The Role of Pleasure and Play in Stress Management

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Are your patients burned out and dispirited? All too often, we underestimate the role of pleasure, play, and social connection in alleviating stress. Read on to learn my recommendations for helping patients incorporate these crucial components into their lives.

The stress response is an innate and essential mechanism that ensures survival. When the body perceives a threat, the acute stress response kicks into gear. The sympathetic nervous system releases norepinephrine and epinephrine, which increase blood vessel dilation and blood flow to the muscles. This ultimately allows us to escape the threat.

In the modern world, however, our stress response kicks into gear far too often. This is a classic example of the mismatch hypothesis, which states that our biology is in many ways poorly adapted to our modern environment (1). Being cut off in traffic, rushing to meet deadlines, and the constant influx of email are enough to send many people into a “fight or flight” response. Far from helping us survive, this can quickly derail our health if we aren’t actively taking time to manage stress.

Have you noticed the powerful impact play can have on your stress levels?

Pleasure, play, and social connection are all deeply nourishing and restorative on both a physical and an emotional level and can provide a powerful antidote to stress. Stress management is particularly important in patients with HPA-dysregulation, but all people, patients and clinicians alike, can benefit from these activities.

Endorphins: Nature’s Feel-Good Chemicals

When we experience pleasure, our bodies secrete endorphins (2). Endorphins interact with opiate receptors in the brain to reduce our perception of pain. They act similarly to morphine and codeine, but unlike these drugs, they do not lead to dependence or addiction. Endorphins are thought to be responsible for the “runner’s high” that many feel after several miles (3).

Secretion of endorphins also leads to an improved immune response (4), release of sex hormones (5), modulation of appetite (6), and feelings of euphoria. Most importantly, high endorphin levels may help us cope with the negative effects of stress.

How to Cultivate Pleasure and Social Connection

I tell my patients to make pleasure and connection as much a priority as eating well and getting enough sleep and exercise. Here is a summary of the recommendations I make to help patients incorporate these components into their lives:

  • Get plenty of physical contact and touch from hugs, massage, sex, partner dance, and partner yoga.
  • Cultivate intimate relationships and expand your social support network by being open and honest, scheduling time with loved ones, joining a friendship group, and putting yourself in situations where you’re likely to meet people you’ll connect with.
  • Get a dog, cat, or other pet. If you already have one, set aside time to play and interact with your pet.
  • Listen to music that makes you feel alive, happy, relaxed, and at peace. Use software or music exchange groups to discover new music and expand your horizons.
  • Volunteer for a cause you believe in, and focus on giving more to the people in your life.

Play Is Fundamental to Life

Imagine a life without play: no games, sports, movies, art, music, jokes, stories, daydreaming, flirting, make-believe, or roughhousing. Such a life would hardly be worth living. “If you think of all the things we do that are play-related and erase those,” says play expert Dr. Stuart Brown, “it’s pretty hard to keep going. Without play, there’s a sense of dullness, lassitude, and pessimism, which doesn’t work well in the world we live in.”

Playing comes naturally to kids. It is effortless, spontaneous, and universal. As we grow older, though, we’re often made to feel guilty for playing. Play is seen as a waste of time, and since “time is money,” play is like throwing money down the drain.

Yet despite these cultural attitudes, a growing body of evidence suggests that play is as fundamental to life as sleep, dreams, pleasure, and connection. Play is not simply a frivolous luxury; it’s necessary for the development of empathy, social altruism, and other behaviors needed to handle stress. It keeps our minds and brains flexible, and it helps us adapt to a changing and unpredictable world.

What Exactly Is Play?

Defining play may seem unnecessary, and perhaps even impossible. But having a better understanding of what play is may help us see more opportunities for cultivating it in all aspects of our lives.

According to Dr. Brown, play is:

  • Apparently purposeless: Play is done for its own sake, not to achieve a goal.
  • Voluntary: Play is not a requirement or an obligation.
  • Inherently attractive: Play is fun and feels good.
  • Outside of time: When fully engaged in play, we lose a sense of the passage of time.
  • Outside of self: When fully engaged in play, we become less self-conscious. We don’t worry about whether we look good or awkward or stupid.
  • Improvisational: Play is spontaneous and doesn’t lock us into a rigid way of doing things.
  • Mildly addictive: Play makes us want to do more of it.

Getting More Play into Our Lives

With this in mind, here’s a list of tips for encouraging your patients to incorporate more play in their lives:

  • Take your play history. Think about the things you loved to do as a child or when you had more play in your life. What got you excited? What gave you the most joy? What activities did you lose yourself in?
  • Make a list of play activities. Using the results of your play history above, make a list of ways you love to play and put it somewhere you will see it every day. It’s easy to get wrapped up in the hustle and bustle of life, and sometimes a quick glance at this list will be enough to remind you to do something playful.
  • Create opportunities for play. Play is all about perspective. If you look for chances to play, they’re everywhere: throw a ball for a dog, play hide-and-seek with your kids, improvise on the piano, have a board game night, carry a sketchbook with you, or simply go on an aimless walk in the woods.
  • Embrace “beginner’s mind.” In Zen practice, the term “beginner’s mind” refers to an attitude of openness, curiosity, and humility and a lack of preconceived notions. This is an excellent mental state to cultivate for play, since fear of looking silly, awkward, or unskilled is one of the biggest obstacles to play for adults.
  • Follow your bliss—but don’t mistake play for fun. Play can be fun, but it can also be absorbing, challenging, and demanding. For example, if you’ve always dreamed of building your own sailboat and sailing it to Mexico, much of that process may not be fun, but it can still be play.
  • Make play a priority. If you’re busy with work, family, and other obligations, it can be difficult to find time for play. Schedule time for play just as you schedule time for other necessities in your life. If this seems daunting, start small—perhaps just 30 minutes a week. My guess is that after you experience the benefits of play, you’ll naturally find time for more.

With a little more pleasure, play, and social connection, your patients are that much more likely to reach their health goals and will form daily habits that will last a lifetime.


  1. For the past two years I have scheduled a painting get away in Eureka California. I go alone and spend time with a group of men and woman who love to paint. The days fly by but my mind gets so into the project that it lets go of all the business/medical stuff. I miss my husband but am eager to get back to him but he enjoys me doing this too.

  2. I absolutely love this article! Thank you for addressing this topic of adults taking time to play or have fun. My childhood was shortened by my parents need for me to contribute to their business and livelihood. Play was considered a waste of time – too many other things to do. I’m 59 yet I still don’t make time for regular play. My business takes over my days/nights. Conceptually, I know this is not healthy yet I seem to not be wired for play. Am I hopeless? This article gives me hope and reminds me to explore options to take a small step toward finding something all my own that is fun for me.