Since most of modern stress stems from psychological issues, it makes sense to employ psychological methods to manage these problems. Although the sexual abuse was certainly brought on physically, it manifests itself for years inside the psyche and, if not dealt with effectively, it will cause physical disease. An excellent way to begin the healing journey is to have a consultation with a psychologist, psychiatrist, a mental health center, or a support group.

A lecturer, when explaining stress management to an audience, raised a glass of water and asked, "How heavy is this glass of water?" Answers called out ranged from 8oz. to 20oz. The lecturer replied, "The absolute weight doesn't matter. It depends on how long you try to hold it. If I hold it for a minute, that's not a problem. If I hold it for an hour, I'll have an ache in my right arm. If I hold it for a day, you'll have to call an ambulance. In each case, it's the same weight, but the longer I hold it, the heavier it becomes."

He continued, "And that's the way it is with stress management. If we carry our burdens all the time, sooner or later, as the burden becomes increasingly heavy, we won't be able to carry on. As with the glass of water, you have to put it down for a while and rest before holding it again. When we're refreshed, we can carry on with the burden.”

You can always pick up tomorrow whatever burdens you're carrying now. Let them down for a moment if you can. Relax. Pick them up later after you've rested. Life is short. Enjoy it!

Dr. Herbert Benson (www.mbmi.org) worked with hypertensive patients in the 1970s by teaching them the relaxation response through meditation. He found that many could lower their need for medication and that some patients could relax sufficiently to not need any drugs at all to change their blood pressure to an acceptable level. His book, The Relaxation Response, explains this method of Eastern cultures, which can be learned by anyone in a short time. Meditation is a skill that can be used anytime to combat stress. In their book, Handbook of Religion and Health, the authors reviewed studies that evaluated meditation, which found that people who used this relaxation method had lower cortisol levels.(1)

1. Koenig, H.G. et al. (2001) Handbook of religion and health. New York: Oxford University Press.

Dr. Edmund Jacobson described this technique in 1938. PMR involves the gradual relaxation of all the major muscle groups in the body and is also fairly easy to learn. Begin by tensing the foot for ten seconds and then relaxing the foot. Then tense and relax the other foot. Move up the body by tensing and relaxing the muscles in the calf, quads, stomach, back, hands, arms, shoulders, jaw, and face. This may take 20 minutes and should produce a very relaxed state.

Some psychologists use hypnosis to train their patients to achieve deep states of relaxation. Books and tapes are available for those do-it-yourself individuals. In hypnosis or self-hypnosis, messages can be programmed into the subconscious. Positive affirmations, such as "I am feeling better about myself" or "I am a courageous survivor," can help to improve one's self image.

Imagery involves using one's imagination to create a mental scene. One method to achieve deep relaxation is to imagine a peaceful and beautiful setting, such as a bubbly mountain stream in a green forest or a orange and red sunset over a sailboat-filled harbor. Let your mind paint the picture and take yourself there mentally for a mini-vacation. This technique requires some practice but can be used anywhere at any time to relax in the face of stress.

In fighting disease, guided imagery has also been shown to be effective. Dr. Carl Simonton, a radiation oncologist, first used imagery with a patient who had terminal throat cancer. The patient was not even a candidate for radiation but believed this was his last chance and so he used the imagery three times daily. After seeing his improvement, Dr. Simonton delivered radiation treatment. The patient used imagery again, visualizing the radiation as bullets that bounced off the healthy skin cells and exploded the weak cancer cells. After continuing the improve, the patient had scans that revealed the cancer had disappeared.

While this method may not work for everybody, researchers have shown (1) that guided imagery and deep relaxation enhanced the immune response and strengthened the NK cell activity, which extended survival times in breast cancer patients. Dr. Simonton offers CDs and books at his website, www.simontoncenter.com, which explain and teach guided imagery. Dr. Bernie Siegel has also worked with cancer patients and has developed successful ideas (www.ecap-online.org) along these lines.

Since many of us already have cancer in our bodies, which our immune system keeps dormant, it might be wise to use imagery every day to mobilize our defense cells toward any unknown tumors. This is preventive medicine. We use dental floss to prevent cavities and gum disease, but how often do we use "mental floss"?

1. Spiegel, D, Bloom, JR, Kraemer, HC, Gottheil, E: Effect of psychosocial treatment on survival of patients with metastatic breast cancer. The Lancet: 2:888-891, 1989.

Many contemporary motivational speakers and authors underline the importance of thinking in a positive vein. Statistics show that only 30% of the population thinks in this way, while 70% are negative thinkers. By taking lemons and turning them into lemonade, one can learn to deal with any stressful encounter.

Mark Twain claimed that the worst things he worried about in his life were those that actually never happened. So many of us think the same way. We worry about future outcomes before they occur. Often we are surprised that what we worried about so much turned out so well.

Dr. Denis Waitley, a sports psychologist, delved into the psyches of champion golfers and swimmers in the 1970s and found a series of traits that all of these superb athletes had in common. They expected the best continually; they never gave up; they learned to relax under pressure; and they always enjoyed the challenge of competition.

Pour water into a glass until it is filled halfway. Stop and look at it. Ask yourself if the glass if half full or half empty. Then decide how you want to live your life.

Socrates, the Greek philosopher from ancient times, said "Gnosce te ipsum," a Latin translation that means "know thyself." Thousands of years later, his advice still makes sense. Knowing one's personality can help in self-understanding and self-acceptance. In surfing the Internet, one can find millions of sites for personality surveys. One book that explains a predictable method is Please Understand Me, an easy-to-read volume written by Dr. David Keirsey, a psychologist. He explains that each personality type is wonderful in itself, a unique gift from God. Information about this can be found at www.keirsey.com.

By evaluating your personality, you can begin to understand your preferences. If others, especially those close to you, also understand your preferences, then they can understand why you want to do certain things. Expecting an introvert to thrive at an all-night party is unrealistic. Likewise, expecting an extrovert to enjoy a weekend retreat of reading books also can invite frustration. Our television commercials often glorify the bar scene, where everyone is smiling, laughing, and drinking beer. Let’s face it: beer marketing gurus would never choose a scenario of reading novels in the library to sell their product. Yet, both the extrovert and the introvert have their rightful place in society and neither should feel that the other is odd. Knowing that it is OK to be you can be a powerful step in gaining happiness and a healthy self-image, so essential in avoiding disease.

Of all the stress management strategies to help the SA survivor, improving self-image and self-esteem is probably the most crucial and the most difficult. The sense of guilt and shame often make it hard for the survivor to like herself or himself. Yet, loving oneself is the cornerstone to relationships. It is impossible to love someone else, your spouse, children, parents, if you don’t love yourself.

Getting rid of the guilt and shame may take time and it’s going to be a longer process if you have had multiple adverse childhood experiences, as the research shows. This cleansing may require visits to a psychologist or psychiatrist and/or a lot of reading. One practical and effective way to increase your self-esteem is to do a good deed … without telling anyone about it. The old story about the Boy Scout helping the old man across the street helps the scout as well as the elderly one. Take an orphan to the zoo for an afternoon; volunteer at the hospital; pick up some litter on the sidewalk; take food to a family in need. The list goes on and on. Be creative and remember not to tell anyone about it. Only you need to know. You will begin to feel better about yourself. And you should because you are a survivor, a courageous hero who isn’t afraid to fight the demons and the flashbacks. And remember: you are somebody because God doesn’t take the time to make a nobody.

In 1984 Drs. Maddi and Kobasa, professors of psychology, wrote The Hardy Executive. They based this book on the reactions of the employees of AT&T during the stressful time of the large break-up of this large utility company. They found that some employees flourished but others got sick from the stress. After analyzing the personalities of these employees, they discovered a personality trait called “hardiness,” which enabled the successful employees to excel in times of stress. Those who got sick had personalities deficient in this trait.

The authors described hardiness as a personality style whereby individuals feel in control of their lives, a trait that helped them to remain healthy in times of stress. They found three commonalities in people rich in this trait, the three ‘Cs’: commitment, control, and challenge. Employees high in hardiness showed a true commitment to their job, their families, and themselves. Even though the company was switching their roles and often requiring them to move to a different city, they felt that they were in control, in charge of their destiny. They did not assign control, or purpose in their life, to an external source. Finally, these hardy folks looked at the many changes, brought on by their company’s massive reorganization, as a challenge, not a hassle, and wanted to see how they could handle this challenge.

Finally the authors suggest that some may increase their hardiness, especially in times of extreme stress, by learning something new (taking a course in a university or school-based program) or starting a new activity (yoga, volleyball, etc.).

Although childhood sexual abuse (or that which occurs during adulthood) would never fall into the category of small stuff, much of what happens to us in everyday life is indeed small stuff. In his book of the same title, Dr. Richard Carlson lists one hundred ways to manage daily stress. He begins by quoting William James, “The greatest discovery of my generation is that a human being can alter his life by altering his attitude.” And to paraphrase the motivational speaker, Zig Ziglar, you can change your altitude by changing your attitude. By spending two minutes each morning in reading one of Carlson’s chapters, you, too, can change your altitude.

Dr. Bernie Siegel has written a similar book, 365 Prescriptions for the Soul, in which he offers a daily epistle and follows it with a “soulution of the day.” Dr. Siegel is a retired surgeon who works behaviorally with cancer patients and has written other books for this population.

A variety of authors have attempted to teach us how to master our emotions; how to control them instead of allowing them to control us. Dr. Wayne Dyer is one of the foremost in this field. His analysis of the words we say is interesting. How many of us start a sentence with “I have to…” instead of simply saying “I am going to …”?

I have to go to work; I have to go to the store; I have to take the kids to soccer, etc. are phrases that assign our locus of control to external sources. Yes, our words do reflect the way we view life. When others control our lives, we feel powerless, trapped, and somewhat unhappy. Dyer suggests eliminating the “I have to” phrase from our vocabulary and doing things because we want to, not because we have to do them. So, try this and see if it helps. I’m going to the store sounds much stronger than I have to go to the store. And, if you really dislike going to the store, try to find something positive about it and turn those lemons into lemonade.

Ask yourself to avoid using certain phrases such as "I can't," "I have to," and the host of negative words that seem to enter into so many conversations. Often this is used as an excuse because we don’t want to do something. First of all, you can do just about anything you want to do – within reason and within your ability. Secondly, there are few things in life that you really "have to do." Breathing and going to the bathroom are two exceptions. Learning that you control your life, rather than being controlled by external event, will help to boost your confidence.

However, “I can’t afford it” may sometimes be true and may be advice worth following. But we limit ourselves with this phrase so many times that we may be shortchanging our abilities. While it may be true that average Joe golfer can’t beat Tiger Woods, there are a lot of things that we can do, if we only believe in ourselves. Recently I ran the Grandfather Mountain marathon in North Carolina, listed as one of America’s toughest marathons. I would agree with its ranking after huffing and puffing up and down the mountainous course. I ran with a 45-year old lady who told me that she had been anorexic in college and was down to 87 pounds. She then decided gaining weight was OK and bulked up to 209 (on a 5’5” frame that’s called obesity). Finally she had an epiphany in her life and decided to trim down and start running, which she does very well, having finished 19 marathons. We can do just about anything we want to do, including being in charge of our emotions and deciding to eliminate anger, frustration, jealousy, and fear from our lives.

Goals are dreamt about by multitudes, talked about by many, but written down on paper by only a few. What goals do you have? To learn to love yourself? To lose weight? To run a marathon? To improve a relationship? To be happy every day and avoid negative emotions? The list can be endless. But goals can significantly improve the lives of SA survivors and can help them avoid disease in the future.

Make your goal realistic. Having a goal of being a National League pitcher when you never made it past Little League is a pipe dream. But being the most valuable player on your YWCA softball team may be achievable. Learn to distinguish between impossible goals and those that can be reached. However, don’t be afraid to shoot for the stars. It’s better to try and fail than to never have tried at all.

Goals are not goals until they are written on paper. Let me repeat: goals are not goals until they are committed to in writing. But, don’t worry: you don’t have to show them to anyone, if you so choose. To begin, write down the goal, develop a way to reach it and set a time limit for accomplishing it.