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Ten top ways to combat stress

Hugh Koch and James Koch suggest some steps for easing the pressure that GPs can take straight away.

The culture of long hours, detailed work, time pressures and ultimate professional accountability for actions (and inactions) result in a need for GPs to manage varying and, at times, high levels of stress.

Attempts to reduce stress are most effective when the approach you take is practical and immediate. Use strategies small enough to do relatively easily and quickly that you can put into practice today. We call these 'active steps'.

Practical stress reduction falls into six categories covering the key areas of everyday life. These are:

Motivation Why feel less stressed?

Thinking Thinking more positively, logically and mindfully.

Lifestyle Nutrition, exercise and managing healthy home/work environments.

Communication Giving and receiving positivity (positive thinking) and warmth.

Behaviour Getting better organised and relaxing more.

Personal action plan This can help you remember what to do to reduce stress and when to do it for longer-term benefits.

The following are 10 active steps to use in your surgery and at home today, tomorrow, this week and next.

These ideas work, so do try them out.


1. Why feel calmer?

Motivation Consider how feeling calmer could improve your quality of life.

Benefits could be improved long-term health, increased success at work, improved relationships, feeling happier, more positive and relaxed on an everyday basis.

2. Stay optimistic

Thinking From the start of each day, try to think and talk positively about yourself and your day. Optimism and hope are good not only for health, but are a powerful force for problem solving and achievement.

3. Recognise your successes

Thinking Adopt the habit of recognising all the little things you achieve each day. Seeing the first patient of the day, phoning a friend, being honest and supportive, smiling at someone in the street ... these are all successes. Appreciating them will feel good.

4. Go for a walk

Lifestyle Make the most of a gap in your day with a 10-minute walk.

Even a small amount of exercise can help burn up stressful adrenalin, release feel-good endorphins and leave you feeling a bit more clear headed and at ease. No two walks will be the same.

5. Maintain a work-life balance

Lifestyle At the end of the working day leave your work at the surgery. Enjoy your time when you get home. Do fun things with your partner and family, enjoy a hobby (such as cooking, exercise, writing, or playing a musical instrument) or just relax.

6. Make small connections

Communication See other people as your friends who can help you feel calmer (and you them), for example, people you pass in the street or whoever serves you at the newsagent. Exchanging smiles, saying hello or having a small conversation will help you to feel good.

7. Don't bottle things up

Communication You spend a lot of time listening to others. It is also important that you discuss how you feel.

During or after a tough day, contact someone you enjoy talking to and tell them how you are feeling. This will help you feel more relaxed, positive and connected.

8. Control the controllable

Behaviour Make a plan of what you can do today and this week to get organised, rather than worry about what is outside of your control. Keeping your home and surgery space as clean and tidy as you can will help you feel like you are winning.

9. Practise 'instant relaxation'

Behaviour Use a trigger word such as 'relax' to get you started at the beginning of your next surgery. Take a deep breath and let it out slowly, counting to 10 as you go. Feel your mind clear and your muscles relax. Repeat regularly throughout the day.

10. Review your progress

Personal action plan It is important to identify what works for you.

Does a short walk after your surgery session clear your head? Does it feel good when people smile back at you in the street? Does instant relaxation give you a warm feeling inside? If so, keep practising these skills. The more you do them the more natural they will become and the greater the benefits.

  • Dr Hugh Koch is a clinical psychologist and his son James is also a psychologist. Their book 'Active Steps to Reducing Stress', price £9.99 is available from www.brackenbooks.co.uk and bookstores

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