Stress Management Techniques

The research on stress management uses the term stress management strategies and measures such strategies. The concept of strategy is fairly general. Hence we decided to check if the stress management strategies are expressed in more specific behaviors. Lazarus and Folkman describe coping as “constantly changing, cognitive and behavioral efforts, aimed to master specific external and internal expectations, evaluated by a person as aggravating or exceeding his/her resources” [1, 2]. To make the coping effective, it is needed to make it flexible and adjustable to the conditions, taking into account the context of the situation [3, 4]. Coping can be described as the kind of all activities that a person makes in a stressful situations. The activities are compound and dynamic, aimed on change of the difficult situation [2]. They constitute the set of behaviors called strategies, various particular activities included in the stress coping process.


INTRODUCTION
The research on stress management uses the term stress management strategies and measures such strategies.The concept of strategy is fairly general.Hence we decided to check if the stress management strategies are expressed in more specific behaviors.
Lazarus and Folkman describe coping as "constantly changing, cognitive and behavioral efforts, aimed to master specific external and internal expectations, evaluated by a person as aggra-vating or exceeding his/her resources" [1,2].To make the coping effective, it is needed to make it flexible and adjustable to the conditions, taking into account the context of the situation [3,4].
Coping can be described as the kind of all activities that a person makes in a stressful situations.The activities are compound and dynamic, aimed on change of the difficult situation [2].They constitute the set of behaviors called strategies, various particular activities included in the stress coping process.

Strategies and techniques
Numerous research has been aimed to categorize and therefore make a commonly used clas-sification of the strategies.There are many classifications but none of them was assumed as the one proper.Classification made by Folkman and Lazarus [5] ) created categories such as: problem-focused coping, distancing, self-control, seeking social support, acceptance, avoiding, planned problem solving, positive reassessment.
On the other hand Moos [6] distinguished four separate categories: active-cognitive strategies aimed at the problem (logical analysis and positive revaluation), cognitive strategies aimed at emotions (cognitive avoidance and acceptanceresignation), active-behavioral strategies aimed at the problem (searching for information and support and actions aimed at solving the problem), behavioral strategies aimed at emotions (seeking alternative gratification, emotional discharge).
Another category was offered by Carver, Schier and Weintraub [7] who distinguished 13 different scales, divided into three categories.The first includes the instrumental activities, aimed to change the situation (problem focused coping), the second category of activities addressed at dealing with the emotions (emotion focused coping), the last category described as less effective than others, often having no adaptive effects.
Even though in the above categories one can distinguish cognitive and behavioral strategies, they are general and often vague.Based on the observations of people's behaviors, it cannot be fully stated what general strategies are used by them.The only specific behaviors can be observed as the ways of coping with stress.If those behaviors were distinguished, one could learn more about the effective ways of stress coping.
In this paper it was decided to use a term not present in literature -the term of technique.Techniques are specific behaviors, aimed to reduce the feeling of stress by gaining emotional balance and handling a difficult situation.Strategies are methods of coping with stress, described and classified according to scientific theories.The techniques are understood as behavioral manifestation of the coping strategies.

Categories of the techniques
The techniques we have developed are based on the Helena Sęk [8] conclusion that when asking people about the ways of coping with stressful situations it is very difficult to get answers in terms of strategies.They can be better described as the some groups of behaviors.Sęk [8] has made such a list of behaviors, which were selected from the answers of subjects describing the known for them and used by them methods of handling stressful situations.Based on Sęk's techniques, we have described them in more detailed behaviors.These techniques have been included in The Questionnaire on Stress Handling Techniques [9].
The following categories of the techniques have been included [9]: 1. Physical activity includes: walking, tourism, individual physical exercises, physical exercises in group, physical work.Some of the techniques were added to the list presented in the Sęk's publication [8].We have added the following categories: individual physical exercises and exercises in group.Some of the new studies [10] emphasize, that physically active students have better stress management level than those not active.It has been found that the most popular exercises were aerobics and fitness [10].

Replacement gratification -techniques in-
clude: listening to music, reading, creative activities, hobbies, meeting with friends.Creative activity is understood as creative spending of time, making something, drawings, poems and so on.It has been found artistic activities can help in stress reduction of those suffering of chronic and serious diseases [11].3. Distancing, stepping away from the problem -techniques in this category are: sleeping, joking about the situation, forgetting the situation, escape in fantasies, pseudo-rational explanation of the situation, neglecting the stress factors.The category is focused on defense mechanisms, such as "joking about the situation" (humor as defense mechanism), "forgetting about the situation" (connected to denial), "escape in fantasies" (connected to fantasizing), "pseudo-Archives of Psychiatry and Psychotherapy, 2015; 4: 23-30 rational explanation of the situation" (connected to rationalization) [12,13] 4. Escaping the difficulty -techniques are: seeking pleasure in food, risky behaviors, substances abuse, religious practices, resting.Religious practices were not included in the research of Sęk even though they are vital in handling stress behaviors.It is a way of support, which people get in religious practice and participation in groups.It allows one to handle better a stressful situation, by taking the responsibility from oneself and seeking the sources of the events in the will of God's [14].

Solving problems -techniques of this cate-
gory include: concentration on solving the problem, analyzing and planning actions (both techniques have been identified in Sęk's study [8].6. Support -techniques are: looking for support of others and contacting specialists.The category was added due to its importance, and because it has been listed as the separate category of coping [3].Support of others is aimed to strengthen the person as well as make people to be aware of the possessed resources and limitations which are important in dealing with difficult situations.To the support category we have included the technique known as "contact with specialists" which mean seeking help from the professionals (psychologists, counselors, etc).

Adjusting tension and emotions -tech-
niques included in the category are: relaxation, meditation, breathing techniques, muscle strengthening techniques, Jacobson's progressive muscle relaxation, Schultz's autogenic training, visualization, focusing on sensual impressions, self-suggestion, selfaffirmation.From all the above situations only relaxation, breathing and positive thinking were described as methods regulating the tension [8].
In our study we have added techniques, which are often understood in terms of stress coping: • Meditation (connected to contemplation) -it requires focusing on reflection, leading to the better understanding of one's thoughts [15].• Muscle strengthening techniques -they are focused on learning how to control muscles as well as developing the consciousness of one's body [13].• Jacobson's progressive training -it is a mechanical method of stretching and relaxing muscles, allowing for a distraction from a stressful situation [15].• Schultz's autogenic training -it refers to autosuggestion and focusing on bodily expressions, such as warmth, heaviness or cold [15].• Visualization -it refers to focusing on sensual and emotional experiences.Going through them allows for realizing future plans and handling future difficult situations [13].• Focusing on sensual experiences -it refers to the mindfulness technique, that is focusing on the present moment by being open onto all feelings from the inside and outside world [16].• Self-suggestion, also referred to as autohypnosis, is about giving oneself the suggestion, that can influence the feeling of calmness, sleepy and positive mood [13].• Self-affirmation -it is positive reassessment of the stressful situation, neutralizing the negative emotions connected to the situation [2].8. Lack of activity, helplessness -include behaviors: resigning, passive waiting.Both techniques were described in Sęk's publication [8].

OBJECTIVE AND AIM
The study aimed to find answers to the following questions: • What techniques are most often used in stressful situations?• Is there a correlation between the subjective feeling of stress and the number and the kind of the techniques used?

METHOD AND MATERIAL
The Kwestionariusz Technik Radzenia Sobie Ze Stresem (The Questionnaire on Stress Handling Techniques) [9] has been used.At the be-ginning the subject was asked to answer the question: "What is a stressful situation for you?Give an example of a stressful situation, with which you deal most often?".Next question is related to the description of one's feeling stressful at the moment on 1-100 points scale.The following part includes d 37 techniques used in the stressful situtations, as they were described earlier.The subjects were asked to indicate whether they used a given technique in the stressful situtations and if so, how often.They were informed about the aim of the study, as well as the details of anonymity and free participation.
The study group consisted of 100 persons (random sample): 58 women and 42 men, age between 19-74.The average age was 34, 6.Most of the subjects were in the age of 19-29.74% of subjects were living in a city of a population more than 100.000,14% in a city of less than a 100.000inhabitants, 12% declared that they are village inhabitants.The subjects represented different educational level.Moste of them declared higher eductaion (54%).The second group (27%) were people during their studies.The rest declared education as follows: secondary education (10%), technical (6%), vocational (2%) and elemetary (1%).

The categories of the techniques of stress coping used by the subjects
Frequency of the categories of the techniques use was the first step of analysis.Techniques indicated as "often use" (described as used: daily, every couple of days, usually, weekly, always) are presented in tab. 1.The analysis has shown, that only the "solving problems" category included all available the techniques (2), used by the biggest number of subjects (63%).
The category "replacement gratification" turned out to be a category that included 60% of the possible techniques.The least often used category was "the lack of activity".That was marked by only 17 % of the subjects.The techniques included in category "adjusting tension and emotions" have been used very seldom, most of the subjects reported use only one of ten techniques.

Using of specific techniques
Among all the techniques of stress management used, the minimum was 3 and the maximum was 27 out of all 37 techniques.Tab 2. presents the percentage of subjects using each of the techniques.The analysis has shown that the most often used techniques are: listening to music (74% of subjects), concentrating on problem solving (74%) as well as analyzing and planning future activities (71%).Techniques that were hardly ever used include: Jacobson progressive training (1%), Schultz autogenic training (3%), muscle strengthening techniques (3%) and meditation (7%).
An additional estimate was made on how many checked techniques fitted into a given category.The percentage of the answers that fitted (no matter how frequent they have been used) were estimated in relation to all the possible checked techniques in each category (taking into account the uneven number of techniques in each category).The analysis showed that the most often used techniques came from the category of "solving problems" (72,5 %), "replacement gratification" (57,8%) and "distancing" (53,8%).The least used techniques included "adjusting tension and emotions" (18,6%) and "lack of activity" (23,5%).

Techniques of handling stress and subjective
feeling of being stressed.
The subjects described their subjective stress level, on a scale level of 0 to 100.Among all the respondents the lowest marked value was 10 and the highest 95.The average level was 47,65 (SD = 19,25; skewness = 0,21; kurtosis = -0,67).The distribution of answers resembles normal curve.
In order to check the differences between differently stressed people within the techniques they prefer to use, the subjects were divided into two groups based on the stress level differences: low stressed group (results from 0-50) -63 persons and high stressed group (results from 51 -100) -37 persons.
The results used in the analysis were averaged on the basis of people using techniques of each category.A t -Student test was used to measure the differences.Statistically significant differences have been found only in the scales of "Replacement gratification" (t = -3,52, p < 0,01) and "Lack of activity" (t = -2,84, p < 0,01).People with higher stress levels (51-100) use techniques of these categories significantly more often than less stressed ones (0-50).

DISCUSSION
The results showed that people experiencing the stressful situations use different to cope with the experienced stress.Most often used techniques are: solving problems (72.5%),replacement gratification (57.8%) and distancing (53.8%).It would mean that people are trying at the same time different ways how to cope with stress experiences [2].It can also mean that the techniques people are using are different in the different stressful situations.We have not asked how useful have been the applied techniques for the coping with the stressful situation.The frequency of used techniques could suggest that successful can be the techniques which are dealing directly with the difficult situation (solving problems techniques) but also to try to step away from the problem or to look for the social support of friends, to look for the gratification doing something what is pleasant, involving, tension reducing.May be the solving problems techniques are easy to apply when person experiencing stress is getting some distance to the situation, diminishes tension and emotions by the vicarious gratification.
It works probably for those who feel less stressed.Comparisons between less and higher stressed indicated that those more stressed significantly more often use techniques of various gratification category and lack of activity.It can suggest the relationship between level of feeling stressful and kind of techniques applied to the stress coping efforts.A similar number of people used the following techniques: analyzing and planning future tasks, meeting with friends, rationally explaining the situation (71%).It can mean that in stressful situation people tend to distance themselves from the situation (and maybe relax emotionally) and then search for a solution by concentration on problem solving and planning activities, seeking simultaneous contact with friends as a mean of gaining support.Such interpretation suggests the need of a different categorization of the above mentioned techniques.
People who are more stressed (scale of 51 and above) statistically use more often techniques from replacement gratification and lack of activity.Lack of activity seems to be one of the indicators of less effective way of how to cope with stress.Lack of activity can also mean that someone do not have access to differentiated techniques because of lack of friends, hobbies, abilities to be creative, ability to joke, even escape from the difficult reality some time.

CONCLUSIONS
Most of the people can manage with the difficult situations by using various techniques, dependent on their level of feeling stressful, level of access to the different techniques.
Techniques, as used in this research, can be useful for better understanding of the ways of coping with stress and it would be interesting how they are related to the existing stress coping strategies [5] The results may suggest the importance of health promotion the in modern society, especially in terms of stress handling.The knowledge and skills how to deal with the difficult, stressful situations should be widely promoted, so each person can choose techniques best for oneself, thus allowing a better handle of a stressful situation.

Table 1 .
The percentage of the techniques often used in each of the categories

Table 2 .
The percentage of subjects using techniques of stress management

Table 3 .
Differences is using various techniques categories between low and high stressed groups.