Saturday Extra

Dr Antony Kidman looks at techniques for reducing stress – by changing your thinking about stressful events – challenging negative thoughts and practising more rational, realistic thoughts to take you through the event.

Transcript

This transcript was typed from a recording of the program. The ABC cannot guarantee its complete accuracy because of the possibility of mishearing and occasional difficulty in identifying speakers.

Geraldine Doogue: While we're talking stress, Dr Antony Kidman is back with me now for Everyday Health. He's a clinical psychologist who's just written a very useful, practical, little book, I stress little, all about stress. It's called Stress - Coping and social support in the age of anxiety.

Welcome back, Antony.

Antony Kidman: Glad to be back, Geraldine.

Geraldine Doogue: Now let's talk about how we might manage stress better. What is the latest view about the impact of stress on health? Because this is not necessarily easy to measure, is it?

Antony Kidman: No. Look, there's plenty of evidence from correlation studies that when people are under high levels of external stressors for a period of time, this seems to exacerbate a whole lot of conditions that they may well have, but it sort of exacerbates them; whether it's asthma or ulcers or a whole range of conditions that it makes them worse. And the evidence is that the immune system is influenced by how we interpret the external world, the stressful events, we get anxious, the fight and flight response, that has an effect on the nervous system and the immune system. And there is evidence that our immune systems, in vulnerable individuals, can be lowered, and thus we're more susceptible to a whole range of conditions. And there's muscle pain, there can be people with jaw problems, clenching of teeth, Bruxism, it's called, and then of course the symptoms of chronic anxiety, the butterflies in the stomach, and the people when they get really anxious, tense, stressed, can go into panic attacks.

Geraldine Doogue: Sure. How long, from what we know, do people have to be exposed to this type of stress in order to start really developing problems, as opposed to just getting in there with a little bit of an emergency problem and then moving out?

Antony Kidman: Well probably weeks and months. Again it depends on our individual genetics. Some people can put up with extraordinary levels of external stress. There's plenty of evidence from people in prison camps, concentration camps and so on who seem to sail on, while others seem to go downhill very quickly. So there's genetic elements. I'm arguing that many of us who are more susceptible than we would like, to some of these too stressful events, can learn to manage them more effectively, using the techniques we're going to talk about in due course. So there's plenty out there going on, there's plenty of people catastrophising and allowing the external world to overwhelm them, and yet there are many others innately who seem to be able to manage it much better. I'm arguing strongly that all of us can learn to do better than we do now.

Geraldine Doogue: Medication: What's the current view about whether that's useful for people with stress, as opposed to your full-blown depression, say?

Antony Kidman: Well for anxiety and depression, medication can be very appropriate for an acute episode. People go through, yes, loss of a loved one, children being ill, even death of a child is one of the most severe stressors anyone can go through. Break-up of a marriage and all that sort of thing. And it's appropriate if they're having poor sleeping and eating poorly and so on, medication has its place. I would strongly believe that it's important, besides having medication, to undertake psychotherapy, well that they go and see a professional, or to learn some techniques in conjunction with the medication. But the objective being to come off the medication in due course, rather than relying on an ongoing -

Geraldine Doogue: But what? A 12 to 18 month regime?

Antony Kidman: No, no, I would suggest less than that, hopefully. I'm not saying that some people might have to go to that extent, but unfortunately some of the medications for anxiety say, can be addictive. Depression, not so bad.

Geraldine Doogue: But does it give people, again, what do the studies show? Does it give people a window in which to allow their good coping mechanisms to come to the fore?

Antony Kidman: Yes, you've just hit the nail right on the head, Geraldine. It allows people who are so far emotionally down well, so to speak, can come up to a certain level where cognitive techniques, in other words using the central nervous system to manage our catastrophising thinking about what's going on around us, to work, so that our levels of depression and anxiety can be brought to more appropriate levels perhaps of sadness and appropriate concern.

Geraldine Doogue: So you have to go to a doctor to get those, don't you? These are not over-the-counter.

Antony Kidman: No. There are some preparations you can get over-the-counter for sleeping and so on, but by and large, the Benzidozipans, the anti-depressants and so on are on prescription. But in conjunction with - if it's a GP you're going to, there are many GPs who work with a psychologist, which I am these days, many, and often that kind of joint relationship can be a very effective team, and there's no shame in seeking professional help. I want to emphasise that. No shame, these days.

Geraldine Doogue: Well you say that, but what about the people who are listening and saying, Well I'm sorry, I was raised to believe that this was about character?

Antony Kidman: Well you see, then I'd start saying Well we need to dispute that irrational thought, because you wouldn't hesitate to go and have someone assist you if you had a broken limb or an infection, you would go and seek help from a physician.

Geraldine Doogue: Well let's talk about this disputing irrational thoughts, because you put quite a lot in your book on that; I think it's very interesting. Is this a new way of thinking about it? It's obviously a part of cognitive behavioural therapy, I take it?

Antony Kidman: It is. It is relatively new, in the sense that when I say it's been around for 50 years, but it's been prominent I'd say for the last 30 years, and is now very much a mainstream approach used by clinicians, psychologists, psychiatrists, GPs. And it is about from a purely cognitive point of view, challenging the automatic catastrophising thoughts that all of us get from time to time when we think everything's going out the window, we're going to wind up in the gutter, or whatever, because of some event. And it is never quite like that. There's always alternatives and cognitive behaviour therapy teaches people how to dispute the catastrophising negative thoughts and to come to a more appropriate thinking.

Geraldine Doogue: You actually give a little template of how people might write these down in one column: Situation, Automatic Thoughts, second column; Rational Response, third column; Disputing Form can go in the next set of columns. So you actually find that people writing this down helps them?

Antony Kidman: Well the evidence is very good, over many studies, that getting it out of one's head, because one's head is where wild thoughts go on.

Geraldine Doogue: The beauty of the human imagination.

Antony Kidman: Yes, we all know what I'm talking about Geraldine, I'm sure you and I and all the listeners, a wild red-hot thought can drive us up the wall with anxiety. Getting it out on paper, whether it's the workplace, family, health, and then getting it writing out of the head, and then disputing it, using the little procedures I show here.

Geraldine Doogue: Can you just give me a very brief, for instance, please?

Antony Kidman: Well let's have a look. I'm quoting, if I may, from the book. 'At a function with strangers, felt they were watching me'. A lot of people have anxiety, social phobia and so on, and the automatic thought was 'People are looking at me, I must be doing something wrong; perhaps I said something stupid' etc. etc. This is a simple sort of example. And then Disputing Thought: 'I'm standing around like anyone else; no-one is pointing at me, so people do that from time to time.' OK. So the idea of getting a dossier.

Geraldine Doogue: And you actually suggest people write this down and build up a habit of disputing their catastrophe.

Antony Kidman: Right. Of disputing their catastrophising, depressogenic, whatever it is, thoughts. And then having that little file so that they can go and look at it and re-read it every now and again, to enhance their skill and practice.

Geraldine Doogue: You do another one here: 'Situation: Was thinking of all the things I want to get done over the weekend' (this is me, you see). The Automatic Thought is: 'I'll never get all of this done, it's too much for me.' The Rational Response: 'I've done more than this before, and there's no law that says I have to get it done anyway.' Have you tried this yourself, does it work?

Antony Kidman: I have. It does. I tell you when we're prone to negative thinking. You wake up at 3am and you suddenly think things are like that. And it does work, because by the time you get to the next day and it's 10 o'clock and so on, things are different. But you want to get back to sleep, so stuff like that can help.

Geraldine Doogue: Very quickly, have you seen people fundamentally change their stress habits?

Antony Kidman: I have. I'm not saying this is magic, I'm not saying it's the be-all and end-all, but I've seen people move into more appropriate ways of thinking, feeling and acting, which means that they are leading happier lives in spite of the events going on around them. And sometimes we cannot alter the events, we're stuck in a job, stuck in a relationship, stuck with a health problem, but we change our reaction to it. Sounds easy, hard, but the payoff is well worth it.

Geraldine Doogue: Dr Kidman, thank you again.

Antony Kidman: Thank you.

Geraldine Doogue And Tony Kidman's book is called 'Stress - Coping and social support in the age of anxiety'. And its publisher is the Foundation for Life Sciences. All the proceeds from it are going back into his particular department.

Guests

Dr Antony Kidman
Clinical Psychologist, director of the Health Psychology Unit at the University of Technology, Sydney

Publication

Title: Stress, Coping and Social Support in the Age of Anxiety
Author : Antony Kidman
Publisher: Foundation for Life Sciences
Price: $14-95