Dr. Jane Chen's 2018 presentation of stress management based on a CBT model
Dr. Jane Chen’s 2018 presentation of stress management based on a CBT model

Qin Chen is a PhD in cognitive psychology and a licensed clinical professional counselor. The following presentation is meant to be used as a self-help tool for reduction of stress symptoms. It is based on a CBT model. Please keep in mind, if your stress becomes aggravated, e.g., turns into persistent anxiety, depression, repeated relationship difficulties, being unable to take care of routine household responsibilities or, being unable to complete regular tasks at work, you need to seek care from a mental health counselor.

If you are looking for insight driven psychodynamic therapy, please contact me at 773-614-0536 or email jane@jc-therapy.com. During the COVID-19 pandemic, I am providing therapy mainly through a confidential HIPAA compliant video platform. Occasionally, in-person sessions can be arranged. My office is located in downtown Chicago. For fees, insurance coverage and other information, please consult my Psychology Today profile.

Understanding Stress

What is Stress?

Stress is a perception. It is your body’s response to the anticipation of a challenge. Acute or Episodic Stress and Chronic Stress are the two main types of stress. The physiological aspect of stress is caused by the release of hormones, such as adrenalin. There are two types of stress Acute or Episodic Stress and Chronic Stress.

Here is an example for an episodic stress:

You are crossing a big street, which you walk across every day and know the traffic light is going to turn red in about 30 seconds. Now, all of a sudden (that is, 20 seconds sooner than you have expected) the light is blinking yellow and a car is driving at full speed towards you! Instantly, your body heats up, your heart starts to race…, and within two seconds, you are dashing towards the other side. In this case, stress is the sudden change of the traffic light and the reckless driver, your anticipation of fatality or severe injury, and your body’s reaction to avoiding being hit by the car!

Acute or Episodic Stress

Acute or episodic stress
Acute or episodic stress

The trigger of an acute stress usually is an intense event, a perceived threat, or a challenge. Although it is intensely physical (i.e., entailing our body’s immediate reaction), it is short-lived. Our response to an acute stress is known as the fight-or-flight response.

Typical signs include shaking (from adrenalin), rapid heartbeat, sweating, dry mouth, upset stomach, unstable blood pressure, quick impulsive judgement and increased energy levels.

Signs of acute stress
Signs of acute stress

Chronic Stress

Chronic stress is our response to pressure suffered for a prolonged period of time. Although its etiology varies, it usually centers on a perception of little or no control. The effects of chronic stress can not only be harmful on their own, but they also can contribute to the development of physical illness, anxiety disorders and mood disorders, such as depression and PTSD. Here are some examples of chronic stress: Anticipated failure in school, a chronic illness, or financial difficulties.

Signs and Symptoms of Chronic Stress

Presentation in the Body

An Illustration of presentation of chronic stress in the body
Illustration of presentation of chronic stress in the body
  • Tension headache (contraction of muscles in the back of the neck)
  • Dizziness, lightheadedness
  • Skin irritation
  • Somatic vigilance
  • Non-cardiac chest pain, aches, and pains
  • Increased muscle tension
  • Eating problem (overeating or no appetite)
  • Stomach problems
  • Sleeping problem – Insomnia
  • Exhaustion (adrenal fatigue)
  • Loss of sexual desire or ability
  • Increased vulnerability to infection, e.g., Frequent colds

Presentation in the Thoughts

Signs of chronic stress: disorganization, forgetfulness, inability to focus, being negative or pessimistic, irritable or angary.
Signs of chronic stress: thoughts

Presentation in the Thoughts

Signs of chronic stress in behaviors included nervous behaviors, increased use of alcohol, cigarettes or substances and, self-harming behaviors.
Signs of chronic stress: Behaviors

Two Sides of Stress

Stress often is bad, but some amount of stress can be positive
Two-sides of stress

Feeling stress is not necessarily a negative input in and of itself. We all have stories to share in which mild stress can actually be beneficial. I know a little girl who has a natural talent playing piano and goes to competitions. She would complain about stress days or even weeks prior to a competition. Yet, during the competition, she would perform beautifully, usually better than the best time she ever practiced. Like this little girl, some people say that they “thrive under a little stress”. Positive aspects of stress include adaptation to urgency (e.g., stress spurs us into action) and heightened awareness, increased motivation and energy.

Positive aspects of stress include adaptation to urgency and heightened awareness, increased motivation and energy.
Stress is not always bad.

When Stress Is Too Much

When stress turns into distress or develops into physical illness, anxiety disorder or mood disorder, we are in trouble.

Distress is the emotional state we are trapped in when we fail to adapt to stressors and become, for example, extremely worried, pained, or sad all the time. When stresses develop into an anxiety disorder, for example, we experience a feeling of distress, unease, or a persistent and excessive worry or dread even in the absence of a stressor. Now, we not only cannot manage the stressor itself, but also become incapable of general functioning as effectively even in the absence of the stressor. We are paralyzed or in a mode of dysfunction.

Stress Management

Stress management: A self-help tool
Stress management: A self-help tool

Stress is a part of modern life. I am not sure if we can get rid of stress entirely, but there are approaches that we may adopt to gain control over our stress. Here, we are going to talk about how we can take the matter into our own hands and try to tackle the problem by seeking a conducive environment, by managing our time wisely and by having our goals and priorities in check. We can also channel our thoughts by staying positive, using humor, and self-talk. Last but not least, I would like to direct our attention to the importance of utilizing our support systems and practicing self-care.

Time Management

This is perhaps the most intuitive part of stress management. The essence of it is simple: Tackle the problem by spending time on it, wisely. When it comes to stress, some tend to drag their feet and choose to do “fun things” first, or even “boring things” first. However, the longer we put things off, the more worried we become. We started by worrying about a task… Now we are spending a lot more time worrying about that worry. The cycle goes on.

When you are sweating over a deadline, try to be rational. Delay or procrastination will only add work to you. Time management comes to the rescue when we carry out activities around priorities and reduce time spent on non-priorities. How about considering taking a break from spending so much time every day on Twitter, Facebook, gaming, movies, or just swiping your phones aimlessly? The point is to work smarter, not necessarily harder. When we are mindful of our “prime time”, that is the time when we are most alert and keen, we are more likely to insulate and protect our time. A related note is environment. An effective workspace is conducive to productivity and well-being. A tidy office, for instance, helps in completing paperwork or tasks. Equally important is the removal of distraction.

Time is like money. With money, we budget what type of apartment we can pay for, what kind of grocery items to get, what type of cars to buy, etc. We should similarly budget our time. How do we set priorities and goals? Sometimes it is an extensive list written out on a sheet of paper; Sometimes it is what you enter in an app; Sometimes it is what you store in your head. It does not have to be formal.

An Example:

Last weekend, I was hoping to hang out with a few friends, but there was a deadline on a project and a presentation to prepare. It was not an easy call, but I decided not to let work lend itself into a stressor… Here I am, talking about stress management, but I am not stressed myself. Well, it could be a different situation had I squeezed 6 hours hanging out. Just imagine the stress!
(By the way, we rescheduled and met a few weekends after, and all of us had a great time.)

Cognitive Strategies – Work on Your Thoughts

Remember: Stress is the way we perceive a threat, a demand or a change. This is a very big topic. What I would like to touch upon here is attitudes toward ourselves and positive thinking.

Examples of Cognitive strategies: Self-talk, let go, use humor, working to make improvement
Examples of Cognitive strategies: Self-talk, let go, use humor, working to make improvement

Self-talk is a key part of effective stress management. It is an endless stream of unspoken thoughts that run through our head. It is what we cognitive psychologists call automatic thoughts. These thoughts could be positive or negative, logical or misconceptions. When you think that the glass is half empty most of the time, you probably are not an optimist. Maybe it is in your DNA. Regardless, you could benefit from some practice in positive thinking. You may feel better once you free yourself from being preoccupied with the idea that the next bad thing is lurking somewhere.

I know it is hard but try not to take things too personally. Your boss mentioned anonymously a mistake you made in the staff meeting. Okay, it did not feel good. I agree. But you are not going to lose your job; She was just using it abstractly.

Be gentle to yourself and let go. Here is an example. Five years ago, a guy broke a precious vase from his great grandma. He would be stressed out every single time when he met his mother. Well, it would really help if he let go of guilt and negative thoughts. I am, of course, not advising against caution when handling fragile items. What I am suggesting here is not to exert endless energy on items we cannot fix. Don’t be too hard on yourself. Be open to humor and give yourself permission to make mistakes, to smile or laugh, especially during difficult times.

We can also try to adapt by identifying areas to change, a little bit at a time.

Relationships and Support Networks

To some people, a problem shared is a problem halved. There are some elements of truth to this, as we are social beings. Other places and other people are the fabric of our life. How we relate to others in part makes us who we are. We want to share good times; We also can use help or just moral support in stressful times.

Social networks can give a sense of belonging, increased sense of self-worth, feeling supported and secure. Some ways of making connections include following your interests, taking initiative, and taking advantage of something small, such as a coffee break with a classmate or, a quick chat with a neighbor next door or at church.

Importance of social support network and how to maintain relationships
Importance of social support network and how to maintain relationships

How to Maintain Relationships?

One of the most important things to do is to stay in touch. Be there for others and be a good listener. If you feel awkward in social situations or are at loss for words, try asking simple questions about the other person, such as “how are you?”, or get to know others over shared activities, such as bike riding or a book club. If you feel extremely anxious in social situations, consider talking to a psychotherapist to work on social anxiety and social-skills training.

When to Seek Psychotherapy?

Signs that you should seek therapeutic help include being unable to handle stress with the coping strategies you have, such as experiencing an extended period of overeating or loss of appetite, repeated relationship difficulties, being unable to take care of routine household responsibilities or being unable to complete regular tasks at work. In addition, when your friends suggest that you see a therapist, it may be indicative of their preoccupation with their own challenges, or they feel that they are not well equipped to help you. It could also be that they feel that the issue you have is too sensitive or too private for them to get involved.


Self-care is personal. We have different circumstances, different inclination and different needs.

Self-care is multidimensional. There are many ways of categorizing domains of self-care. Often, they cover personal, physical, psychological emotional, spiritual, and professional topics. Although distinct to some extent, these categories are interrelated.

Examples of Personal Self-care

Examples of personal self-care include planning long-term and short-term goals, picking up a new hobby and, spending quality "Me time".
Personal self-care examples

Examples of Physical Self-care

Examples of physical self-care: sleep hygiene, physical exercise, healthy diet
Physical self-care helps you feeling well rested, energized and healthy

Examples of Psychological Self-care

Examples of psychological self-care include hobbies, active relaxation , friendship and networking
Examples of psychological self-care

Examples of Emotional Self-care

Some people tend to be bottled up when they are under stress or overwhelmed by emotion. The problem is that this may lead to an emotional explosion later on, or worse, a mental health condition (such as an anxiety disorder, depression or substance abuse). It is usually healthier to listen to your feelings, process them, and try to understand them.

Give yourself permission to safely experience your emotions fully by laughing or crying. This can be achieved by spending time with your friends, journaling, tuning into music, and so on.

Example of emotional self-care include journaling, keeping a sense of humor, friendship, networking and asking for help
Self-care: Taking care your emotional needs

Examples of Spiritual Self-care

Spiritual self-care is deeply personal. Whatever your practice, it should nurture your inner-self, to give you a sense of perspective beyond the day-to-day life. We can use prayer (going to a church, a mosque or a temple) or engage in practices that help us get in touch with our inner self. Meditation or yoga are two well-known and frequently practiced approaches. By connecting the mind and the body, these practices help to increase both our physical and mental peace and calm.


Mindfulness is about tuning in and being more aware and more fully appreciative of the present moment. In general, the benefit of mindfulness helps us become more focused, more relaxed, more creative, and more in peace with ourselves. Rooted in Buddhist traditions of thousands of years ago, it is considered very important for the path to enlightenment. In Buddhist teachings, mindfulness is utilized to develop self-knowledge and wisdom that gradually lead us to the complete freedom from suffering. Key elements of mindfulness include awareness and acceptance.

Practice mindfulness, awareness and acceptance, helps to increase physical and mental peace and calm.
Practice mindfulness to increase physical and mental peace and calm

Acceptance does not mean we do not make judgments. But when we do, we simply notice them and let go of them. We accept whatever arises. We observe it mindfully.

Cognitively, mindfulness is being present and being aware. Some experiences are pleasant and some are unpleasant, but on an emotional level, we simply do not react. We notice it arising, passing through us, and ceasing to exist.

An Example:
I have been going to Yoga classes for a couple of years and consider myself an intermediate level Yogi, skill-wise. I have to admit often when it was Savasana time, lying on the floor, eyes closed, completely relaxed, I wondered whether I am a beginner. The essence of Savasana is entering a truly relaxed state, one that is deeply refreshing in itself and that also can serve as a starting point for meditation. True, my body would be very relaxed. The problem is that I am just not too sure about the mind as it tends to wander a little. However, even with my not yet well trained Yoga mind, during Savasana, I have never had thoughts about anger or felt hungry. There was also no worry, no sadness, no self-doubt… I guess I was in the present moment, just me and my body, more or less. Well, that is a good start!

Examples of Professional Self-care

Examples of professional self-care include leaving work at work, taking breaks, setting boundaries and seeking out new challenges.
Self-care: Manage career, work stress and work life balance

Concluding Notes

The purpose of this presentation is not to give you a magic bullet to shoot down “stress” because there is no way that anyone can get rid of stressors in their life. The purpose of this presentation is to, hopefully, help you become better at managing your stress. Next time when your heart is pounding and you are shaking from stress, you know you can trust yourself that “this is just my body helping me to rise to the challenge”. Remember stress is inevitable; Getting sick from it is not.