In December of 2020, Cedar Counseling & Wellness Owner, Carrie Nicholes, did an excellent job of illustrating stress versus burnout in her blog post: Understanding Stress & Burnout. She noted the difference between unhealthy stress and burnout. She also posed these very important questions:
What if, however, you are in an intense stress response that a run or two can’t stave off for long? What if you are overwhelmed, burned out, and struggling to find a way to accomplish even basic tasks?
The answer she provided eloquently described the importance of rest, identifying unreasonable expectations, and self compassion as effective antidotes to both unhealthy stress and burnout. I agree that these strategies are key to optimizing our health and well-being.
This post is meant to recognize a third level of stress, different from unhealthy stress or burn-out. This third level is chronic stress. The key characteristic of chronic stress, is that it is unchanging, repeated, stressful dynamics. Some examples of chronic stress include: living in poverty, systemic racism, repeated microaggressions, or toxic relationship dynamics, and more generally, prolonged exposure to unabating stressors. Contrast these examples to what cause unhealthy stress and burnout, such as, work related stress, stress that accompanies life transitions, difficulties achieving work-life balance, etc. One can change their work environment, take time off, or rearrange priorities. With chronic stress, one cannot change, control, or escape from the dynamics that are causing them stress.
It is incredibly important to note that one cannot compare pain. Unhealthy stressors and chronic stressors can be equally as painful, and can affect different individuals in different ways. One is not more or less difficult to endure than the other. The distinction here is made to note the unchanging nature of chronic stress versus unhealthy stress, not to minimize the negative impacts of unhealthy stress.
It may be difficult to know when you are feeling the effects of chronic stress, given that it is often your “normal”. Chronic stress repeatedly triggers the fight/flight/freeze responses Carrie described in her last post. Many do not know that the body also has two other trauma responses: submit, and attach. Often, when chronic stress is caused by maladaptive or dysfunctional relational patterns, we find ourselves submitting to, or attaching to, the person who is the source of chronic stress. This creates a traumatic relational pattern that fuels the cycle of chronic stress. Many of my clients describe a visceral, “gut feeling” that is triggered when they are around those who are the source of chronic stress. Our bodies hold much wisdom. Always listen to these “gut” instincts, do not minimize them.
Often, chronic stress leads to physical health symptoms as well. Some common signs of chronic stress include: muscle tension or pain, frequent illness, difficulty sleeping, changes in appetite, propensity to isolate oneself, severe lethargy, increase in alcohol consumption or illicit drug use, increase in irritability/lashing out towards others, and/or feelings of personal worthlessness and hopelessness. We often feel stuck and powerless to these patterns when they are the result of chronic stress.
If chronic stress is left untreated, it can lead to more serious health conditions, such as mood disorders, trauma-related disorders, hypertension, diabetes, heart disease and other autoimmune diseases. I will explain how chronic stress leads to these health outcomes further in my next post, What are Adverse Childhood Experiences, and Why do they Matter?
Rest, self-compassion, and re-prioritizing, while incredibly important, may not be enough to reduce the effects of chronic stress. The hopeful message I am compelled to share with you, is that feelings are not facts. That feeling of being stuck that you may be all too used to, is not a fact. You do have the power to alter the effects of chronic stress. You do have the power to change your relational patterns. You do have the power to set boundaries with those who are causing you chronic stress. Below I detail a few key places to start when addressing chronic stress:
1) Set healthy boundaries without guilt.
As Carrie once stated, boundaries tell you and the other person that you both matter. If you truly believe this, it will be much easier to re-frame the feelings of guilt and shame that often accompany boundary setting. When boundaries are crossed in relationships, our sense of safety, consistency, and playfulness are shattered. When boundaries are respected in relationships, we feel safe, taken care of, loved, and also empowered and capable of independence.
The following are a few signs of unhealthy relational boundaries:
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A pattern of trusting others very quickly, and often telling all, even if you’ve known someone for a short amount of time.
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The opposite: a pattern of feeling distrustful of almost everyone, even though you may desperately want closeness and trust with others.
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Always feeling that you have to “go the extra mile” for others, succumb to others’ wishes/desires, even if this means abandoning your personal values.
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Repeatedly feeling defined by others or defined by your role in someone else’s life.
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Propensity to control others or have power over those with whom you interact.
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Taking excessively within a relationship (this could be sexually, financially, emotionally, or physically).
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Or the opposite, giving excessively within a relationship (this could also be sexually, financially, emotionally, or physically).
If the dynamics described above affect you personally, know that you have the power to change them through developing healthy boundaries and assertiveness skills. Boundary setting looks/sounds like:
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“I would love to get to know more about you, and I think that will happen gradually as we spend more quality time together.”
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“No, I am not going to do that for you, because that contrasts with my belief system.”
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“I want to control this situation, but I’m going to ask for your input instead, because it affects both of us.”
2) Develop assertive communication skills.
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Assertive communication is the Goldilocks of communication patterns. Passive communication is “too gentle”, aggressive communication is “too harsh” and assertive communication is just right. Assertive communication is boundary setting in action.
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I always describe assertive communication to clients as a means of setting loving boundaries with others. Assertive communication is direct, firm, and kind.
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Sarcasm, innuendo, and metaphor are not used in assertive communication. The term no is frequently used, and excessive explanation for one’s reasoning is not warranted.
3) Foster positive relationships.
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It is really difficult to set healthy boundaries and communicate assertively when you are surrounded by others who have poor boundaries or unhealthy communication patterns. If you are intentionally making efforts to reduce your chronic stress, limit your time with those who are toxic for you. Increase your time with those who have relational patterns you admire.
Additionally, if you are aware of the toll chronic stress is having on your body and mind, or you have tried to address it and not been successful, be sure to:
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Talk to your primary care physician.
It is important for your primary care doctor to know what you have been through. They can help offer support, resources, and most importantly, screen you for chronic health issues that often accompany chronic stress.
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Seek mental health support if needed.
It is not easy for anyone to escape the patterns that create chronic stress. Our Annapolis therapists are here to help.
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Be open-minded to holistic healing.
Alternative medicine recognizes the effects of chronic stress more readily than traditional medicine. Therapies such as yoga, meditation, acupuncture, chiropractic medicine, reiki and massage therapy, to name a few, can be incredibly restorative.
Sources:
https://www.yalemedicine.org/conditions/stress-disorder
http://counselingresources850.blogspot.com/2014/09/healthy-and-unhealthy-boundaries.html https://www.galtampa.org/establishing-healthy-relationships/
About the Author:
Caroline Fowler is a Maryland Board approved Licensed Certified Social Worker – Clinical (LCSW-C) therapist at Cedar Counseling & Wellness. Caroline specializes in providing compassionate care to individuals who have experienced direct trauma, secondary trauma, and/or chronic stress.
