Lippin Papers > Stress Release: Emerging Tool in Total Stress Management Program



Stress Release: Emerging Tool in Total Stress Management Program

Excessive or poorly managed stress represents a threat to worker health, safety and productivity

By Richard A. Lippin, MD, Centre Square Medical Director, Atlantic Richfield Company, Philadelphia, Pa.


Excessive or improperly managed stress and its effect on the psychological and physiological wellbeing of workers has gained increasing attention by the occupational health community. Due largely to scientific strides in stress research and advances in neuroscience, it is now generally accepted that excessive or poorly managed stress represents a major threat to worker health, safety, and productivity.

In response to this important issue, many corporations have instituted a wide variety of stress management programs. Most of these corporations are now aware that, in order for these programs to achieve success, changes must occur at both the institutional and individual levels. Changes that have occurred on the institutional level within the workplace setting include increased participative management, development of so-called “quality circles” and providing flexible employee benefit menus which may be tailored to the individual employee’s need in an increasingly complex world. These benefits include such concepts as flex time, day care, educational benefits and various health care benefit choices to meet individual needs. Also, most progressive corporations have established Employee Assistance Programs (EAPs) which respond to a wide variety of employee psychological needs, ranging from alcoholism and drug abuse to family and financial problems.

Corporate Programs. In addition to social changes at the workplace, corporations have offered employees a variety of individualized stress management programs or techniques, Prominent among these include educational seminars on stress, general exercise programs and relaxation training programs.

Commonly available stress management tools or techniques individuals can use are divided into cognitive and behavioral categories as depicted in Figure 1.

One behavioral concept that is not included in this figure and has been largely overlooked in stress management programs is “stress release”. Stress release can be defined as the active ventilation of stress in a socially acceptable manner. Examples of unacceptable reactions to stress include a range of emotional problems and dependence on drugs and alcohol.

The history of stress release, ventilation or catharsis, is not new. In the late 19th century, Joseph Breuer (1842-1925) a prominent Viennese psychiatrist and a colleague of Sigmund Freud developed his “cathartic method of hypnosis” which was widely accepted conceptually. Other prominent psychiatrists such as Wilheim Reich, Otto Rank or, more recently, Dr. Alexander Lowen continued to explore the value of abreaction, catharsis, or energy release.

In 1970, Dr. Arthur Janov published a landmark book entitled “The Primal Scream” which defined and described an entire theory of neurosis and psychotherapy based on the concept of repressed pain (or stress) and the physiological need to express that pain. Although Janov’s work has not been widely accepted and practiced in traditional psychiatric settings, there is increasing scientific evidence that emotional catharsis has significant and measurable benefits.

Recently, scientific studies of crying behavior, for example, at the Psychiatry Research Laboratory at St. Paul Ramsey Medical Center by Dr. William H. Frey II suggest that weeping has definite physiological benefits. It was noted that tears could be differentiated into irritative (reflex) vs. emotional tears according to biochemical analyses. Stress hormones such as ACTH (adrenocorticotropic hormone) can be found in tears leading to the hypothesis that crying could indeed be “nature’s safety valve” for humans which when practiced in appropriate settings can reduce stress.

Norman Cousins, a non-medically trained prominent writer, popularized the concept that laughing has health giving or salutary effects. Laughing, like weeping, is also being studied scientifically at Stanford University by Dr. William F. Fry Jr. and to date, results tend to confirm what Cousins suggests, namely, that deep belly laughing does produce physiological changes which correlate to reduction in stress.

Another classical stress reliever is the well studied sexual response where certainly it has been proven that the orgasmic response in particular is associated with profound physiological energy release followed by a period of relaxation.




I. Cognitive

·         Attitudinal shifts (e.g. "don't sweat the small stuff")

·         Counseling or psychotherapy (e.g. assertiveness training)

·         Positive thinking and imagery.

II. Behavioral

·         Reduce caffeine, alcohol and nicotine use.

·         Increased general exercise program.

·         Increased rest and relaxation (vacation, hobbies)

·         Formal relaxation techniques (the relaxation response, meditation, Yoga, deep muscle relaxation)



Recording Thoughts. Even writing a letter, angry or otherwise, keeping a journal or diary, writing a poem or short story, has cathartic value for many people. Patients have reported to me that they experience a sense of relief when their thoughts are recorded on paper especially if these thoughts are of an emotional nature.

Finally, specific exercises tend to fend themselves to a stress release phenomenon. These include any exercise involving a hitting or kicking motion, such as punching a bag, handball, any racquet sport, golf or soccer. Martial arts also have a role to play in stress release. For example, scientists are beginning to investigate the physiology of karate. The scientific hypothesis pertaining to stress releasing exercise is that when stored muscular energy (tension) is released onto an inanimate object, muscle tension, which is a well-known physiological concomitant of stress, is reduced. This could be referred to as “the strike response”. The techniques for stress release are summarized in Figure 2.

The implementation of these activities or responses requires that health professionals provide suggestions, counseling or, if necessary, formal training on techniques leading to the incorporation of these activities into an individual’s life. For example, one might propose to a patient that he initiate a home library of movies, tapes, books or letters which might stimulate or precipitate the mirth or weep response.

Also, there are known physiological methods, such as deep breathing or sound, to enhance or augment the weep, laugh, strike or sexual response. Most importantly, if the health professional simply provides “permission” or validation to engage in these techniques, a significant service has been done. Also, the health professional should encourage the patient to practice and utilize these techniques in a socially acceptable setting which is most often the privacy of one’s own home. Patients who practice these techniques must be sensitive to the limited ability of many others to feel comfortable when witnessing some of these behaviors.




Activity                                                  Psychological Response

Crying                                              the "weep response"

Laughing                                          the "mirth response"

Orgasm                                            the "sexual response"

Writing                                             the "scribe response"

Hitting or Kicking Exercises               the "strike response"


Stress Threat. In summary, because excessively or improperly managed stress is increasingly being recognized as a major health and safety threat for working Americans, we must maximize our capabilities of dealing with this problem.

The accident illness model based on stressors as primary stimuli and catharsis or normal venting as a healthy release mechanism is depicted in Figure 3.

Many proven stress reduction pro grams and techniques are being successfully implemented throughout corporate America. Scientifically-based stress releasing techniques add yet another set of tools for use by the stress managers.

Total stress management programs should consider prescribing one or more of these techniques to the appropriate stressed worker.





1.   “Handling Stress, Current NIOSH Research.” Occupational Health & Safety November-December 1983.

2.   Masi, D. “Designing Employee Assistance Programs” - American Management Association, New York, 1984.

3.   Freundlich, D. “An Historical Perspective of Primal Therapy” Center for the Study of the Whole Person-Publication May 1975

4.   Janov, A. “The Primal Scream,” Dell Publishing Co., New York, New York 1970.

5.   Frey, W.H. II “Not So Idle Tears.” Psychology Today pages 91-92, January 1980.

6.   Cousins, N. “Anatomy of en Illness (As Perceived by the Patient)” New England Journal of Medicine-1976 Vol. 295 Pages 1459-1463

7.   Fry, W.F. “Catharsis and Arousal: Humor as a Paradigm” Abstract from an Address Given at the Annual Meeting of the American Psychological Association. New York, September 1979.

8.   Black, T.W. “Laughter, Special Communication” J.A.M.A. No. 21, pages 2995-2997, December 1974.

9.   Geer, T. Heiman, J., Leipenberg, H. “Human Sexuality” page 46, Prentice Hall, Englewood Cliffs, New Jersey 1984.

10. Stricevic, M.V., Tanner, A., Okazaki, T. et al “High Tech Karate-Monitoring Cardiovascular and Metabolic Responses to Selected Techniques” Black Belt Yearbook.  Burbank, Ca Vol. 22, 1984

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