If I asked you to list and rank order the 5 events that cause you the most stress and then to tell me how you relieve stress what would you say? I know what I would say. My wife and friends and I have just returned from a holiday in south-east Alaska. In Juneau, Alaska's tiny capital, there is a cable car that goes from the center of the town up to the top of Mt Roberts. My wife loves these experiences - I detest them. I didn't realize I had acrophobia - extreme fear of heights - until I was driving up to a small village in India called Nainital. This pretty little British hill station lies at 6000 feet in the Himalayas. The trip nearly paralysed me. The experience also humbled me as I learned what it is like to have screamingly high levels of stress, anxiety and fear.



Everyone has a different Stress trigger. Some people test their physical and psychological limits through bungee jumping, rock climbing and so on. For me heights are a problem so I have to think of ways of relieving the stress. In the most extreme cases, my stress relief strategy is avoidance.

What are your triggers? What things, creatures, events, meetings, circumstances are your stressors? There are quite a few groups of triggers or stressors that will increase your adrenaline rush and make you feel anxious and worried. Let's look at some of them and, while you are reviewing my list of triggers, note down any that are a particular worry for you.

In the workplace we have these triggers: organizational changes, unfair or excessive workloads, too much unpaid overtime, stressful demands and expectations, duties that do not match individual's job specification, work that is boring and is not motivating, no (or limited) autonomy over the work situation, job insecurity and threatened redundancy, inadequate training for the demands of the position, inadequate, inappropriate or excessive supervision, a work environment that does not meet occupational health and safety standards, inadequate resources to do the job. Others include inappropriate social culture in the workplace, for example, racist, harassing, discriminatory, poor relationships with colleagues or bosses, and dramatic events in the workplace, for example, death, severe injury, hold-ups. What a list. It is a wonder that so many of us enjoy our workplaces a well as we do.

We can also have emotional or internal stressors such as fear of animals, insects, people or places. Other internal triggers are being in social settings and not knowing what to say. Worries about appearing dumb or stupid. Fears that you are not dressed appropriately for the occasion. Concerns about what other people think of you. Preoccupation with your body shape, size, weight - butt too big, stomach sticks out - you know.

There are of course, stressors that are family based. Worries about your children's education and development and/or their behaviour, relationship problems, financial difficulties. Drugs are always a worry for parents and for the victims themselves. Feeling dependent is a stressor. Triggers can be unwelcome news, problems with fidelity, fears about the future. There are plenty of triggers out there.

We each need to know what it is that causes stress and we have to learn how to relieve the stress. I use a simple acronym to help people manage their stress - BE CALM. It is B for build, E for examine, C for confront, A for accept, L for let go (forgive, forget), and M for Move on with your life. I explain this more carefully in clinical settings but the important point is that we can map out a program to relieve and manage stress very well.