Counselling and Psychotherapy for Stress Management

What is Stress?

Stress is our internal, conditioned response to the demands of the environment. It is primarily a physical response, evolved from our primitive ‘fight or flight’ reaction to physical threats in the olden days. Though we no longer encounter physical threats these days, we experience stress in response to modern day stressors, such as unemployment, death of a loved one, or relationship issues.

We have all experienced stress at some points in our lives. However, stress is often experienced differently among different individuals. For example, an event (e.g. public speaking) that may be perceived as stressful to one individual may not be perceived as stressful to another. Different individuals may also respond differently to the same stressor (e.g. unemployment), because of differences in coping and personal resources.

The Holmes and Rahe Stress Scale

The Holmes and Rahe Stress Scale, also known as the Social Readjustment Rating Scale (SRRS), is a list of stressful life events (1). Each life event has been assigned a numerical value (‘Life Change Units’) according to its estimated impact. By adding up the values of stressful life events that one has experienced over the last 12 months, the total score predicts how likely one is going to have a major health breakdown due to stress.

Here are some of the common stressful life events that we may experience:

  • Death of a spouse (100 units)
  • Divorce (73 units)
  • Marital separation (65 units)
  • Being fired at work (47 units)
  • Troubles with the boss (23 units)

Interpreting Your Scores

300 and above: High risk of a major health breakdown (80%)
150 to 299: Moderate risk of a major health breakdown (50%)
Less than 150: Slight risk of a major health breakdown

You can score your stress levels using the Holmes and Rahe Stress Scale here.

Have you experienced major changes in your life in the past year? If your score on the Holmes and Rahe Stress Scale is moderate or high, you may want to consider getting professional help to manage your stress.

Counselling and Psychotherapy for Stress Management

Signs and Symptoms of Stress

Stress is experienced differently among different individuals. However, here are some of the symptoms that are commonly associated with stress:

  • Difficulties in falling and/or staying asleep
  • Falling sick easily
  • Experiencing various physical symptoms, such as headaches, backaches, gastric pain, fatigue or sexual dysfunction
  • Constantly feeling tense, worried, anxious, depressed, frustrated or overwhelmed
  • Easily irritable and quick to anger
  • Experiencing interpersonal conflicts with others
  • Difficulties in concentrating
  • Having negative and disorganized thoughts

Seeking Help for Stress Management

Stress tends to build up over time, and as a result, weakens our ability to cope. Hence, it is important to seek help for managing your stress when it starts to feel overwhelming.

You should seek help for stress management when you are:

  • Feeling increasingly overwhelmed in your day to day life
  • Feeling that the stress is affecting your physical health (e.g. headaches, gastric pain, chest pains, falling sick easily)
  • Using unhealthy methods to cope with your stress (e.g. alcohol, drugs or smoking)
  • Having angry outbursts that are affecting the people around you

01 | Psychotherapy

Psychotherapy, or ‘talk therapy’, is a process that allows individuals to talk about their personal problems through structured conversations. The individual can work with the psychotherapist on identifying and managing personal stress triggers, changing negative thoughts, and exploring adaptive coping strategies.

A common intervention for stress is called Stress Inoculation Training. Stress Inoculation Training is a form of psychotherapy method that helps individuals prepare themselves in advance to handle stressful events successfully.

02 | Mindfulness

Mindfulness practices can help individuals struggling with stress as well. Mindfulness is the practice of being focused on the present moment. The practice of mindfulness helps individuals accept what they are experiencing, and not dwell on stressful or unpleasant situations.

Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are two mindfulness-based programmes that have been developed for stress, anxiety and depression.

Tips for Reducing Stress

01 | Understand Your Stress Triggers

Some individuals perform their best under the pressures of a tight deadline. Others thrive when they get to plan their work ahead of time. Take some time to understand the mechanisms of your stress. What gets you stressed? What usually happens for you when you are stressed?

Understanding your personal stress triggers will allow you to make changes in your environment and to find appropriate strategies to cope with the stress.

02 | Maintain Positive Habits

No matter how busy you are, or how the circumstances in your life change, it is good to stick to the ‘non-negotiables’ – important positive habits that should not be compromised. The three most important ones are: eating well, having enough sleep, and having adequate exercise.

Besides, exercise has been found to be a great way to relieve stress. It increases the levels of endorphins in our brains, and improves our mood (2).

Read more: 5 Powerful Positive Habits to Practice Everyday

03 | Relaxation Techniques

Simple relaxation techniques such as deep breathing and visual imagery can help individuals to calm themselves down when they are feeling stressed.


(1) Holmes TH, Rahe RH (1967). “The Social Readjustment Rating Scale”. J Psychosom Res. 11 (2): 213–8. doi:10.1016/0022-3999(67)90010-4
(2) Hegberg NJ, et al. Physical activity and stress resilience: Considering those at-risk for developing mental health problems. Mental Health and Physical Activity. 2015;8:1.

Featured images by Freepik

Counselling and Psychotherapy Services

Sofia Wellness Clinic offers counselling and psychotherapy services for teenagers and adults. If you would like to seek professional support for you or your loved ones, contact us today for more information or request for an appointment.