Stress, An idea, a metaphor…

In the article: “Stress, Back to Basic”, I have compiled all of the information contained within the last newsletters, making sure to make it as easy to understand as possible, so that everyone can get a better idea of what stress is and how it can affect our lives.
I have explained that stress is only a problem when it becomes CHRONIC, when a person is unable to manage it (or to cope under the pressure), and when it is affecting one’s health.
 
Today, I am so happy to revisit the Wellcome Library. I can (and love to) drown myself in knowledge, feeling more and more secure in the fact that I know more and more on any given subject, and this time, enough to write the final chapter of my journey to better understanding stress. As I write this article, my heart feels with joy because I am able to learn, and closer to understand stress and how it is perceived in society and through the ages, which is such an amazing discovery of the world and of “self”, and how it can be experienced by different societies and people. ​

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A physical, chemical, or emotional factor that causes bodily or mental tensions and may be a factor in disease causation

Having read many books, consulted many Medical Journals and Peer-reviewed papers online, I love the fact that I can actually turn a page and discover a new facet on the subject. 
For example, Dana Becker, in “One Nation under Stress – The Trouble with Stress as An Idea” (2013 – ISBN 978-0-19-974291-2), writes in her chapter “Stress as Metaphor”:
 
“Stress has had many different meanings over the centuries, and because of this, the way we talk about “stress” now bears only a shadow of a resemblance to the way people talked about stress long ago. At once time, stress was a name for “what was hard and had to be endured” (don’t you love that term?), as Robert Kugelmann has noted. Stress demanded strength and fortitude. The image that was often invoked was that of a ship tossed about by the stress of bad weather, and in that image Kugelmann sees the difference between the stress of then and the stress of now. The storm-tossed ship represented something that neither challenged the forces outside it nor was wholly separate from those forces. Stress was what “proved the strength, power, and virtue of ship and crew”. It was occasional, like the wintery blasts that assailed that metaphorical ship; stress signified hardship, and endurance was needed to deal with it.”
 
She carries on explaining: “Early engineering gave us the idea of stress and strain, and from these followed the metaphor of the body as a machine with a finite store of energy and with parts that life could grind down. The 1949 edition of the Merriam Webster Collegiate Dictionary defined stress completely without reference to human beings, as the “action of external forces; especially to overstrain.” Today, the definition reads like this: “a physical, chemical, or emotional factor that causes bodily or mental tensions and may be a factor in disease causation” and “a state resulting from a stress; especially one of bodily or mental tension resulting from factors that tend to alter an existent equilibrium.” Stress now derives from physics, where it refers to the force that can transform material in ways that cause it to change its form or to break. In our vernacular, stress can be both a cause (“It was stress that caused his heart attack”) and an effect (“When the plane was late I was so stressed out”). But although we refer to stress as both a force outside the person and an inner state, recently it is the inner state that has been getting the primary emphasis.
 
“In Middle English, stress denoted “hardship or force exerted on a person for the purpose of compulsion”, suggesting that stress was someone else’s will forced on the individual rather that, as today, something we conceive of as integral to the “self”. Today’s stress concept owes a great deal to the dominant ideology of liberal individualism in which human beings are seen as free to act in accordance with their own judgement. It is an ideology that prizes not only individual freedom, but also individual success and self-actualisation. The “self” has become something we can think about – something we can even remake, if necessary. But individualism or no, the self is not separate from social expectations and norms; it can’t be considered apart from the way it is talked about and judged, as psychologist Nikolas Rose has pointed out. Many of the events in our lives (marriage, unemployment, combat) are open to judgements about how we have coped with or adjusted to them, and these judgments are steeped in psychological language that has slipped its middle class moorings to become the currency of our time.”  ​

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Stress now derives from physics, where it refers to the force that can transform material in ways that cause it to change its form or to break.

“People say, “I’m a commitment-phobe” or “I didn’t use to have any self-esteem”. Or “I’m pretty possessive about it”, or, more to the purpose of this book, “I’m stressed out.” These statements and the language they’re couched in didn’t come out of thin air, a function merely of our unique personalities and family histories; these are the available terms through with many of us come to understand ourselves. A philosopher Ian Hacking has noted, certain ideas play a part in how we are “made up” as people. They become part of who we are and what we do. And we are made up at a particular time in history and in a culture that subscribes to certain ideas and practices that themselves have a history.”
  
I particularly like the following from Dana Becker, who pursues in her definition of stress: “We can say that the concept of stress “makes up” or produces people who can act and think about themselves in certain ways: they can be anxious, irritable, depressed. They can behave in certain ways: overeat or drink too much or not take care of themselves. They can develop illnesses because their immune system is out of whack. They can see themselves as overwhelmed and/or out of control. Of course, this does not describe the entire universe of how “stressed” people can feel, behave, or perceive themselves, but you get the idea. I’m not saying here that experiences aren’t stressful or that people don’t experience something called stress. What I am saying is that at other times in our history, when the stress concept didn’t exist, we couldn’t experience ourselves in the way that stress both describes and delimits.” 
“When People believe that feeling “stressed” ruins their relationships, their work lives, and/or their health, they feel impelled to do something about it. The idea that people should constantly monitor themselves for signs of stress speaks to what Michel Foucault termed “technologies of the self”, practice that, as he put it, enable people to “operate on their own bodies and souls, thoughts, conduct, and way of being, so as to transform themselves in order to attain a certain state of happiness, purity, wisdom, perfection, or immortality. Of course, Foucault wasn’t referring to actual technology in the form of iPhone apps – though there are apps out there that purport to monitor stress. That’s right; one app asks you questions to determine how stress out you are and you can repeat this ritual daily until you have a “progress report on your stress-reduction efforts.” Another requires you to put your finger on the Smartphone’s camera lens so the camera can detect your pulse, turning the phone into a heart rate and blood-oxygen level monitor (of course, heart rate and blood-oxygen levels can vary for many reasons and not reliable indicators of stress, but this did not deter the app developer). Depending on the reading, the application dispenses advice, generally of the not-so-profound variety: “take a deep breath, a walk or a few deep breaths and slow down”. The media and their expert consultants – psychiatrists, psychologists, and other helping professionals – encourage people to maintain vigilance over their mental and physical states so they can transform those states when they judge they’re stressed out. They can avoid certain risks; take certain measures to monitor their health; use relaxation techniques, yoga, medication, meditation, psychotherapy, journaling, or organizing. These techniques as I argue throughout the book, are middle-class answers to primarily middle-class problems. But, as generally happens, dominant cultural ideas eventually become more widely influential. And as people take in the prevailing ideas about stress and its effects, they become adept at monitoring themselves for signs of stress and selecting stress management strategies from the available cultural menu of options.”   
 
I find the last statement rather pertinent, because it shows how stress has evolved through the times and how it is perceived today, and also that it has become something that can be taken advantage of. By giving people tools to address and manage their stress levels, it creates a demand. You must be stressed therefore you need…  And now someone can cash in.
Without a shadow of a doubt many people can benefit from help, but usually people suffering from the side effects of stress, chronic anxiety and depression, are left to deal with it on their own, until something snap and they understand that they cannot carry on going at it alone. Before this happens, if it happens at all, people often suffer in silence, distancing themselves from the world, and confining themselves to the safety of their four walls. It is why I need to stress that if you see a loved one, or someone you care about, being in a state that negatively impact on his or her health and well being, you have the responsibility to help. He or she might not want it. He or she might not see that they are self-sabotaging their own health and path to a happier life. They might not have the right tools to grief properly. But if they know you are by their side and that you are with them for the whole way, they will understand that something must change and that they can get better. Different people require different approach.
Some people after reading my newsletters will feel equipped enough, for they can understand what is preventing them from moving on and let go of the past and what is the source of their chronic stress. Some people my need counselling, therapy, or to join social gathering to open up their heart and mind to new people and activities.
Some people are stressed out mainly from family issues, feeling like they cannot cope, juggling with a heavy schedule and kids to feed and care for; some feel stuck in a relationship, sometimes abusive; sometimes they don’t see their home as a safe place. 
Some other people are stressed out because of their job. Overwhelmed by the demand on their productivity, or time, they take on themselves until one day something breaks.
Theses latter cases are easily manageable. Getting an au-pair, or some help around the house can relief most of the pressure and lead to a happier life and family time. Walking out of an abusive relationship can be the best someone can do. Starting afresh the best of solutions, no matter what lies in store. Changing job can be much rewarding than being stuck and crumbling little by little each day, with the feeling of not being recognised for the results obtained on a daily basis. 
 
Dana Becker further writes:
“In 1963, at a symposium on stress, Stanley J. Sarnoff of the National Institute of Health (NIH) was quoted as saying, “Stress is the process of living.” At the same symposium, Hans Selye (the actual creator of the term stress. You can read more about him in my previous newsletters), the principal architect of the stress concept as we know it, remarked: “One cannot be cured of stress, but can only learn to enjoy it.”
 
This reminds me that once I have read a very good advice about a meditation guru. If something, a noise for example, makes you crazy, such as the ticking of a clock, or a builder site outside your window, transforming the noise into music or something pleasant, or mimicking it, it will become part of who you are and you can then let go… It will no longer be a nuisance. Easy? Right…
 
“A piece on MSNBC’s website entitled “Can Stress Actually Be Good For You?” also tells us something about the gulf between Selye’s ideas about stress and our own, pursues Dana Becker: Stress can be positive, but get too much of it – when the flood of hormones bombards your body longer than 24 hours, doctors say – and all kinds of bad things start to happen [high blood pressure; heart disease; exhaustion; depression]. ‘Over time, if you’re constantly in fight-or-flight, if your heart muscles and valves are awash in epinephrine, it causes changes in the arteries…’ says Dr. [Lynne] Tan. The problem is, it’s difficult to shut off the onslaught of stress hormones when they become harmful. People can’t control how high their hormones go when they experience a difficult situation. ‘What we can do is change the way our brains respond to [stress] with coping techniques such as deep breathing and exercise,’ says Dr. Bruce Rabin. The goal isn’t an absence of Stress. It’s an unavoidable reality. Besides, without it, life would be a pretty dull experience. The key is channelling stress energy into productive action instead of feeling overwhelmed, experts say.”
 
Finally, I am able to give the actual history, or timeline, of how stress came about and to enter our modern language so easily. Until now, it was only fragments of information and dates, names and ideas. I believe to understand stress, we need to understand how it was perceived through the ages to become what we know of today.
 
“For all its ideological precursors in the nervous disease of the nineteenth century, the concept of stress did not enter popular culture until the mid-twentieth century. But as early as 1914, Walter Cannon, a Harvard physiologist, had used the term stress. Cannon was greatly influenced by a French physician, Claude Bernard, who had argued in 1878 that in order to manage conditions in the external environment, the body’s internal environment had to be constant [what we refer today in Naturopathic Medicine as “terrain”]. 
 
What follows is what is the most important part in history to understanding stress.
 
“Cannon studied the physiology of cats when they were in the presence of dogs, their natural rivals. Applying what he had learned about cats to humans, he concluded that in response to rage and fear (what he called “disturbing” conditions), the body released Adrenalin, the heartbeat sped up, and blood sugar rose. He noted that, despite these potentially disruptive effects, the body was able to keep “on an even course”, returning like a thermostat, to a steady state. Cannon called this state homeostasis.
“Cannon’s use of the term stress was different from today’s. His focus was not on the relationship between disease and the fast pace of life. Cannon described stress in terms of heat, hunger, oxygen deprivation, and other phenomena that can cause predictable physiological responses.”

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We react to an angry boss the way our Stone Age counterparts reacted to a sabre-tooth tiger, but we can’t run away.

It is generally agreed that, after Cannon, all stress theories were based at least in part on his ideas about homeostasis. It is also agreed, according to Cannon that there is an ongoing battle between our out-of-date physiology and the demand of our modern life. We make biological adjustments that are no longer functional: “we react to an angry boss the way our Stone Age counterparts reacted to a sabre-tooth tiger, but we can’t run away.”
   This is when our modern understanding of stress surpassed the notion of Homeostasis, because it was not enough. This is why the term Allostasis, came to life. But it all started with the work of Selye, as Dana Becker explains:
 
“Cannon may have been first to use the term stress, but Hans Selye, an endocrinologist born in Czechoslovakia, believed that in creating his theory of stress, he had made a discovery on a par with that of Columbus and Louis Pasteur. This initial “discovery” came about as a result of his attempts in the early 1930s to find new female hormones by injecting rats with a variety of tissue extracts. When, to his dismay, he found that all the different extracts caused the same response in rats, he started to think that the body might have a general response to noxious agents introduced to it, and he began to call these agents “stress”. By the late 1930s, Selye was convinced that a set of reactions he had observed, which he called the General Adaptation Syndrome (G.A.S.), was universal. In his formulation, the stress response was a general (nonspecific) response to any demand. The G.A.S. consisted of three stages: an initial alarm stage, in which the body prepared for either for fight or flight by, amongst other things, increasing blood sugar, perspiration, and heart rate and releasing hormones that would increase heart rate; a resistance stage in which these changes were essentially repaired; and if stressful external conditions persisted, a stage of exhaustion when adaptive processes began to break down and disease or even death might ensue. 
   “In his book The Stress of Life, written for a popular audience, he calls stress “the rate of wear and tear caused by life.” He used the new term stressor to refer to the “agent that produces the G.A.S.”
   “For Selye, health represented successful adaptation to the environment; disease, unsuccessful adaptation. He wrote that “disease is not just suffering, but a fight to maintain the homeostatic balance of our tissues, despite changes.”
   “Selye’s popularisation of the stress concept resurrected both old and new themes. Warning that “our reserve of adaptation energy is an inherited finite amount, which cannot be regenerated.” […] “Man’s ultimate aim is to express himself as fully as possible, according to his own lights” (Selye’s italics). In order to do this, he told his readers, “You must first find your optimum stress-level, and then use your adaptation energy at a rate and in a direction adjusted to the innate structure of your mind and body.”  
 
   What does this means for us today?
   We need to understand stress in a way that not everyone deals with stressors the same way; not everyone grieves the same way; not everyone can deal with the same load or pressure the same way; not every single way to deal with stress works for everyone.
   As Richard Lazarus, together with Susan Folkman, will later explain in their book Stress, Appraisal and Coping: psychological stress is “a particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being,” and said that “our immediate concern must be with what causes psychological stress in different persons.”
   In his writings, Lazarus continually refers to this person/environment relationship. But to Lazarus, the stressful event or circumstance itself is not what determines the person’s response; what matters is how the person appraises the stressor and how he or she copes with it; what meaning the event or circumstance has on the person.
   Lazarus and Folkman model brought the idea that stress resulted from circumstances that overwhelmed  person’s ability to cope, and these abilities depend largely on the person appraisal of what is overwhelming, and this is where the link between stress and disease lies. The link between stress and the immune system is today extremely well documented and it all comes down to how each person identifies stress and how able they are to cope with it. 
 
   As I have written in the introduction:
Stress is only a problem when it becomes CHRONIC, when a person is unable to manage it (or to cope under the pressure), and when it is affecting one’s health. 
 
Knowing that, you have at hand the most amazing tool to deal with stress.
Identify what overwhelms you – if you don’t know already – and find what techniques works on reducing the manifestation of stress (rapid heart beat, blood pumping faster, tingling in your hands, hanger or rage, numbness, feeling worthless and other unhealthy inner-conversation, self-inflicting pain, etc.), so that you can return to a normal you, to an homeostatic sate, where stress does not have a negative impact on physiologic processes.