Stress Management


According to the World Health Organization, stress is a “global epidemic.” The American Institute of Stress states that 43% of all adults suffer adverse health effects due to stress, 75-90% of all visits to primary care physicians are for stress-related complaints or disorders, and stress has been linked to all major causes of disease and death. 

Stress is a serious health concern. 

The term stress was first applied to the human condition by Hans Selye in his 1976 book, The Stress of Life. In this work, he proposed the idea that stress may trigger physiological responses in the body which are related to disease.

Stress is now recognized as the inability to cope with a perceived (real or imagined) threat to one’s mental, physical, emotional, and spiritual wellbeing, resulting in a series of physiological responses and adaptations (Dossey, 2004). When the body is stressed, it experiences a series of events which are beneficial for immediate needs but harmful to the body long-term.

Fight or Flight

The physiological response to stress includes either flight/fear or fight/anger. Fear is associated with the flight or the freeze response, whereas anger is associated with the fight response. Prolonged stress normalizes these conditions of fear and anger.

Early studies from the 1950s indicated that many of the physical responses to anger and fear are similar, but some, such as peripheral vasodilation, differ. During times of fear, the amygdala can override the conscious brain that is responsible for higher reasoning. 

Emotional wellbeing is the ability to feel and express the entire range of human emotions, and to control them, not be controlled by them. When it comes to stress management, learning how to manage the emotions associated with the fight and flight responses to stress play a significant role in overall wellness. 

There are many evidence based tools for reducing both the physical impact of stress and the emotional dysregulation that occurs as a result of the body's stress response. 

Physical Activity for Prevention

During physical activity, the stress response is activated. While this may seem counter-productive, evidence indicates that this controlled stress response helps to train the body to recover to a state of homeostasis. 

Regular physical activity produces an improved sense of self-efficacy, increased mental alertness and information processing, and decreased feelings of anxiety and stress. Optimal wellness requires a balance between physical activity and rest.

Stress Reduction Goals

Stress management lifestyle related goals can also be part of the core problem. Many health coaches and clients set goals of eliminating stressors in life–a goal that is completely unachievable.

Stress reduction goals should be achievable to avoid being counterproductive. Because stress can result in physical symptoms, many studies use those physical manifestations as the outcome for intervention efficacy evaluation. 

Mindfulness Based Stress Reduction

Mindfulness refers to the state of being aware, on purpose, of your surroundings. Put simply, it involves pausing activity to take in your body's sensory environment. Mindfulness involves recognizing the signs and signals your body is sending you, and it can have a powerful effect on overall health. 

A 2017 followup to a previous study on mindfulness based stress-reduction as compared to usual care for lower back pain revealed that mindfulness reduced pain far more effectively that usual approaches (Cherkin, 2017).

Other health conditions that can be treated with mindfulness-based stress relief include poor cognitive function, sleep disorders, traumatic brain injury, substance abuse, obesity, social anxiety disorder, fibromyalgia, chronic headache, and PTSD.

Other evidence based stress reduction tools may include journaling, expressive art therapy, hobbies, deep breathing techniques, music therapy, yoga, aromatherapy, progressive muscle relaxation, or massage therapy. Many of these approaches integrate principles of mindfulness to achieve efficacy. Whatever approach is ideal for you and your client, the key is to focus on consistency for a sustainable approach to stress reduction. 


Brantley, J. (2005). Mindfulness-based stress reduction. In Acceptance and mindfulness-based approaches to anxiety (pp. 131-145). Springer US.

Cherkin, D. C., Anderson, M. L., Sherman, K. J., Balderson, B. H., Cook, A. J., Hansen, K. E., & Turner, J. A. (2017). Two-Year Follow-up of a Randomized Clinical Trial of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care for Chronic Low Back Pain. Jama, 317(6), 642-644.


Meet Dr Hawkins

Dr. Hawkins brings 20 years of expertise in the integrative health field to her role as Executive Director of the Franklin School of Integrative Health Sciences and the leader of our clinical research team.

She holds a Bachelor’s Degree in Environmental Health from Union Institute and University, a Master’s Degree in Health Education & Promotion from the University of Alabama, a post-graduate certificate in epidemiology from the London School of Hygiene and Tropical Medicine, a PhD in Health Research from Middle Tennessee State University, and is completing the post-doctoral Global Scholars Research Training Program at Harvard Medical School. She also holds certifications in numerous natural health fields including aromatherapy, aromatic medicine, herbalism, childbirth education, and labor support.