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How does CBT help stress?

January 16, 2020

‘I’m stressed!’ is something most of us have said at one time or another when we’re feeling under strain. But what does ‘stress’ really mean? According to the Health and Safety Executive (HSE), it is "the adverse reaction people have to excessive pressures or other types of demand placed on them".

The theme of this year’s International Stress Awareness Week (4-8 November) is building resilience to cope with stress – something which might seem unachievable. After all, if we have an exam coming up, or we’re doing two people’s jobs at work, there’s not a lot we can do to change that. But we do have the power to change the way we think about and respond to situations like these, and lower our stress levels as a result.

Let’s take a look at what causes stress.

The trigger could be acute – for example a driving test, or a major event such as a wedding. Stress can also be caused by the ongoing pressures of everyday life, perhaps coming from different directions, which become overwhelming: a heavy workload, kids needing to be ferried around, a sick parent, a long list of household tasks...

We all react to stress in different ways, but our response generally involves:

Physical symptoms

These might come on quickly in response to a situation that sends our body into ‘fight or flight’ mode. A racing heart, a dry mouth and shaking are common. If someone is experiencing long-term stress they might get a headache or upset stomach every day, or feel like they’ve constantly got ‘butterflies in the tummy’.


We might find ourselves thinking ‘This is all too much!’, ‘I just can’t do this, it’s impossible’, or ‘This is never going to end’. For some people, these thoughts manifest as images: they might visualise themselves collapsing under a pile of paperwork, or see their to-do list as an endless scroll.


We might start eating more or less, drinking more alcohol, watching more TV, doing less housework or avoiding important tasks. We might run around like a headless chicken trying to get everything done, or feel paralysed by the amount we have to do, and unable to handle any of it.


Stress affects our mood, and people often experience feelings of being overwhelmed, on edge and down.

Sometimes, these responses can become a vicious cycle. Feeling helpless in the face of an endless to-do list might lead to a headache and nausea, for example. We might then feel too unwell to do anything, so put things off – which increases the stress.

The power of thought

Stress occurs when the demands put on us are greater than what we’re capable of doing, or – and here’s the important bit – what we perceive we’re capable of.

Some situations are inherently stressful – such as the loss of a loved one, divorce, and moving house. However, any situation can cause stress if you think about it a certain way. A wedding is supposed to be an exciting and happy occasion, but it can easily become overwhelming if you feel there’s too much to organise, or you worry that people will judge you if everything isn’t perfect, for example.

Any situation can be managed if we can change how we approach it. For example, one person going through a divorce might think “I don’t want this to happen – and I can’t deal with it”, whereas another might think “This is sad, but it’s the right thing to do, and I can cope”. The second person will feel less stressed than the first.

Cognitive behavioural therapy (CBT) can help with this change of mindset, using a number of different approaches and techniques.

Tune into how you’re feeling

We encourage people to notice what’s happening in their mind and in their body. This helps them define exactly what ‘stress’ means for them, and what keeps it going.

Recognise the self-imposed rules

There are two types of demands. External demands are the things we really have to do. Internal demands are those we place on ourselves – for instance that we must finish our to-do list by the end of the week. Someone with a different approach might have just as much to do, but think “I’ll try my best to do everything by the end of the week, but if I don’t I’ll do it next week”.

Test out the rules

Challenge any rules that put you under undue pressure. Are they true? Do you really have to finish everything on your list? Can anything wait? If you don’t clean the car every week, what will happen?

Acknowledge the possible

If you feel you can’t cope, or that something is impossible, think about times in the past when you’ve survived or succeeded in difficult situations. Remember this, and use it as evidence that you can deal with what’s ahead!

Take action if you can

If someone has a concrete problem at the core of their stress, we work with them on a plan to solve it – for example, talking to an employer if there are too many demands at work.

Have outlets that help you find balance

Imagine a bucket with no holes in. If it keeps raining into the bucket, at some point the water will overflow. Stress is a bit like this; you need some holes in your bucket! These will look different for everyone – it could be walking the dog, losing yourself in a film, doing a dance class, gardening…whatever helps to keep the level down.

We don’t always have control over the sources of our stress – but we can change how we think about them. CBT can help with this: find out more about CBT.

ieso Online Therapy
This blog has been written by a member of the clinical team at ieso.
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