would simply be subjected to our environment, the things that influence their life

(Carlson, Watts, & Maniacci, 2006, p. 12).

Ways of Dealing With Stress

Some ways reduction stress will return are to listen to music, read, exercise or walk,

spend time with family and friends, and pray. A lot of people participate in unhealthy ways of

dealing with stress; such as caffeine, alcohol, Internet, over eating and not eating enough. It is

important that people adopt a healthy lifestyle. To do this a person strengthens their physical

health to increase their resistance towards stress (Smith, Gill, & Segal, 2009). They must first

exercise regularly.

To prevent stress, physical activity must be done (Smith, Gill, & Segal, 2009).

Exercising for about 45 minutes, three times a week helps release any tension of stress on the

body. By individuals increasing their fitness levels they are able to sleep better. Any form of


exercising can act as a stress reliever. Exercising increases people overall health and give them a

sense of well being. It is important for people to do an exercise that they love, such as walking,

yoga, bicycling, and tai chi.

Eating a well-nourished healthy diet helps people cope with stress (Smith, Gill, & Segal,

2009). Eating a healthy breakfast, keeps people energized. It is good to eat nutritious meals

throughout the day. To relieve stress junk foods must first be avoided. It’s important to eat more

fruits and vegetables.

Limiting caffeine and sugar from the diet people may feel more relaxed and sleep better.

Having too much caffeine and sugar can lower energy and affect mood (Smith, Gill, & Segal,

2009). To keep blood sugar levels steady and body energized a person must drink water (Smith,

Gill, & Segal, 2009).

Unhealthy eating habits such as sweets cause people to suffer from sleep problems.

Certain foods that people consume in their bodies play a major role in how they function. Sugar

and caffeine makes the adrenals work twice as hard, which leads to causing more stress on an

individual (Smith, Gill, & Segal, 2009). These items may give a temporary boost of energy to

the body, but it eventually leads to loss of energy and fatigue. Avoiding alcohol, cigarettes, and

drugs only relieves stress temporary (Smith, Gill, & Segal, 2009).

It is good to face the problems head on with a clear frame of mind. Avoiding the issue

can later cause trouble. Making sure to get enough rest helps fuel peoples mind and body

(Smith, Gill, & Segal, 2009). Not getting enough sleep may increase their stress level and may

cause irrational thinking (Smith, Gill, & Segal, 2009).

Some relaxation techniques that are used are deep breathing, progressive muscle

relaxation training, autogenic training, guided imagery, and meditation. When these items are


practiced daily it produces a reduction of stress in a person’s everyday life. The client’s

practicing deep breathing may result in their being less anxious and tensed (Smith, Gill, & Segal,

2009). A persons heart rate and blood pressure equals stress, therefore by deep breathing it helps

a person to lower stress in their body (Smith, Gill, & Segal, 2009). By breathing deeply it sends

a message to the brain to calm down and relax. The brain also sends this message to the body

(Smith, Gill, & Segal, 2009). Increased heart rate, fast breathing, and high blood pressure all

takes place when people are stressed (Smith, Gill, & Segal, 2009). However, deep breathing

helps decrease and relax all of the physical symptoms above. The way people breathe can have

affects on their whole body (Smith, Gill, & Segal, 2009). Deep breathing helps people to relax,

reduce tension, and relive stress.

Progressive muscle relaxation training helps individuals become familiar with tension

changes in different muscle groups in their body (Calderon, & Thompson, 2004). The technique

helps people to reduce their overall body tension, by tensing up a group of muscles.

Autogenic training helps remove any signs of tension and disturbances (Calderon, & Thompson,

2004). This technique helps people to become aware of specific body sensations. Autogenic

training reverses stress responses. For example, a person tries to achieve their goal of relaxing

by not working actively as in progressive relaxation (Calderon, & Thompson, 2004). It also

teaches the body to respond to verbal commands (Calderon, & Thompson, 2004). Autogenic

exercise allows individuals to communicate between the mind and body, by influencing their

body reactions, such as, blood pressure, heartbeat, and body temperature (Calderon, &

Thompson, 2004).

Guided imagery helps focuses on mental images and scenes that evoke relaxation

(Calderon, & Thompson, 2004). To reach a calm state of mind individuals must first imagine


their favorite place. Once they have a mental imagine they must close their eyes, relax their

breathing, and try to see and feel their surroundings (Calderon, & Thompson, 2004). To master

guided imagery individuals must first practice with real objects until they are able to vividly

picture them in their mind (Calderon, & Thompson, 2004). For example, listening to audiotapes

can be a good way to visualize imagines when practicing this technique. Meditation techniques

involve having people in a comfortable position with their eyes closed (Calderon, & Thompson,

2004). Having the individual focus their attention on their breathing produces relaxation.

Changing the environment can reduce stress.

There are many ways to deal with stress at work. A lot of people do not know how to

manage their time properly. One way to manage time is to create a to do list (Smith, Gill, &

Segal, 2009). This will help to organize and manage time wisely. Plus it is a nice visual to alert

when there are have too many items on the list to complete in a day.

It is important to never allow to get overly stressed. Asking for help from a friend or

loved one when you need it is important. By having a strong support system it makes it seem as

though you are not alone. Therapy is another way to reduce stress. When an individual comes

into therapy they are able to relieve stress by talking to a professional. The purpose of therapy is

not to remove stress, but to educate people on how to properly manage it. Stress mimics feelings

of depression, which may cause a difference in how an individual performs throughout his or her

day. An extreme level of stress may result in feelings of anxiety. With the help of a professional

the levels of stress can be decreased in return promoting motivation. Through therapy an

individual will develop coping skills and methods to effectively handle stress. Overall, these

tactics will produce ways to cope with situations that may be stressful. This allows individual’s

to function without feeling a weight of stress on them.


Learning how to take more breaks instead of being in the same environment all of the

time can reduce stress (Smith, Gill, & Segal, 2009). For example, going for a 15 minute walk

outside will help make it easier to reduce your stress. By leaving their environment it will make

it easier for them to come back to that same environment with a clear mind. Making little

adjustments can make a world of difference when it comes to limiting stress in life (Smith, Gill,

& Segal, 2009).

Listening to music relieves stress. It allows individuals to continue their regular activities

without taking away time from their busy schedule. Music can take an individuals mind off of

all that they need to get done for the day (Smith, Gill, & Segal, 2009). This will allow them to

approach their day with less stress. When it comes to dealing with stress, the right music can

lower blood pressure; relax a person’s body and mind (Smith, Gill, & Segal, 2009).

Specific Techniques That Manage Stress

Many people don’t recognize how stressed they are. Creating a list of stressors will help

people pay close attention to their response of stress (Stein, 2001). For example, arguments and

job demands that trigger symptoms of stress could be listed. It is important that take note of the

changes that is occurring in body. Know what symptoms are and how many times they

symptoms occur; including back pain, anxiety, insomnia, and headaches.

Keeping a log on what the person is feeling and experiencing when their stressed (Stein,

2001) or finding a secluded place to practice techniques without any interruptions or distractions

(Stein, 2001) would be helpful. When starting a new technique people should start out slow and

increase over time when they can handle it. Techniques should be incorporated into daily routine

(Stein, 2001). Set some time aside either once or twice a day to practice. It is best to practice

during the morning, instead of later on during the day when errands need to be done. People


should try and keep the same schedule for the technique at the same time each day (Stein, 2001).

This way the routine will become easy to do.

Changing of attitude can help lower stress levels. When self-talk becomes negative, the

perception leads to more stress (Smith, Gill, & Segal, 2009). It also hinders people from taking

the appropriate action to improve a situation and create more problems (Smith, Gill, & Segal,

2009). This prevents people from overcoming stress. Changing negative self-talk into positive

ones helps an individual to overcome their stressful situations (Smith, Gill, & Segal, 2009).

Positive thinking creates a healthy mindset.

Changing the atmosphere can reduce stress. Getting rid of clutter must first be removed

to reduce stress (Stein, 2001). Things that don’t need work should be pushed aside for later. If

the important things are prioritized stress can easily be avoided.

Biofeedback therapies are used to manage stress. It’s the use of medical equipment that

allows the person to monitor changes in biological activity that was thought to be involuntary

such as blood pressure, headache and pain (Calderon, & Thompson, 2004). A person can know

exactly the effects of stress on mind and body (Calderon, & Thompson, 2004). Biofeedback

provides information that is not normally available about what is happening within the body of

the individual. Voluntary control of bodily functions can be learned. The trained therapist serves

as a coach guiding the patient in relaxation techniques, self-regulation, self-awareness and home

practice.

Managing time can be a good effective way to control stress. Prioritizing tasks and

avoiding over commitments are crucial to making sure a person not overscheduled (Stein, 2001.

Using a calendar or planner helps a person to manage their time without over committing.

Keeping a diary or journal to identify time wasting tasks can help people to notice where they


may be losing time (Stein, 2001). When managing time, people must leave enough room in their

daily calendar to accommodate any crises and last minute emergencies. People can reduce their

tasks, and stress by asking for help. For example, children can do simple tasks such as washing

the dishes, and sweeping the floor. This can shorten the list of tasks that needs to be completed.

The Program Presentation

An experiential project was designed to provide the community with self-techniques on

how to manage their stress. Further research was conducted on stress management to determine

what stress is and how it affects the mind and body of people. The project focused on many

ways of dealing with stress. Two PowerPoint presentations on stress management were

developed and presented to the city of Richfield employees. A handout was given to participants

at the workshop on how to reduce their stress through self-help.

At the City of Richfield, fifteen city employees participated in the stress management

program. A majority of the participants were women in their 50 who either have young children

or are empty nesters at home. To promote the lunch & learn workshop flyers were sent to the

employees email. For each employee that attended the workshop they earned 5 points in the

2010 live healthy wellness program. The participants would also be eligible to win casual day

stickers if they came to the workshop. A pretest was administered in the beginning to determine

the participant’s baseline of knowledge of stress. Adler’s three life tasks was used to ask the

participants whether they have experienced stress in love, friendship, and work. Many of the

participants expressed that there is never enough time in the day to fulfill their obligations as a

parent and employee.

Diaphragmatic breathing was one of the instruments that was used to conduct the

program. The instrument consisted of the participants sitting down comfortably, with their knees


bent and shoulders, head and neck relaxed. They placed one hand on their upper chest and the

other just below their rib cage, allowing them to feel their diaphragm move as they breathe

(Calderon, & Thompson, 2004). Next, they were instructed to tighten their stomach muscles,

letting it fall inward as they exhaled through their mouth (Calderon, & Thompson, 2004).

Participants were informed that when practicing diaphragmatic breathing their hands on the

upper part of the chest must remain still as possible (Calderon, & Thompson, 2004). This

guaranteed that the participants were practicing the technique correctly. As babies they

automatically breathe properly, however somewhere between infancy and adulthood the majority

of us switch to rapid breathing as stressors compound and multiply. Sympathetic when activated

prepares them to fight a battle or walk away. If they can’t do neither they will become ill.

A relaxation tape was played for the participants. Before the tape began each individual

was instructed to rate him or herself on a 1-10 scale. With 1 being the least stressed and 10 being

the most stressed. The participants were asked than to sit in a comfortable position with their

hands being a part from their body. As the tape began participants began to follow the

instructions on the tape. When the tape was over, the participants were asked to rate themselves

again to see if they were able to see any change from the first score. Most of the participants

stress level came down tremendously when they rated themselves for the second time.

A seven-question survey was administered to participants. To keep the participants

responses unknown, they were informed to not place their names on the survey, and to turn it

over when they are done. Many of the participants felt that they needed more information on

what they can do on their own to prevent stress. As a group we discussed some other options to

reduce stress. Some of those options were, yoga, changing environment, reading, karate, making


personal time for self, asking for help if needed. Others within the group thought that the

breathing technique was helpful.

Many of the participants became overwhelmed in the presentation when they discussed

their stressors. Majority of their stressors came from work and family life. The strain of

balancing and maintaining a household and work was a major issue for the group. Not having

enough time caused many of the participant’s stress. The group talked about ways they managed

their stress. Some read, while others practiced yoga and drink alcohol. The group had many

activities taking place throughout their daily lives and they didn’t know how to prioritize what

was important to them. After the presentation was over the group realized that most of their

stress came from mismanaging their time, and unhealthy behaviors of coping with stress. One

thing the group learned from the presentation was to focus on the things that are important rather

than focus on the things that are not important. They also learned to slow down and ask for help

when they are stressed.

Conclusion

In conclusion, Americans adopt unhealthy ways of dealing with stress such as drinking,

smoking, procrastinating, overeating, and sleeping too much. How much stress an individual can

take is different in each person. The lack of knowledge of the enormity caused by stress on the

various systems within the mind/ body is well documented. Americans in their homes and

workplace are experiencing high levels of stress. Biofeedback therapy is one of the oldest and

best research techniques in controlling the wear and tare of stress on mind and body.

When stress is encountered symptoms tend to go unnoticed; responses remain undetected

and become a habit that is hard to break. A lot of people experience significant amounts of stress

when work begins to interfere with personal time. Having an intimate relationship can also lead


to stress. For example, arguing or fighting with a loved one can lead to stress. Stressors cause

people to react interpersonally, familial, and through job related events. Stress can either affect

in a positive or negative way. If stress remains and progresses overtime it can lead to chronic

habits and ultimately to pain. It is best to be aware of the changes that is occurring in your body,

to make a change in your lifestyle.

Stress is an unavoidable part of an individual’s life, which consists of deadlines,

competitions, relationships, deaths and births. When stress is not properly handled it can lead an

individual to be emotionally unstable, and angry. These symptoms could cause an individual

health many problems. For instance, they can develop ulcers, high blood pressure, headaches, or

strokes.


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