I think high stress full tilt training should be done FOF style, and while FOF should comprise a lot of your training (particularly NON gun FOF, IMO, but that's a different topic) only maybe 3-5% of all your training should be full tilt, stress inoculation style, if that.
I have been posting a lot about Southnarc's classes and lessons I personally learned taking 3 (Armed Movement in Structures, Edged Weapon Overview, and Extreme Close Quarters Concepts). I think the most time-effective sane way to train is to use his class (or one just like it which I'm unaware of existing) to get a basic feel for your weak points, and take that class once or twice per year to cahrt your progress.
After taking ECQC (the most recent one I took) and getting my butt kicked intermittently just like everyone else who took it, I zeroed in on the following:
-Work on my gun handling skills to make them automatic and secondary to decision making processes about my external environment
-Take BJJ to ensure I can maintain mobility/consciousness (top priorities in the paradigm Shivworks' curriculum teaches)
-Work on "fighting fitness"
What I'm getting at here is, nothing I could legally, safely do outside of that classroom setting will come anywhere near the level of stress I experienced there. I will do some "higher pressure" training to lock in some skills as I build them, but don't believe it is necessary to patch up the holes exposed in my game by the class.
So basically you don't just throw stress in like you would some Mixed Up Salt on scrambled eggs.
You need to figure out what your priorities are, and whether you are even building the correct skill set and habits. Then you need to patch the holes. Patching the holes can be:
Visualization/mental programming
Dry fire and dry run type training (focusing on positioning, verbal skills, whatever)
"Hard skills" like martial arts, live fire, or another discipline useful to the goal within a goal (overall goal being survival, subgoal being improve self-defense, subgoals being patch up holes in your SD game)
When you are comfortable you have built the skill you need in the area you previously lacked it - and trust me, most everyone is lacking somewhere, and all the worse off if they are unaware or rationalizing - you go back to that butt-kicking class and test it, then start the process over.