Coping with stress through healthy thinking Published June 22, 2016 By Prerana Korpe Air Force Surgeon General Public Affairs FALLS CHURCH, Va. (AFNS) -- Stress. Even the mention of the word can increase anxiety for some. Everyone deals with stress differently, but how a person copes with daily stressors can have great impacts on their quality of life and overall health. Stress is actually the body’s response to any demand, including change. According to the National Institute of Mental Health, there are at least three types of stress that can create risks to physical and mental health. These include routine stress from daily pressures; stress brought about by a sudden negative life event; and traumatic stress, which can be experienced after a distressing or life-threatening event. Not all stress is bad. The Centers for Disease Control and Prevention reported that stress can help people develop coping and adaptation skills to deal with new or potentially harmful life situations. Stress is a natural phenomenon that helps people develop the ability to deal with challenges, obstacles and even failures. Maj. (Dr.) Joel Foster, the chief of Air Force Deployment Mental Health, explained that coping with daily stressors in a healthy way and getting the right care can help put problems into perspective, and reduce the negative impact of stressful feelings. Just like practicing a sport improves agility and strength, actively managing stress day to day can help build adaptive resistance to the negative effects of stress. “Life is full of challenges. It is important to recognize and embrace this,” Foster said. “If you have expectations that things are going to be easy, you are setting yourself up to experience a lot of frustration. It is important to have realistic expectations of how things will be. “Everyone faces daily stressors,” he continued. “Experiencing this stress does not mean there is something wrong with you and the avoidance of problems should not be the ultimate goal.” The Air Force is actively engaged in social norming campaigns that provide information to help people feel more comfortable about seeking and receiving care, in an effort to promote healthy lifestyle behaviors. There are healthy ways to manage stressors and people are encouraged to seek appropriate care as needed. The emphasis is that healthy people seek the help they need. “We are not intended to manage these stressors alone,” Foster said. “Reaching out for help is a sign of strength, not weakness.” Healthy coping is about aligning thoughts with reality. “Many people do not align thinking with reality and distortions in thinking can lead to depression and anxiety,” he said. According to Foster, distortions in thinking are thoughts just below the surface of awareness. People usually do not say them out loud, but they guide one’s behavior. These distortions influence the way people feel and behave. Part of healthy thinking is to examine these distortions and make corrections to align one’s thoughts with reality. Take for instance, striving for excellence. While this is a positive goal, it is important to remember that each person fails at some time. The process of learning from those mistakes and failings and realistically assessing the situation is critical to maintaining healthy thinking. Making mistakes or failing at some point is expected and this is part of the journey towards excellence. When someone makes a mistake, they should quickly bounce back rather than going down the path of cognitive distortion. For example, instead of fixating on the mistake or failure, accept that everyone makes mistakes. Part of healthy thinking and adapting to stress is to recognize when distorted thinking may arise. It is important to recognize this and make an active effort to put the stressful thought into perspective. Adaptive coping is a healthy strategy for everyone, Foster explained. Healthy thinking helps to avoid cognitive distortions, or mistakes in thinking. ABCs of emotion: - “A” stands for activating event. - “B” stands for belief system. - “C” stands for consequence, which is an emotion or behavior resulting from the belief system. Fosters said it’s important for people to understand the relationship between these three variables. Take for example, when someone makes a mistake at work. This would be considered the activating event. If a person considers the consequence, they might feel depressed or sad. It is important then to examine the belief system, through which everything is filtered. A, making a mistake at work, filters through B, the belief system, to get to C, the consequence, which is the emotion or action resulting from A processed through B. If, for example, a person believes they have to be perfect and that it’s a terrible thing to fall short of perfection, then a mistake can result in distorted thinking and adverse emotions or actions may ensue. It is important to adjust the belief system in order to process activating events in a healthy way and avoid mistakes in thinking. A healthy alternate involves replacing the maladaptive irrational thought with an adaptive, rational thought. Irrational thought: I have to be perfect all the time. Replace with rational thought: I would like to be perfect all the time but it is alright to make mistakes. I can learn from making mistakes. I will achieve excellence only by learning from my mistakes. 1. Identify your thought. Can you see recurring thoughts or themes? 2. Challenge the thought. Evaluate the thought and look for evidence for or against it. Does the thought make sense? Is it an irrational thought that is not consistent with evidence and reality? Would this thought be supported in a court of law? Is there any evidence that disputes this thought? 3. Replacement. Replace the thought with something more reality based. Replace the maladaptive irrational thought with more adaptive rational thoughts. Thinking, emotions and behaviors are inter-correlated. The more a person makes an active effort to engage in healthy thinking and the more realistic their thoughts, the more positive their thoughts and they will be engaged in the positive feedback loop. The goal of the ABC model is not to go from negative thinking to positive thinking, Foster explained. “It is about making subtle changes in irrational distorted thoughts. It is important to bring thoughts more in line with reality,” he said. “Making small changes can have a huge impact on quality of life.” Something like changing a thought from “I must be perfect all the time,” to “I would like to be perfect all the time,” can make a huge impact. The outcome is not that a person does not feel any negative emotions, but they are less intense, do not last as long, and do not lead to extreme behaviors. Foster emphasized that it’s important to work within the context of life. The goal is not to avoid problems but to embrace challenges and work through them with rational, adaptive, reality-based thoughts. This is the basis for healthy thinking. Rational thinking is very much in line with the Comprehensive Airman Fitness model, which includes four pillars: physical, spiritual, mental and social. Maintaining a good balance in these areas leads to more healthy outcomes, Foster said. For example, physical exercise reinforces good mental functioning because of changes within the brain resulting from exercise. These changes have mood elevating effects. Social relationships can influence the way a person thinks about himself. The spiritual domain encompasses an awareness of a person’s values. This involves contributing to the world in a meaningful way. Leading a life that is full of purpose and meaning is an important factor that contributes to people’s sense of wellbeing. Improving the way a person thinks decreases cognitive distortions and allows people to bounce back from disappointment, overcome adversity and maintain a sense of meaning and purpose throughout life’s challenges. “Most of the research that has been conducted in the area of psychotherapy -- particularly psychological disorders -- demonstrates that cognitive behavioral therapy is probably the most effective form of intervention for people with psychological distress and disorders,” Foster said. Cognitive behavioral therapy (CBT) builds on the ABC model to examine the relationship among events, beliefs, behavior and emotions. From this approach, it is not the events that can make a person feel miserable, but the interpretation of those events. The CBT model is short-term, typically ranging between six to 12 sessions with an outpatient therapist. Depending on the issue at hand, these sessions lend themselves to the compressed military environment and offer time-limited therapy in lieu of several months of treatment. “CBT is highly effective, adaptable and easily taught,” Foster said. “We have very good research to support this type of intervention.” Individuals interested in exploring CBT are encouraged to talk to their health care provider. The Air Force Behavioral Health Optimization Program uses cognitive therapy models and offers behavioral health care through a primary care setting. BHOP is available to all beneficiaries and does not require a referral.