Stress Rating Instrument
Series: Internal Awareness

Julia Mitchell-Hoffman, ECE Behaviorist (2015)

Dr. Holmes presented the following instrument as a means to identify why a person's level of stress was so high. As you consider each of the following events, think about how often in the past year you have experienced the event. It can be an eye opener as to why we find ourselves overly stressed. I have listed some prevention tools at the end of this list.

Stress Rating Instrument
Thomas Holmes, MD


1. A lot more or a lot less trouble with the boss.
2. A major change in sleeping habits (sleeping a lot more or a lot less or a change in time of day when you sleep).
3. A major change in eating habits (eating a lot more or a lot less or very different meal hours or surroundings).
4. A revision of personal habits (dress, manners, associations, and so on).
5. A major change in your usual type or amount of recreation.
6. A major change in your social activities (e.g. clubs, dancing, movies, visiting, and so on).
7. A major change in church activities (attending a lot more or a lot less than usual).
8. A major change in the number of family get together(s) (a lot more or a lot fewer than usual).
9. A major change in your financial state (a lot worse off or a lot better off).
10. Trouble with in-laws.
11. A major change in the number of arguments with spouse (a lot more or a lot fewer than usual regarding child rearing, personal habits and so on).
12. Sexual difficulties.
13. Major personal injury or illness.
14. Death of a close family member (other than spouse).
15. Death of spouse.
16. Death of a close friend.
17. Gaining a new family member (through birth, adoption, oldster moving in, and so on).
18. Major change in the health or behavior of a family.
19. Change in residence.
20. Detention in jail or other institution.
21. Minor violations of the law (traffic tickets, jaywalking, disturbing the peace, and so on).
22. Major business readjustment (merger, reorganization, bankruptcy, and so on).
23. Marriage.
24. Divorce.
25. Marital separation from spouse.
26. Outstanding personal achievement.
27. Son or daughter leaving home (marriage, attending college, and so on).
28. Retirement from work.
29. Major change in working hours or conditions.
30. Major change in responsibilities at work (promotion, demotion, lateral transfer).
31. Being fired from work.
32. Major change in living conditions (building a new home or remodeling, deterioration of home or neighborhood).
33. Spouse beginning or ceasing to work outside the home.
34. Taking out a mortgage or loan for a major purchase (purchasing a home or business and so on).
35. Taking out a loan for a lesser purchase (a car, TV, freezer, and so on).
36. Foreclosure on a mortgage or loan.
37. Vacation.
38. Changing to a new school.
39. Changing to a different line of work.
40. Beginning or ceasing formal schooling.
41. Marital reconciliation with mate.
42. Pregnancy.

Looking at each event:

What personal meaning do you attribute to the change?

What feelings do you relate to the change?

In what ways can you adjust to each change?


Take time when you are making choices and try to anticipate what might occur.

Planning ahead is essential in reducing stress.

Give yourself the time you need to accomplish a goal or task.

Appreciate what you do.

Use relaxation skills (deep breathing, muscle relaxation)

Be gentle with yourself

Accept the things that you can NOT change

Choose what changes you would like to work on

Plan small steps at a time

Do something good for yourself everyday

Internal Awareness What is Stress

Julia Mitchell-Hoffman, ECE Behaviorist (2015)
Stress can be broken down into four specific sources:
1. Environmental
2. Social
3. Physiological
4. Cognitive (our thought process)
Environmental Stress
Where we live, work and play has many different types of demands that cause us stress. Today is a perfect day to be discussing environmental stress as to the fact we have tons of snow here in Illinois. Here are a few stresses that you might have experienced this morning:

• Will the children have school? If not who can I get to sit with them? If they do, will there be bus service?
• I need to leave early today to drive to work in case there are traffic issues?
• Man I hope people are going to use common sense driving today.
• I wonder who will call out sick today and who I can get to cover shifts.
• I really hope my clients call to cancel their appointments if they decide they cannot make it in.
Environmental stressors can also include noise, air pollution and so much more.
Social Stress

This area tends to represent the anxieties placed on time and attention. These can include such things as deadlines, interpersonal relationships and communication, professional dealings, difficulties paying bills, scheduling, death of a loved one, the birth of a child, parenting issues, and so much more.

Physiological Stress

There are natural stress that happens to the body such as growth, menstruation cycle, aging, illnesses and menopause. There are also things we do that can add to this type of stress such as
• Lack of exercise
• Poor nutrition
• Not enough sleep
• Ignoring warning signs
• Not taking care of an injury
When we are experiencing stress from the environment or from our social life we often have physiological symptoms such as upset stomachs, headaches, depression and anxieties.
Cognitive Stress

Our brain sets an alarm off informing us of the need to respond when we are presented with stress. How we see the situation and how we think it will affect our future can help determine how we will respond to the stress. If we can see the situation as something that will help us, we tend to relax and breathe. If we interpret the situation to be dangerous, risky or problematic we may tend to not breathe correctly and our emotions get stirred up. This can best be described as anxiety provoking.

Let’s look at an example:

You come home from work and your love one looks at you with what you determine is a sour look. You begin to run through your head all the possibilities of reasons she might be mad at you. 
Did I leave the toilet seat up? Did I forget the trash? 
Did I forget her birthday? 
Did the children act up at school? 

Anxiety has been triggered.

Or maybe:

You come home from work and you see a look on your love one’s face that seems like she is tired or preoccupied with her own thoughts. You smile at her and pull her into a warm embrace and ask her how was her day.

How we respond or interrupt the situation determines how and when stress begins.

When we become over stressed and anxious we often decide that the situation is out of our control; it is just too painful and dangerous; and/or we do not have the resources to handle the situation.

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