Indicators of Stress: Cognitive Indicators
Cognitive indicators of stress are thinking responses that include problem solving, structuring, self-control or self-discipline, suppression and fantasy. Problem solving involves thinking through the threatening situation, using specific steps to arrive at a solution. The person assesses the situation or problem, analyzes or defines it, chooses alternatives, carries out the selected alternative, and evaluates whether the solution was successful.
Structuring is the arrangement or manipulation of a situation so that threatening events do not occur. For example, a nurse can structure or control an interview with a client by asking only direct, close questions. Structuring can be productive in certain situations. A person who schedules a dental examination semi-annually to prevent severe dental disease is using productive structuring.
Self-control (discipline) is assuming a manner and facial expression that convey a sense of being in control or in charge. When self-control prevents panic and harmful or nonproductive actions in threatening situation, it is a helpful response that conveys strength. Self-control carried to an extreme, however, can delay problem solving and prevent a person from receiving the support from others, who may perceive the person as handling the situation well, as cold, or as unconcerned.
Suppresion is consciously and willfully putting a thought or feeling out of mind: "I won't deal with that today. I'll do it tomorrow." This response relieves stress temporarily but does not solve the problem. A man who keeps ignoring a toothache, putting it out of his mind because he fears the pain of having a filling, will not obtain relief of his symptoms.
Fantasy or daydreaming is likened to make-believe. Unfulfilled wishes and desires are imagined as fulfilled, or a threatening experience is reworked or replayed so that it ends differently from reality. Experience can be relived, everyday problems solved, and plans for the future made. The outcome of current problems may also be fantasized. For example, a client who is awaiting the results of a breast biopsy may fantasize the surgeon was saying, "You do not have cancer." Fantasy responses can be helpful if they lead to problem solving. For example, the client awaiting breast biopsy result might say to herself, "Even if the doctors says, 'You have cancer', as long as he also says it can be treated, I can accept that". Fantasies can be destructive and nonproductive if a person uses them to excess and retreats from reality.