Psychotherapy for Stress
If you’ve been feeling constantly wound-up, exhausted, or on the edge of overwhelm, you’re not alone — stress is one of the most common reasons people come to see me. The good news is that it’s also one of the most treatable, because stress is rarely just a reaction to what’s happening around you. It’s shaped just as much by how you’re relating to the pressure — the judgments you’re making about it, the coping strategies you’re falling back on, and whether you’ve built any resilience to draw on. Change any of those, and the pressure itself often becomes far more manageable.
What is Stress?
‘Stress’ is a term created by Dr Hans Selye in the 1950s to describe the results of General Adaptation Syndrome — the failure to adapt to life problems. Leading to a variety of medically unexplained symptoms, such as fatigue, headache, pain and immune system failures.
Unfortunately, it has now become an over-used and confusing term. It can refer interchangeably to any of the following issues:
- Adverse life events (e.g. unemployment, separation, financial problems, etc.)
- Conflicts in relationships or at work
- Anxiety
- Over-arousal and agitation (feeling ‘hyper’)
- Feeling overwhelmed
- Feeling run-down or exhausted (‘burnout’)
- Symptomatic (‘stress-related’) illness
- Trauma
Article here: 7 warning signs of stress
The Causes of Stress
Stress is the result of an interaction between external life events, unhelpful judgments, poor coping strategies and an absence of resilience.
To give a concrete example:
Martha is on probation for a job in a bank. She is extremely over-worked, with punishing deadlines, little training and support, and under constant threat of dismissal. At the same time she is a perfectionist who worries about failure, and finds it difficult to stand up to people. She has guilt when she fails to live up to impossible standards, and shies away from discussing her problems with anyone else. She believes that the answer to her problems is over-work. In that way she loses work-life balance, and practices little self-nurturing. Gradually she experiences panicky feelings, racing thoughts, headache, insomnia and exhaustion. Eventually she is signed off on fitness leave and is referred for psychotherapy.
What’s the difference between stress and anxiety?
Stress and anxiety often get used interchangeably, but they’re not quite the same thing. Stress is usually a response to something identifiable — a deadline, a difficult relationship, a financial worry — and tends to ease once the situation resolves or you get some distance from it. Anxiety is more free-floating: it can persist, or even intensify, without an obvious external trigger, and it often involves catastrophic thinking about the future rather than a reaction to present pressure. In practice the two overlap heavily — prolonged stress reliably produces anxiety symptoms, and anxious thinking styles make stress harder to shake off.
What’s the difference between stress and burnout?
Stress is usually episodic — it rises with pressure and falls once the pressure lifts. Burnout is what happens when stress has been left unaddressed for months or years: it becomes a persistent state of exhaustion, cynicism and reduced capacity that doesn’t recover with a weekend off or a holiday. Where stress often comes with urgency and over-arousal, burnout tends to look more like flatness, detachment and depleted motivation. If ordinary rest isn’t touching the exhaustion, that’s usually the sign you’ve crossed from stress into burnout.
Why is stress causing physical symptoms like headaches, insomnia or a racing heart?
This isn’t incidental — it’s the mechanism Hans Selye first described. Sustained stress keeps the body in a prolonged state of physiological arousal, and when that arousal has nowhere useful to go, it shows up as symptoms: headaches, muscle tension, disrupted sleep, digestive problems, a racing or irregular heartbeat. These are sometimes dismissed as ‘medically unexplained,’ but they’re a predictable consequence of the nervous system running in overdrive for too long, not a separate problem layered on top of the stress.
Why do I feel stressed even when, on paper, nothing is going wrong right now?
Because stress isn’t purely a reaction to what’s happening this minute — it’s shaped just as much by unhelpful judgments, poor coping strategies and an absence of resilience as by the external event itself. Someone under a genuinely demanding workload who also carries perfectionist standards, struggles to ask for help, and has no outlet for winding down can feel more stressed than someone facing a bigger external problem with better coping resources. The external pressure is only one part of the equation.
What actually helps with chronic stress, beyond ‘relaxing more’?
Relaxation techniques can take the edge off in the moment, but they rarely resolve stress on their own if the underlying pattern — the judgments, the coping style, the absence of boundaries — stays unchanged. Effective work usually addresses several layers at once: the thinking patterns that amplify pressure into crisis, the coping strategies that aren’t actually working, and the resilience skills that were never built in the first place. That’s a different, more durable target than simply calming the nervous system down for an afternoon.
How many sessions does therapy for stress usually take?
There’s no fixed number — it depends on how entrenched the pattern is, and how much of it is being driven by an ongoing external situation versus the thinking and coping patterns layered on top of it. In practice, most clients see meaningful change well within the one to eight session range that’s typical across this practice; stress rooted in a single identifiable pressure often resolves faster than long-standing burnout.
Can stress be fully resolved, or is it something I’ll always have to manage?
Most stress responds well to addressing its actual drivers rather than just managing symptoms — once the thinking patterns and coping strategies that were amplifying the pressure are changed, the stress response itself usually settles substantially. That said, life doesn’t stop producing pressure, so it’s less about eliminating stress permanently and more about changing your relationship to pressure, so that it stops escalating into the racing thoughts, sleeplessness and physical symptoms described above.
What’s the actual way out of chronic stress?
Not by trying to relax harder, or push through. The FLOAT approach moves through four related shifts: Awareness — stepping back enough to notice the judgments and reactions that are amplifying the pressure, rather than being swept up inside them. Acceptance — allowing the stress response to be what it is, a nervous system doing exactly what it’s built to do under pressure, rather than treating it as a personal failing. Witnessing — noticing which specific judgments, coping habits and situations reliably feed the cycle, without immediately trying to fix or argue with them. Dissolving — once the resistance drops and the pattern is met with steady attention rather than panic, the physiological arousal that’s been driving the symptoms has far less to sustain it, and tends to settle.
Psychotherapy for Stress
Psychotherapy first assesses the multiple sources of the client’s problem:
- External pressures
- The client’s personality traits
- Thinking patterns
- Problem behaviours
- Physical and emotional reactions
The aim is to identify the impact of external events, how these are made worse by the client’s thoughts and reactions, resulting in sub-optimal coping strategies, leading to stressful feelings and symptoms.
The next step is to assist the client in changing his thinking patterns, improving his reactions to environmental stressors, developing better coping strategies, and building resilience. Using any of the following techniques and approaches in combination:
- Thought defusion and thought challenge (Cognitive-Behaviour Therapy)
- Thought replacement (CBT)
- Developing coping mechanisms for life problems (Resilience Coaching)
- Assertiveness training
- Mindfulness (Mindfulness-Based Therapy)
- Relaxation and calming techniques
- Hypnotherapy
- Exercise programs
- Decision making
- Behavioural activation (Acceptance and Commitment Therapy)
Article here: 30 stress management techniques
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Image by Pete Linforth from Pixabay