Effective behavioral and cognitive techniques for managing stress

Stress management can be achieved through both cognitive and behavioral techniques. Biofeedback is a cognitive therapy, it has four types of treatment such as

electromyogram (EMG), temperature biofeedback, galvanic skin response training, and electroencephalogram (EEG). Relaxation training includes deep breathing, deep muscle relaxation, quieting imagery, hypnosis, and gentle stretch and exercise. Other techniques used are such as cognitive-behavioral therapy, meditation, mindfulness, yoga, cognitive restructuring and music therapy.

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Biofeedback is also known as the mind-body therapy (Mayo Foundation for Medical Education and Research, 2008). It helps to maintain our health by using our mind. From research, it is proved that our involuntary bodily functions can be affected by our thoughts. Biofeedback therapists will teach their patients how to manage their health by guiding them with signals shown by the machine. Bodily functions that have to be controlled are blood pressure, heart rate, muscle tension, body temperature, sweats gland and brain functions. As long as the patients recognize these bodily functions well, the chances to manage good health are higher.

Biofeedback is useful in managing stress. It treats asthma, headaches, Raynaud’s disease, nausea, cardiac arrhythmias, constipation, blood pressure, and epilepsy (Mayo Foundation for Medical Education and Research, 2008). Biofeedback is effective because it may reduce the chance to get medication for stress. It may be more effective in treating sickness than taking medication. We learn the process and methods of managing health from the feedback information we get. Medication costs could be reduced as well.

Biofeedback is a safe treatment, but it should not be used with patients having depression or psychosis disorder. Diabetic patients should practice it more carefully because it could interfere with insulin. Biofeedback training is provided in physical therapy clinics, medical centers and hospitals (Mayo Foundation for Medical Education and Research, 2008). Patient can choose to practice it at home or with therapist. To ensure best results of health, it is advice to practice with a therapist.

Biofeedback therapy normally holds about half to one hour. The duration and sessions are dependent on the patient’s health condition and how fast he can practice it. In a treatment session, the patient’s body is applied with electrical sensors so as to detect signals from their physiological response. Example, when muscle tension is detected, information is sent to the patient by beeping or flashing. By recognizing the signals, patient learned to relax the muscles.

There are a few types of biofeedback treatment, such as electromyogram (EMG), temperature biofeedback, galvanic skin response training, and electroencephalogram (EEG). EMG is used for muscle tension treatment by using electrodes. It is used to relax the muscle tension such as backaches, headaches, neck pain and bruxism (Mayo Foundation for Medical Education and Research, 2008). EMG is also used to treat asthma and ulcers and some other stress related illness.

Temperature biofeedback measures our skin temperature by attaching sensors to our fingers or feet. Once we are under stress, temperature biofeedback measured a low temperature of our body. This feedback tells us we must relax ourselves in order to increase body temperature back to normal. This technique can be used to treat Raynaud’s disease. It is also useful in treating headaches.

Galvanic skin response training uses sensors to measure our sweat glands activity. This technique helps to treat emotional disorders such as phobias, anxiety and stuttering (Mayo Foundation for Medical Education and Research, 2008).

Electroencephalogram (EEG) measures the brain waves activity, such as wakefulness, relaxation, calmness, light and deep sleep (Mayo Foundation for Medical Education and Research, 2008). It is a useful biofeedback in treating insomnia and epilepsy.

Relaxation training is another technique used to release stress. It requires regular practice so that it will be more effective in the outcome. Five practices such as deep breathing, deep muscle relaxation, quieting imagery, hypnosis, and gentle stretch and exercise are taught in relaxation training (Matt, 2007). Deep breathing is known as the easiest skill in relaxation training. We relax ourselves by breathing in deeply and slowly. This exercise has to be practiced regularly in order to reduce the chances of becoming stress and also to improve our health and life.

Deep muscle relaxation teaches us to relax the tense muscles by using audiotape instructions. One approach involving tensing tight muscles and then release the tension of the muscles. Another skill is to just sit or lie down and focus on the tense muscles. Then tell yourself to release the tension of the muscles. This technique is often practiced together with deep breathing and the main focus is on releasing muscle tension which in turn helps to reduce stress.

Quieting imagery teaches us to imagine while breathing deeply and also to tell ourselves a story to make us relax. Typical quieting scenes may involve lying on the beach on a warm day or sitting in a sunny meadow in beautiful mountains (Matt, 2007). Select a place where we feel comfortable with and relaxing. Then we focus ourselves in that place by using our imagination and deep breathing practice. Hypnosis is very similar to quieting imagery only that hypnosis focuses more on the deeper concentration of the unconscious mind than imagination. During hypnosis, patient has to practice deep breathing while concentrating on the unconscious mind. Gentle stretching and exercise are to be practiced regularly on a daily basis so as to help reduce stress.

Cognitive-behavioral therapy (CBT) involves how our thoughts can influence our feelings and behaviors. From that, we learn to change our thoughts in order to act properly. CBT is the shortest time needed technique in managing stress. The average number of sessions needed is 16. It is a very brief technique because it is highly instructive nature and it makes use of homework assignments (National Association of Cognitive-Behavioral Therapists, 2008). It is time-limited as it gives understanding to the patients regarding the process of the therapy in the beginning of the session and how it will end. The ending of the therapy is all depending on the patient himself.

It is needed to have a trusting relationship between therapist and patient in CBT. Besides that, patients themselves also have to change their thoughts and behavior. CBT therapists focus on teaching rational self-counseling skills. The therapist’s role is to listen, teach, and encourage, while the patient’s roles is to express concerns, learn, and implement that learning (National Association of Cognitive-Behavioral Therapists, 2008).

CBT emphasize on stoicism which teaches patient to be calm when facing difficulties. When we are facing problem, we have to learn to act calm so that we feel better and not so stress. CBT uses the Socratic method which requires asking questions very often. Therapists also encourage their patients to ask themselves questions such as “Why are they looking at me in such a manner?” Therapists normally teach their patients how to think and act but not telling them what they should do.

Stress can be managed through meditation. Kabat-Zinn’s program combines elements of Vipassana, a Theraveda form of Buddhist meditation from Burma, and Zen practices from Japanese Buddhism with Hatha yoga in a training regime identified as Mindfulness-Based Stress Reduction (The Physical and Psychological Effects of Meditation, 2004). In this program, they teach patients stretching, relaxation, and various forms of seated meditation. Body scanning, a method which involves following the path of the breath through different parts of the body as a guided visualization is taught to the patients as well (The Physical and Psychological Effects of Meditation, 2004).

Kabat-Zinn has been researching on the hormone melatonin, which is thought to be cancer cells growth inhibitor. He thinks that melatonin not only photosensitive, but also psychosensitive. Melatonin levels have been proved to increase significantly in the body of meditators. William Mikulas (1981) stated that “meditation practices can be broken down and understood in terms of traditional constructs in experimental psychology, such as vigilance, attention, and concentration” (The Physical and Psychological Effects of Meditation, 2004).

Another method of managing stress is by practicing mindfulness through meditation. It helps to keep us aware of our sensory stimulus. Mindfulness helps to treat problems such as anxiety disorders, depression, and stress. Researches have shown that mindfulness helps to stop negative thoughts that causes stress, and is also useful in decreasing anxiety. Regular practice of mindfulness helps to maintain both our physical and mental health.

Yoga practice is an effective behavioral technique in stress management. It helps reduce stress, lower blood pressure, slow down aging process, increased strength and flexibility, allergy and asthma symptom relief, and reduced anxiety and muscle tension (Scott, 2008).

Cognitive restructuring is a process of recognizing, challenging, and changing cognitive distortions and negative thought patterns (Scott, 2007). First, we need to be aware of our cognitive distortions. Mental filter is a kind of cognitive distortions. People having this problem will always notice the one wrong thing over the correct ones, and always hold on to the negative thoughts. People having poor constructive thinking will normally be more stressed in their lives. According to Epstein, “poor constructive thinkers contribute to the stress they experience by spontaneously generating negative thoughts in the absence of external stressors” (Franken, 2007, p.258).

Music therapy, is another technique in managing stress. Research has shown that music has a profound effect on our body and mind (Scott, 2007). Music therapy is known to be effective in treating patients with cancer. It helps reduce pain and depression, ease muscle tension and to calm people. Through research, it is shown that music with a strong beat can stimulate brainwaves to resonate in sync with the beat (Scott, 2007). Faster beat promotes alert and sharp concentration, whereas slower beat promotes calm and relax. Research also shows that music promotes lasting effects to our mind. Music prevents the damaging effects of chronic stress, also can promote a more positive state of mind.

In conclusion, both cognitive and behavioral therapies seem to work effectively in managing stress. In my opinion, among all the techniques discussed earlier, I think that music therapy would be the best treatment for patients suffering stress. Music also can help us to be calm and relax sometimes. Even though relaxation training, and meditation are also quite effective. Music therapy, if compared to other techniques, it requires less time and costs. As for yoga, we have to pay for the lessons and also it needs to practice regularly to achieve good health, same goes with meditation, relaxation training, and biofeedback.

Types of techniques in managing stress
Treatment of illness
Benefits from treatment

Cognitive technique


electromyogram (EMG), temperature biofeedback, galvanic skin response training,electroencephalogram (EEG).


Cognitive restructuring

Music therapy

asthma, stress, headaches, Raynaud’s disease, nausea, cardiac arrhythmias, constipation, blood pressure, epilepsy, negative thoughts.

Reduce stress, lower blood pressure, promote positive state of mind, reduce headaches.



1. Relaxation training

deep breathing, deep muscle relaxation, quieting imagery, hypnosis, and gentle stretch and exercise.

2. Meditation

3. Yoga

stress, blood pressure, allergy, asthma, anxiety, muscle tension, depression.

Relief asthma and allergy, reduce anxiety, ease muscle tension, relaxing mind.

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