Need to know
James was a busy primary school teacher, married with three young children. In the middle of term time, he got particularly stressed, occasionally shouting at his class, and at his children at home. He soon caught himself but could get self-critical afterwards, even doubting whether he was in the right job. His sleep was frequently disrupted and after a tough week, he often resorted to drinking more alcohol than he would like, meaning he was overly tired and got stressed with his family. James had tried mindfulness training, but he couldn’t find enough time to keep it up. His wife prompted him to see a counsellor or psychologist, but James’s stress would come and go, and so he never looked into the possibility.
Stress is a part of everyday life, at work and at home. Everyone experiences the symptoms of stress in different ways, to different degrees. James’s story is just one example out of countless others – and we’ll return to him later. Stress for you might mean waking up early and not being able to get back to sleep, or becoming a little snappy and irritable with others. Or perhaps you are more easily overwhelmed, and when you’re stressed, your head feels full, you worry most of the time, and you’re constantly on edge or in a low mood. When stress is extreme, it can involve swings in mood, feelings of depression, flashbacks of upsetting events, and being excessively self-critical. Wherever you sit on this spectrum of stress symptoms, we hope this Guide will help you.
Stress is usually seen as a bad thing for understandable reasons. But the ‘soft’ signs of stress, such as worries popping into your mind, are an indication that your brain is trying to help you sort out a problem. For example, if you are immersed in work and a memory that you’ve got to give a presentation next week suddenly pops into your mind, this might act as a prompt to remember to start doing some prep for the talk! But if you don’t attend to your worries (you push the presentation out of your mind and make no plans to prepare for it), your brain can eventually fall back on more primitive ways of coping – such as the tensing of muscles, breathing faster and jumpiness. These are all part of the ‘fight-or-flight’ system that your brain uses to deal with an immediate danger (and which evolved in our mammalian ancestors to escape or attack a predator). They can be triggered on the (hopefully) rare occasions that you are suddenly physically threatened, but they can also come online because of danger that you imagine or anticipate, for instance, if you started to imagine your presentation being a complete disaster.
In our roles providing emotional support to a range of people and organisations (Louise), and researching mental health support models (Warren), we’ve found that although there are many ‘stress management’ programmes available, none of them fit with what we’ve discovered is the most helpful for people, nor with what people told us they were looking for.
People told us they wanted helpful information and a range of strategies so they could choose how to deal with their own stress. Fortunately, we were already using a clinical approach that takes this perspective, based on what’s known as perceptual control theory (PCT).
According to PCT, life requires control, and feeling well and coping with stress is about being in control of what matters. Ultimately, what matters to a person can only be determined by the person themselves, not by others and their assumptions of what ‘should’ work. From the perspective of PCT, stress comes about when trying to control one aspect of your life conflicts with trying to control another aspect. For example, it is not stressful to work extra hours if you have the time and energy to do so, but it is stressful if you need to get home in time to care for your family. Put simply, all problems are conflicts.
James’s situation that we introduced at the start involves many different conflicts. He shouts at the class to try to help them calm down to learn better, but he doesn’t want to be the kind of person who shouts at children. He drinks to relax, but drinking can make him more stressed the next day. He wants to be more ‘mindful’ and improve his wellbeing, but doesn’t want to use up the time that he could be doing other more important or interesting activities.
Fortunately, your brain has a way of resolving conflicts – known as ‘reorganisation’ in PCT – but for this to work effectively, it needs to be focused on the source of the conflict for long enough to come up with a solution. This is why talking or writing about a problem can be helpful if it is self-motivated and done in the spirit of discovery.
Based on the insights from our work and drawing on PCT, we developed the ‘4Ds for dealing with distress’ – a unique collection of activities, tools and techniques, some of which might be familiar to you, and others that will be novel.
The 4Ds approach to dealing with stress is based on these basic principles:
- Our brains are pre-wired to resolve our problems. Have you ever been stuck in two minds about a big decision, and then found that the solution eventually just pops into your head? Just like your body manages your heart rate and body temperature, your brain automatically solves problems – but only if you give it the right raw materials, which means actually spending time thinking about and working through what is bothering you.
- Problems can be dealt with in the short term or the long term. A short-term way of dealing with a slow puncture in a car tyre is to keep pumping it up, but ultimately you will need to find the hole and get it repaired. Stress is similar – you need to have both short- and long-term ways of dealing with it.
- Most of us already have many strategies for dealing with distress, and some of them work some of the time. So what is needed is a way to select the right approach at the right time for a particular problem. And if that doesn’t work, try something else until it does.
- Everyone is different, and everyone’s causes of stress are different. So what people need is a way to learn and practise how to deal with their own stress in a way that works for them.
This is the 4Ds triangle that introduces the four Ds of dealing with distress, starting with short-term approaches at the bottom and working up towards longer-term solutions:
The 4Ds stand for distract, dilute, develop and discover. Each of these terms refers to a different purpose behind the way people try to manage stress. In the next section, we’ll show you how to work through the 4Ds to find an approach to coping with stress that’s effective for you.
What to do
Distraction can help with stress. It is about identifying things that take your mind off the stress. Most of us do all kinds of distracting activities, including some that are pleasurable or relaxing, such as exercise, sports, hobbies, reading, listening to music, and watching TV shows and films.
One challenge with using distractions effectively to cope with stress is that we don’t always remember, or find time, to do them. Another potential problem is that most distractions take your mind off the stress in the short term but can stop being effective after a while (often because they don’t deal with its root cause). Sometimes an activity might start as a distraction but then develop a different purpose. A classic example is engaging with nature, such as going for a walk in a forest. It can feel calming but, for some people, it can also provide an opportunity to think about their problems in new ways – which is a later step that we’ll return to.
Some people may use unhelpful ways of distracting themselves to excess, such as overeating, abusing alcohol, or staying overly busy to the point of exhaustion. According to PCT, an activity is a problem when it conflicts with important goals that a person has. For example, James used to go for a run as a way of distracting himself and it rarely caused any problems for him. However, he also used alcohol to ‘switch off’ and relax during the evenings at the weekend, but the tiredness he experienced the next morning made him feel more stressed during the morning routine, and he was also too tired to go for a distracting run. James decided to continue to use alcohol as a distraction, but he set himself a limit of three drinks in any one session. He also tried out some other distractions on other evenings: going for a walk, having a long bath, and reading a novel.
This step of the 4Ds is about you being in control and finding the most helpful ways of distracting yourself from distress.
Have a think about what your ‘go-to’ distract activities are. Write two of them down. Now write one more, but this time make it something you haven’t done for a long time. Write down when you might find time to do it next.
Dilute your stress
This step is about finding ways to get better control over the stress in your body and mind that feels out of control, or at least unpleasant. There are various techniques to choose from that can help you get into a state of mind that is less overwhelmed. You may have come across some of the techniques listed below already and found them helpful.
Slow breathing. If you’re stressed, sometimes your brain can start to prepare you for danger by breathing faster to get more oxygen (and less carbon dioxide) into the bloodstream. Slow breathing can help you gain control of your breathing rate, which in turn will help to slow down your thinking and activity levels, inviting a more relaxed and reflective state of mind. There are various slow breathing methods, but a popular one (known as square or box breathing) involves breathing in for five seconds, pausing with your breath held for around five seconds, exhaling for five seconds, then waiting around five seconds before you breathe in again for five seconds, and so on. You could count each five-second period in your head, or do something to track equal increments of time, such as slowly tracing the lines of a rectangle, as shown in this YouTube video provided by the University of Alabama at Birmingham.
Applied Muscle Relaxation (AMR). Just like with breathing, at times of stress your brain will sometimes prepare you for danger by tensing your muscles. AMR involves noticing each of the muscle groups in your body, and practising tensing and relaxing them in turn. This will help you get back control and learn where you hold tension in your body, so you are more able to notice it in the future. You can try starting in your toes, curling them tight to feel the tension as you hold it for five seconds, and then release, noticing the muscles loosen and relax. This video on YouTube, produced by clinical psychologist Mark Connelly and paediatrician Jennifer Bickel, will take you through the main muscle groups in your body.
Grounding. Sometimes people can get so stressed that their brain goes into a numbed state as protection, making them feel cut off from the world. Grounding is a way to get back that connection by doing an activity that requires ongoing use of your senses to control something simple – such as squeezing a stress ball, moulding with playdough or playing a basic video game. Another grounding exercise is called the ‘butterfly hug’, which you can try for yourself following this video demonstration shared by the TYF Support Group on YouTube.
Mindfulness Meditation. When you are stressed, your thoughts can start to race, and sometimes this can feel out of control, especially just before bedtime. Mindfulness is a popular technique that is likely to have a number of active ingredients, but one of them is focusing on and sustaining one thought at a time, allowing you to slow down your thinking when that’s what you need. There are many guided examples available online, but one of our favourites is this 20-minute video presented by Jon Kabat-Zinn, the creator of the Mindfulness-Based Stress Reduction programme.
The diagram below shows how the different dilute strategies can help you gain voluntary control over different systems in your body and brain. According to PCT, the nervous system is ‘hierarchical’, which means that it works like a vast branching network of roots. At every level, there is control – for example, to keep a muscle tense requires control. But control in all these ‘roots’ can work automatically and independently, completely outside of your conscious awareness. The dilute strategies work by bringing awareness to all the different systems, reducing conflict and bringing them under centralised, more voluntary control.
Remember, some of the dilute strategies will suit you better than others and their effectiveness can vary across situations. It is up to you to work out when and where they work best, and for what kind of stress in your life. James tried out all of the dilute strategies and found that if he kept a stress ball in his pocket, this helped him to ground himself when he noticed his anger getting out of control. He also used slow breathing but only in certain situations. He found that it took too long to work when he was in a busy classroom, but that it was helpful whenever he was able to find a reason to leave the room for a few minutes.
Develop long-term ways of dealing with stress
Develop is the preparation for the final discovery step and it involves reminding yourself of your own resilience, and planning ahead so that you feel more in control and better equipped to face future problems. From the perspective of PCT, change needs to happen from within the person rather than from the outside, and so the develop step provides ways to make sure that discovery is self-directed, on your own terms and timescale.
Worry time. Worrying thoughts can pop into your mind at any time, often when you are trying to focus on something else. ‘Worry time’ involves noticing the worry but choosing to think about it later, at a specific time and place when you give yourself permission to worry – such as 15 minutes after dinner. Having this plan in place allows you to postpone worries that arise at any other time. Establishing a ‘worry time’ will help you feel more in control. Take a moment now to consider what time of the day would be most convenient for your worry time.
Identify your strengths and resources. If you are preparing to face a problem, it helps to think about how you successfully dealt with problems in the past. Try to think of a time that you did this, such as starting a new job, dealing with a bully or coping after a loss. What helped you? Was it particular strengths or qualities that you have, such as keeping focused, or being OK about sharing your feelings? Or did you use particular resources, such as a journal, friends and family, or a counsellor? After bringing these past experiences to mind, write them down as an added reminder.
Compassionate imagery. To fully prepare to face a stressful situation, you need to feel sufficiently safe, secure and confident. Just as thinking of something dangerous can prompt the mind and body to prepare for fighting or fleeing the threat, thinking of something comforting and helpful can relax the mind and body to prepare for a stressful experience from a more explorative and problem-solving perspective. So, another way to prepare for the discover stage is to use compassionate imagery: for instance, bring to mind an image of a person whom you would feel comfortable talking to about your problems. It might be a person you know, or it could even be someone you don’t know, or a fictional character, or even a spiritual figure. The aim is to use the image to get into a ‘discovery’ state of mind.
James found ‘worry time’ useful, saving up his worries until the end of a school day, thinking them through and sometimes saying them out loud. James also decided to draw on a memory from when he left school at 18 and was looking for a training course. It had been stressful without a job, not knowing what he wanted as a career, but he did find a course and – with it – a career in teaching. He brought to mind how optimistic he was that he would find a way in the end, reminding himself that he was willing to get advice from people to help him decide. He could still imagine a meeting he had with a college tutor who spent over an hour with him, listening to his career ideas – and worries. James listed all of these experiences and he noticed it made him feel more confident about working through the stress he was going through now. He was ready for the final discovery step.
Discover more about yourself and your stress
As explained above, the develop approaches involve planning and preparing a time, a place and a state of mind for working out what might be at the root of your current problem. Once you have prepared in this way, you’re ready to use discovery methods to help explore your problem(s) in more depth and detail, to get a new perspective. Being in a discovery mode often involves the following:
- Expressing your thoughts and feelings through talking, writing, or some other form, such as art.
- Thinking about what you really want – your long-term goals, values and principles.
- Allowing yourself to be in two minds, or uncertain about something.
- Allowing spontaneous thoughts, feelings, memories, impulses and mental images to come up.
Free writing. The simplest way to engage the discovery mode is to do free writing. This involves putting your thoughts into words by writing them down as soon as they appear. Start with a phrase, either ‘What is bothering me at the moment is…’, or if there’s not a worry on your mind right now you can begin with ‘What is important to me right now is…’ It is important to do this for a fixed amount of time (even as short as a few minutes) that you set at the start, knowing that you won’t be interrupted. Once you start, keep writing, literally keep the pen on the page at all times, and don’t worry about spelling, punctuation or grammar. If you can’t think of anything, write that down too, along with any spontaneous thoughts, feelings, ideas, plans, etc that you notice.
Upward arrow. Even a few minutes of free writing can lead to a new perspective on a problem. However, there are ways to enhance this exercise. One is what we call the ‘upward arrow’ approach. In simple terms, it involves asking yourself ‘What bothers me about that?’ to any of the problems that you wrote down. Asking yourself this question several times about a problem can bring to light more about what is at the root of the stress. In turn, this might make the situation feel less stressful or burdensome because you understand the problem better. The technique can also reveal a possible solution to the problem that pops into your mind.
Discovery talk. Beyond free writing and the ‘upward arrow’ approach is a process known as ‘discovery talk’, which is based on a counselling approach called ‘method of levels’. To practise ‘discovery talk’, you’ll require support from another person, but it’s not about them giving you advice or solving your problems. Rather, the idea is that the person in the listener role stays curious at all times, asking you questions about your problem(s) and in doing so they help you to start to see your situation from a new angle. For more information on this approach, see the final Learn More section of this Guide.
James was initially sceptical that free writing would work, but after trying it out for a few minutes, he found that new ‘higher-level’ ideas about his situation were coming to mind. For example, he realised that he was more annoyed about the children in his class not listening to his explanations than he was about whether they were learning in class or not. But surely their learning was more important? This got him thinking about other ways to support the children’s learning that were easier for the children who couldn’t concentrate. Within the ‘upward arrow’ technique, asking himself the question ‘Why does it bother me that children in the class don’t listen to me?’, he realised this was a broader concern in his life – he wanted to be heard and understood for his ideas in general – and the classroom wasn’t the best place to find this. He started to think constructively about where he could be heard and understood in other areas of his life.
Going back down the pyramid
After fully facing a problem in the discover stage, it can sometimes bring up difficult feelings, and you might feel the need to have a break. If so, you can always draw upon the strategies further down the pyramid. For example, choose a dilute strategy such as grounding or slow breathing, or a distract strategy. Have a think about what would work for you after allowing yourself to reflect on your problems: TV, a book, a bath, a long walk, or a nap?
After learning about the 4Ds, James used distraction no more or less than before, but he built up a bigger repertoire of activities, and he did them when he really needed to, such as straight after a time he had allowed himself to worry. He still used some dilute strategies when his stress reached the occasional peak, but he built time for discovery into his week, sometimes using five or 10 minutes of free writing, and every month or so he met with a friend to do ‘discovery talk’. After learning about and practising the 4Ds, James felt more confident that he knew effective ways of dealing with stress, both in the short and long term – and this helped him feel calmer and more in control of his life.
The key novelty of the 4Ds is how it brings together all the different approaches people take to manage stress, and organises them according to their purpose and their impact in the short, medium and long term. A key message is that the way that these strategies work is for you to be in control of when, where, how you use them, and what problems you use them for. All of the strategies have scientific evidence because some of them work for some people for some of the time. We suggest you try out every one of them, even if they are not initially appealing, because this provides you with the best freedom of choice when it comes to what to use in everyday life.
Key points – How to feel less stressed
- Stress can show up in different ways. From sleepless nights to irritability to persistent low mood, the consequences of stress can vary, but underlying them all is a sense of conflict and loss of control.
- The 4Ds approach can help reduce this conflict and bring back a sense of control. The 4Ds are distract, dilute, develop and discover, giving you a range of tools to cope in the short and long term and, crucially, to find what works for you.
- Distract yourself. The 4Ds process begins by finding activities that take your mind off your stress and give you feelings of calm and control. From going for a walk to reading a novel, find what works for you.
- Dilute your stress. Stress manifests in the body and brain, cranking you up to fight or flee an immediate threat. The next step is to regain control by choosing from an array of exercises to help calm your mind and body, from slow breathing to mindfulness meditation.
- Develop longer-term ways to deal with stress. From scheduling ‘worry times’ to reflecting on your strengths and resources, these techniques help you to build your resilience and get into the right mindset to discover lasting solutions to your stress.
- Discover more about yourself and your stress. The final stage is about exploring the sources of your stress and identifying lasting solutions – exercises such as free writing and ‘discovery talk’ will help.
How to start using discovery talk
‘Discovery talk’ in the 4Ds is based on a form of counselling and therapy known as ‘method of levels’ (MOL) which is itself derived from perceptual control theory. The main difference between ‘discovery talk’ and MOL is that the former is designed for people who are not health professionals, so that it can be practised more widely, even through mediums such as texting and social media. MOL has even been emulated by an AI chatbot, known as MYLO (which stands for Manage Your Life Online). Preliminary findings are encouraging and the bot is currently being developed to support youth mental health, although it is not yet publicly available.
If you know someone whom you’d trust to talk to about your problems, then these are the basic rules of ‘discovery talk’:
First, decide who will be the speaker who shares their problem and who is the listener, and agree on a length of time for the conversation.
Assuming that you will be the speaker, you will start to talk about a problem you are having. You will be in charge of what to talk about, what pace to go, and whether to pause and re-start.
The task for the person you trust is to act as the listener and to attend closely to what you’re saying and stay curious throughout. Their aim is not to come up with solutions or give you advice. Rather they should aim to ask you questions about your problem(s) to help you gain more insight for yourself.
The process works best when the questions are varied, genuine, brief and they help you, the speaker, to clarify what you are currently feeling, thinking and noticing.
Remember, the listener does not offer their opinion, advice, interpretation, or try to summarise what you’ve said.
Continue the conversation for the duration you agreed at the start. You could make an agreement to switch roles at some point so that both of you get a chance to talk through a problem. Even within five or 10 minutes, ‘discovery talk’ can help the speaker to put the problem behind their stress into words for the first time, help them to feel listened to, and to explore facets of a problem in more depth and detail than they could possibly manage in their own heads.
Links & books
In this conference talk titled ‘Living in the Loop’ (2022), available on YouTube, Warren Mansell explains perceptual control theory (PCT) and provides an overview of an array of interventions based on PCT, including our 4Ds approach.
The book Should I Strap a Battery to My Head? (And Other Questions About Emotion) (2012) by Peter Totterdell, edited with Karen Niven, is a popular science book that gives much more detail on some of the stress management strategies covered in the 4Ds.
In this 2017 episode of the Renegade Ape podcast on YouTube, Warren explains how PCT may provide a ‘holy grail’ of psychological change by identifying and ‘distilling’ the active ingredients of other effective interventions.
In this interview from 2023, Warren talks to the LIVE with Scientists initiative about the various stress management and mental health interventions developed from PCT, and he describes how to recognise the discovery mode when facing and exploring your own problems.