Coping with Stress

6.1 Lazarus and Folkman's Transactional Model (1984)

The foundation of modern coping theory. Stress results from a transaction between person and environment. The key mechanism is cognitive appraisal:

Primary Appraisal: "What does this mean for me?"

• Irrelevant: No consequences for me
• Benign-positive: Good, nothing to worry about
• Stressful: Harm/loss, threat, or challenge

Secondary Appraisal: "What can I do about it?"

• What coping options are available?
• What is the likelihood of success?

The perceived stress depends on the gap between perceived demands (primary appraisal) and perceived coping resources (secondary appraisal). If resources appear sufficient, stress is low.

6.2 Types of Coping

Dimension	Problem-Focused	Emotion-Focused
Target	Source of stress itself	Emotional response to stress
When Useful	When stressor is controllable	When stressor is uncontrollable
Strategies	Planning, problem-solving, assertiveness, time management	Relaxation, social support, reappraisal, humour
Examples	Study harder before an exam, negotiate with a boss	Meditation after a loss, talking to friends

Avoidance coping (denial, substance use, disengagement) provides short-term relief but is maladaptive long-term - associated with higher burnout and psychiatric morbidity.

6.3 Specific Coping Strategies

Individual-level:

1. Physical exercise: Reduces cortisol, increases endorphins; most robust stress-reduction strategy
2. Relaxation techniques: Progressive muscle relaxation (Jacobson), diaphragmatic breathing, meditation, yoga
3. Mindfulness-Based Stress Reduction (MBSR): Jon Kabat-Zinn (1979); 8-week program; strong evidence for burnout reduction
4. Cognitive restructuring: Identifying and challenging stress-inducing thought patterns (from CBT)
5. Social support seeking: Emotional support (empathy), informational support (advice), instrumental support (tangible help)
6. Time management: Prioritisation (Eisenhower matrix), delegation, saying no to non-essential tasks
7. Positive reappraisal: Reframing a stressful situation as a growth opportunity

Organizational-level:

1. Employee Assistance Programmes (EAPs): Confidential counselling, mental health resources
2. Job redesign: Increasing autonomy, clarifying roles, reducing overload
3. Flexible work arrangements: Work-from-home, flexi-hours, compressed workweeks
4. Mentoring and peer support: Reduces isolation, builds social capital
5. Training and development: Skill building increases self-efficacy and reduces role-related stress