Well, it seemed like a good idea when June asked me if I'd like to write an article for the journal, but that was months ago and the deadline is rapidly approaching, and I'm feeling stressed. Why did I agree to do it? Why didn't I start it sooner? What can I write? ... etc. Oh, and it's to be an article about stress!
So, as I'm demonstrating by my present panic, stress is without doubt a part of life, part of the human condition and it is, therefore, not useful to consider it in terms of its presence or absence, but in terms of its degree and the effect it has upon a person. In this article I will first say a little about the way our bodies respond to a stressor and explore my thoughts on what stress really is.
When a person is under stress the body prepares them for 'fight' or 'flight' by producing a heightened state of arousal - this is achieved by increasing the flow of certain hormones (known as the stress hormones) - which increase heart rate and blood pressure, release stored fuel into the blood stream, increase blood flow to the muscles, suppress the immune system, stimulate the cognitive systems, shut down the digestive process - in other words prepare us for action of one sort or another. As you can imagine, this was a useful response for our ancestors (and other animals) who might have had to face predators like sabre-toothed tigers - it effectively prepared them to run away or to stay and fight. It is this response to stress that enables people, in an emergency situation to lift a huge weight to free another trapped person, something that they would be quite unable to do without the energy from the I stress response'. However, in our society where aggression or rapid physical escape are seldom the appropriate responses to the stressors we face, the stress response can become destructive and health threatening since the energy created by the stress hormones is not physically used up. The most important point that I want to make in this article, which is so relevant to my work as a psychotherapist and counsellor, is that it's not just external events that trigger the stress response, a person's thought patterns can trigger it just as easily - If I'm angry or afraid about past or future events and I spend a lot of time dwelling on these, then what was intended as an emergency reaction may become a prolonged and chronic one. In other words I may live my life as if a sabre-toothed tiger were in the room with me! This can have very serious implications for health - if the immune system is suppressed for long periods it can make a person more susceptible to a variety of illnesses, including cancer, rheumatoid arthritis, infectious diseases etc. If blood pressure is raised and the mobilisation of stored fats into the blood stream continues, then there is an increase in the likelihood of strokes and heart attacks. (For more information, see Ref. 1).
In view of the above it seems to me simplistic to measure stress in terms of external events which cause change in a person's life - the 'Life Events' approach to measuring stress. We have all probably filled in questionnaires which ask us to add up the events in our lives during the last six months, and these are useful as an indication as to whether someone might be under too much external stress, for example, if I've just separated from a partner and moved house, this might not be a good time to change my job. However, this approach will miss the stress that I may be causing myself by my anxiety about past or (possible) future events, so I may have a low score on the questionnaire, yet feel extremely stressed. Another important consideration which may be missed by the 'Stress Questionnaire' is the person's perception of how stressful an event might be for them, for example, I might feel great sadness and anger about my divorce because I still love my partner, I've been deceived and I don't know how I'm going to cope financially and emotionally as a single parent with two young children; whereas you might be opening the champagne to celebrate your new freedom. Obviously, in this situation, I'm going to feel more stressed than you although the event - divorce - is the same. Another important consideration (and this relates to my earlier point about internal response to stress) -is that events in a person's life do not happen in a vacuum, but in the context of their life and in relation to other events. I will bring myself and my history to any current situation - my past and present experiences, my personality, attitudes and beliefs will all shape the personal significance of any event. It is well known that a person who has stressful and difficult experiences in childhood (e.g. the loss of a parent) may experience stronger reactions to stressful events in adult life.
Stress then, is best viewed as a psychological state which will be influenced by my sense of how well I think I can cope with my life at this time. Its important to remember that stress can be exciting and stimulating and joyful in a situation where I feel challenged (but not beyond my perceived abilities), and where I achieve my goals and desires. It's really when I have doubts and fears about whether I can cope with a particular situation that stress is experienced as distress.
The way that a person copes with stress is, then, an important mediator of its effects. Coping can influence whether or not stress is life enhancing or health threatening, and coping implies a feeling of control over events and the perception that the stressor can be controlled. ]be level of physiological arousal (and, therefore, the release of stress hormones) caused by any external stressor is lower when the person feels that they are in control. It would be naive, and insulting, of me to suggest that it is possible to control all events in life - if I am in a concentration camp or a person I care deeply about leaves me (by dying or by choosing to leave) then I don't have any control over the event itself What I do have control over, however, is my response to events. For example, I can choose to feel resentment towards someone who I feel has in some way abused my rights - I can choose to stay resentful for years, or I can choose to feel the underlying feelings (perhaps anger, sadness or grief) that are keeping me stuck in my resentment. I can choose to confront the person I feel the resentment towards or I can choose not to, and either way I can choose to move on. The important thing for me to remember is that if I choose to stay with my feelings of resentment about past events then, really, the only person I harm is myself I can let go of my feelings and, thus, of the accompanying stress response I have created.
The above view of stress, unlike the 'Life Events' view sees the individual as an active participant in their own life, someone who interacts with their enviromnent rather than a passive victim of the external world. This is not to say that people are to blame when they feel stressed, but to affirn my belief that when I take control over toy own life and my response to both external and internal events, then I feel less stressed and much more powerful - I begin to create my life as I want it to be.
1. Cox, T. 'Stress' Macmillan Press, London: 1978
2. Gatchel, et al. 'An Introduction to Health Psychology' Random House, New York: 1989