The Bathtub Model of Stress

The Neuroscience of Navigating Stress to Overcome Burnout, Build Resilience, and Forge Growth

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As a psychiatrist in Silicon Valley, I commonly treat people who suffer from burnout due to the chronic stress of working in a fast-pace and results-driven culture. Burned out, they often develop health issues, clinical anxiety and depression. My job is to help them recover from burnout and the deleterious toll it takes on their mental and physical health. Using a neuroscience-based treatment approach, I educate and empower others to successfully and effectively navigate stress in life. Moreover, in gaining a practical know-how to harness stress, people are able to build resilience and forge growth to become stronger and better. Ultimately, people learn to not only survive, but more importantly, thrive in the face of stress throughout life.

In order to effectively navigate stress, we first need to be aware of how stress affects us both cognitively and physically. Stress affects our cognitive and physical performance in an inverted U-shaped manner, known as the Yerkes-Dodson Law (see figure 1).

Figure 1​. Human response to stress curve (​adapted from​ ​Nixon​ ​P:​ ​Practitioner 1979, Yerkes, Dodson)

When challenged at a moderate level of stress, we enter our growth & learning zone, where we are capable of optimal functioning and attaining peak performance.

The inverted-U relationship indicates performance is optimal at moderate levels of stress and suboptimal at lower or higher levels of stress. When stress is low, we are relaxed in our comfort zone. As stress increases, it triggers our sympathetic nervous system, activating us to become progressively more alert, engaged, and challenged. When challenged at a moderate level of stress, we enter our growth & learning zone, where we are capable of functioning optimally and attaining peak performance.  However, if stress continues to increase, we will surpass optimal performance and descend into our distress zone, where fatigue and exhaustion will begin to impair us. If we are continually exposed to additional stress, we will get pushed beyond our functional limit into our breakdown/burnout zone, physiologically known as the “fight, flight, freeze” state. If we stay in this destructive and dysfunctional zone for a prolonged period of time, we will be at risk of developing mental and physical health issues.

Growth only happens from pushing ourselves past our comfort zone.

To effectively navigate stress, we have to stay on the left side of the curve and avoid getting pushed out into the breakdown/burnout zone. When we find ourselves on the right side of the curve, we must pull ourselves back over to the left side, where we can rest and recover. This is how we develop resilience. Likewise, when we’re on the far left of the curve, we must routinely push and challenge ourselves past our comfort zone so that we can grow and become stronger. Growth only happens from pushing ourselves past our comfort zone. When we deliberately and consistently maintain this perpetual back and forth state of balance between optimal stress and restorative rest, our curve will ultimately shift and expand (see figure 2). As our curve grows bigger, we will perform more optimally in response to stress while increasing our capacity to tolerate even more stress. This is how we ultimately thrive.


Figure 2. Stress inoculation shifts the inverted U-shaped curve to promote resilience (Russo et al., 2012)

To help embed and reinforce the understanding of the Yerkes Dodson inverted U-shaped curve, I use the metaphorical “Bathtub Model of Stress”, which was originally applied in military training among West Point cadets. 

Imagine our body is the bathtub and stress is the water that pours in. In life, we can never turn off the water. We can drain it or we can slow down the rate at which water pours in. The water level is always changing, moving up and down. And sometimes unexpectedly, our drain gets clogged or a sudden rush of water comes pouring in.  And if our water level rises to the top, our bathtub will overflow, as water spills over onto the bathroom floor, damaging everything in its path.

Going back to the inverted U-curve, when we flip it upside down, it becomes the bathtub (see figure 3)! In essence, the area under the curve represents the size of our bathtub, ie. our capacity to deal with stress. The smaller our bathtub, the less resilient we are to stress. Likewise, the larger our bathtub, the more resilient we are to stress.

Figure 3. Bathtub Model of Stress

Maintaining a consistent and regular routine in moving our body is paramount to effectively navigate stress throughout life.

When our bathtub is full, we are in the breakdown/burnout zone. It is critical that we drain the bathtub to prevent prolonged exposure to the harmful effects of chronic stress on our health. The most effective and immediate way to drain the bathtub literally involves releasing water from our body through our sweat. Sweating by moving our body via aerobic exercise, lifting weights, dancing, hiking, sports, whatever gets our heart pumping and body sweating is the most effective way to combat the negative effects of stress. Maintaining a consistent and regular routine in moving our body is paramount to effectively navigate stress throughout life.

Equally important for navigating chronic stress is slowing down the rate at which water pours in. To do so requires that we habitually and intentionally engage our parasympathetic nervous system, ie. “rest and digest” system. To keep our water level low involves engaging in self care, getting sufficient sleep, proper nutrition, connecting with others, spending time in nature, meditating, practicing faith, doing breath work, and cultivating a sense of safety, respect, and love for one another. 

I gave a video presentation of the “Bathtub Model of Stress” at the virtual 2021 Never Alone Summit as told through my personal journey with mental health. It is featured in the Exclusive Content  for viewers who are interested in mental health and wellness.

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