Prologue 📖
One morning while taking a shower 🚿, David felt a small lump in his chest. He was sure it had not been there before. It didn't hurt 🤕, but he was momentarily alarmed ⚠️—his father had had chest cancer 🎗️ a few years before. "It could be a pimple or some other benign growth 💭," he thought. Still, it was very worrisome 😟. He decided not to tell his wife 👫 or his physician 🧑⚕️ about it yet because as he thought, "it may not be anything." Over the next several days 📅, he examined the lump daily 🔍. This was a very stressful time 😰 for him; and he slept poorly 😴❌ and seemed preoccupied 🤔. After a week ⏱️ without the lump changing, he decided to take action 🎯. He told his wife about the lump and made an appointment 📋 to see the physician 🏥.
Another man, Jack, had a similar experience. Finding a lump 🔍 on his chest alarmed him ⚠️, but he didn't deal with the stress as rationally as David did. Jack's initial fright 😱 led him to reexamine his chest just once, and in a cursory way. He told himself 💭, "There isn't really a lump on my chest, it's just a rough spot," and he convinced himself that he should not touch it because, he thought, "That will only make it worse." During the next few months ⏳, Jack was quite worried 😟 about the "rough spot." He studiously avoided touching it 🙅♂️, even while washing. He became increasingly moody 😠, slept poorly 😴❌ and developed many more headaches 🤕 than usual. He also told his wife that he didn't like his body to be touched 🚫. When she asked why he was acting so differently in recent weeks, he denied ❌ that anything was wrong. Jack finally mentioned the "rough spot" to a friend 👥 who convinced him to have his physician 🧑⚕️ examine it.
People vary in the ways they deal with stress 😰. Sometimes people confront a problem directly and rationally 🎯, as David did, and sometimes they do not. For these two men, the way they dealt with their stress had the potential for affecting their health 🏥. Because Jack did not face up to the reality of the lump, he delayed seeking medical attention ⏰ and experienced high levels of stress 📈😰 for a long time ⏳. If the lump were malignant 🎗️, delaying treatment would allow the cancer to progress and spread 📈. As we have seen, prolonged stress ⏳😖 can have adverse health effects ⚠️ even in healthy people 🧍♂️.
In this lecture we will discuss the ways people can and do deal with stress 💪. Through this discussion, you will find answers to questions you may have about the methods people use in handling stress 🧠. Are some methods for coping with stress more effective than others ❓ In the coming lectures we will discuss how people can reduce the potential for stress in their lives 📉. Also, when people encounter a stressor 😰, how can they manage and reduce the strain it produces 💪?
Coping With Stress 💪😰
Individuals of all ages 👶👧🧑👴 experience stress and try to deal with it. During childhood years 👶, people learn ways to manage feelings of stress 😟 that arise from the many fearful situations 😱 they experience.
What is Coping? 🤔
Because the emotional 😢 and physical strain 😰 that accompanies stress is uncomfortable, people are motivated 🎯 to do things to reduce their stress 📉. These "things" are what is involved in coping 💪.
What is coping? Several definitions of coping exist. We will use a definition that is consistent with the way we defined stress earlier. Earlier we saw that stress 😰 involves a perceived discrepancy ⚖️ between the demands of the situation and the resources of the person. Since people engage in coping in an effort to neutralize or reduce stress 📉, coping activities 💪 are geared toward decreasing the person's appraisal of or concern for this discrepancy ⚖️.
Thus, coping is the process 🔄 by which people try to manage 💪 the perceived discrepancy between the demands and resources they appraise in a stressful situation 😰.
The word "manage" in this definition is important ⚡. It indicates that coping efforts 💪 can be quite varied and do not necessarily lead to a solution of the problem ✅. Coping efforts can—and, some would argue, should—be aimed at correcting or mastering the problem 🎯. But they may also simply help the person alter his or her perception 👁️ of a discrepancy, tolerate or accept 🤝 the harm or threat, or escape or avoid 🚪 the situation.
For example, a child 👶 who faces a stressful exam 📝 in school 🏫 might cope by feeling nauseated 🤢 and staying home 🏠. We cope with stress through our cognitive 🧠 and behavioral 🧍♂️ transactions with the environment 🌍.
Suppose you are overweight 🍔 and smoke cigarettes 🚬, and your physician 🧑⚕️ has asked you to lose weight 📉 and stop smoking 🚭 because several factors place you at very high risk ⚠️ for developing heart disease ❤️💔. You have a threat ⚠️: you may become disabled or die ☠️. This is stressful 😰, but you don't think you can change your behavior 🔄❌. How might you cope with this? Some people would cope by seeking information 📚 about ways to improve their ability to change ✨. Other people would simply find another doctor 🧑⚕️ who is not so directive. Others would attribute their health to fate 🎲 or the will of God 🙏, and leave the problem "in His hands." Still others may try to deaden this and other worries with alcohol 🍺 or other similar substances, which would add to the risk ⚠️.
People use many different methods 🔄 to try to manage the appraised discrepancy ⚖️ between the demands of the situation and their resources. This is called the coping process 🔄.
The coping process is not a single event ⚡. Because coping involves ongoing transactions 🔄 with the environment 🌍, the process is best viewed as a dynamic series of continuous appraisals 🔍 and reappraisals 🔄 of the shifting person—environment relationships. Shifts may be the result of coping efforts 💪 directed at changing the environment 🌍, or coping directed inward 🧠 that changes the meaning of the event or increases understanding 💡. They may also be the result of changes in the environment 🌍 that are independent of the person and his or her coping activity. Regardless of its source, any shift 🔄 in the person—environment relationship will lead to a re-evaluation 🔍 of what is happening, its significance, and what can be done. The re-evaluation process, or reappraisal 🔄, in turn influences subsequent coping efforts 💪.
And so, in coping with the threat ⚠️ of serious illness 🤒, people who make efforts to change their lifestyles 🔄 may receive encouragement 👍 and better relationships 👥❤️ with their physician 🧑⚕️ and family 👨👩👧. But individuals who ignore the problem 🙈 are likely to experience worse and worse health 🏥⬇️ and relations with these people 👥❌. Each shift 🔄 in one direction or the other is affected by the transactions that preceded it and affects subsequent transactions.
Functions and Methods of Coping 🛠️💪
You have probably realized by now that people have an enormous number of ways 🔄 for coping with stress 😰. Because of this, researchers 👨🔬 have attempted to organize coping approaches 📋 on the basis of their functions and the methods they employ.
Functions of Coping 🎯
According to Richard Lazarus 👨🔬 and his colleagues, coping can serve two main functions 2️⃣. It can alter the problem ✏️ causing the stress or it can regulate the emotional response 😢 to the problem.
Emotion-Focused Coping 😢💭
Emotion-focused coping 😢 is aimed at controlling the emotional response 😰 to the stressful situation. People can regulate their emotional responses through behavioral 🧍♂️ and cognitive 🧠 approaches. Examples of behavioral approaches include using alcohol 🍺 or drugs 💊, seeking emotional social support 👥❤️ from friends or relatives, and engaging in activities 🏃♂️, such as sports ⚽ or watching TV 📺, that distract one's attention 👀 from the problem.
Cognitive approaches 🧠 involve how people think 💭 about the stressful situation. In one cognitive approach, people change the meaning 🔄 of the situation—for example, by deciding, "There are worse things in life than having to change jobs 💼 because of my heart condition ❤️," or, "Now that my girlfriend 💔 has left me, I realize that I really didn't need her 🙅♂️." Another cognitive approach involves denying 🙈 unpleasant facts, as Jack did with the lump on his chest.
People tend to use emotion-focused approaches 😢 when they believe they can do nothing ❌ to change the stressful conditions. An example of this is when a loved one dies 💔—in this situation, people often seek emotional support 👥❤️ and distract themselves with funeral arrangements ⚰️ and chores at home 🏠 or at work 💼. Other examples can be seen in situations in which individuals believe their resources are not and cannot be adequate 📉 to meet the demands of the stressor. A child 👶 who tries very hard to be the "straight A" student 📚 his or her parents 👨👩👧 seem to want, but never succeeds ❌, may reappraise the situation 🔄 and decide, "I don't need their love 💔."
Problem-Focused Coping 🎯🛠️
Problem-focused coping 🎯 is aimed at reducing the demands 📉 of the stressful situation or expanding the resources 📈 to deal with it. Everyday life 🌍 provides many examples of problem-focused coping, including quitting a stressful job 💼🚪, negotiating an extension 📅 for paying some bills 💰, devising a new schedule 📋 for studying 📚 (and sticking to it ✅), choosing a different career 👔 to pursue, seeking medical 🏥 or psychological treatment 🧑⚕️, and learning new skills 📚✨. People tend to use problem-focused approaches 🎯 when they believe their resources or the demands of the situation are changeable 🔄. For example, care-givers 👩⚕️ of terminally ill patients use problem-focused coping 🎯 more in the months prior to the death ⏳ than during bereavement 💔.
Methods of Coping: Skills and Strategies 🛠️📋
What types of skills and strategies 🔧 do people use in altering the problem 🔄 or regulating their emotional response 😢 when they experience stress 😰? The following list 📋 describes several commonly used ways of coping that Susan Folkman 👩🔬, Richard Lazarus 👨🔬, and their colleagues (1986, 1988) identified from their research 📚. The strategies are labeled as serving problem- 🎯 or emotion-focused 😢 coping functions and give examples of cognitive 🧠 or behavioral 🧍♂️ efforts a hospital patient 🏥 might make when using each strategy. Coping methods that focus on emotions 😢 are important because they sometimes interfere ⚠️ with getting medical treatment 🏥 or involve unhealthful behaviors 🍺🚬, such as using cigarettes, alcohol, and drugs to reduce tension 😰.
Ways of Coping with Stressful Situations 💪📋
Planful Problem-Solving (Problem-Focused) 🎯🧩
Analyzing the situation 🔍 to arrive at solutions ✅ and then taking direct action 🎯 to correct the problem. For instance, Roy, a hospital patient 🏥 who needs to choose a specialist 🧑⚕️ for a serious illness 🤒, might seek and study information 📚 about different specialists before choosing ✅.
Confrontive Coping (Problem-Focused) 💪⚡
Taking assertive action 💪, often involving anger 😠 or risk-taking 🎲, to change the situation 🔄. For example, if Roy's medical insurance 💳 balks at paying ❌ for a desired treatment, he might stand his ground 🛡️ and fight 💪 for payment.
Seeking Social Support (Problem or Emotion-Focused) 👥❤️
Trying to acquire informational 📚 or emotional 😢 support. For instance, Roy might ask friends 👥 and nurses 👩⚕️ about different specialists (informational support 📚 with a problem-focused function 🎯) and describe his worries 😟 to get comfort 🤗 and encouragement 👍 from people he loves 👥❤️ (emotion-focused function 😢).
Distancing (Emotion-Focused) 🙈😢
Making cognitive efforts 🧠 to detach oneself 🚪 from the situation or create a positive outlook 🙂. As an example, Roy might try not to think about 🙈 the health-related problems 🤒 he's facing or try to make light of them 😅.
Escape-Avoidance (Emotion-Focused) 🚪🙈
Thinking wishfully 💭✨ about the situation or taking action to escape 🚪 or avoid 🙅♂️ it. For instance, Roy might engage in fantasies 💭 of miracles ✨ or other external happenings that would make his problems go away 🌈, or he might try to avoid dealing with the problems by sleeping 😴 or using alcohol 🍺 a lot.
Self-Control (Emotion-Focused) 🧘♂️🎚️
Attempting to modulate one's own feelings 😢 or actions 🧍♂️ in relation to the problem. Roy might hide his feelings 🙈 to prevent emotional interactions 💬 with others or slow down the pace ⏱️ of decision making to prevent impulsive choices 🎲❌.
Accepting Responsibility (Emotion-Focused) 🤝✅
Acknowledging one's own role 🙋♂️ in the problem while also trying to put things right ✅. For example, Roy might lecture himself 💭 for not having gotten medical attention 🏥 sooner and promise 🤝 to respond to symptoms 🤒 more promptly in the future ⏭️.
Positive Reappraisal (Emotion-Focused) 🙂✨
Trying to create a positive meaning 💭 from the situation in terms of personal growth 📈, sometimes with a religious tone 🙏. For instance, Roy might become a better 📈 or stronger 💪 person from the experience or feel that he has developed a stronger faith 🙏✨.
Each of these strategies 📋 is quite broad and can be applied in many ways 🔄 and situations. To clarify how people use emotion-focused methods 😢, we can describe some variations on the strategies described above.
Additional Coping Variations 🔄✨
Emotional Discharge 😢💬
For instance, people may engage in a coping method called Emotional discharge 😢, which involves expressing or releasing their feelings 💬 about a stressful situation 😰. This approach usually occurs in conjunction with seeking social support 👥, such as with friends 👫 or family 👨👩👧 or in support groups 👥, and can also involve using jokes 😂 or gallows humor 😅. For instance, a man jokingly nicknamed himself "Semicolon" 😄 after part of his cancerous colon 🎗️ was removed.
Cognitive Redefinition 🧠🔄
Cognitive redefinition 🧠 is a strategy whereby people try to put a good face 🙂 on a bad situation 😞, such as by noting that things could be worse 🤔, making comparisons 📊 with individuals who are less well off 👥, or seeing something good 🌟 growing out of the problem.
People who want to redefine 🔄 a stressful situation 😰 can generally find a way to do it since there is almost always some aspect of one's life 🌍 that can be viewed positively 🙂. Optimistic individuals 😊 are more likely than pessimists 😞 to use problem-focused methods 🎯 and to redefine their situation in a positive way 🙂✨.