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Historically and in evolution terms the natural way for the human body to deal with stress is the basic fight or flight response to a stressor. However, in today’s industrialised world this is often dysfunctional to individuals for many reasons and prevention and/or intervention is needed to ensure there isn’t a detrimental effect on the health and wellbeing of the person.
When early humans were confronted with danger, the instinctive fight or flight stress response kicked in. To help them prepare for decisive, vigorous action, their entire body went into survival mode. The rapid response of the fight or flight mechanism meant the heart raced, breathing quickened, muscles tightened and the individual became hyperalert and instantaniously able to decide whether to fight or flee the danger. This still works well in non-industrialised nations where hunter-gathering roles still exist.
In Western industrialised societies there are relatively few life or death situations where the full fight or flight response is needed and stress is an inescapable part of modern life. Stressors come from a variety of forces and pressures which can be physical, psychological or social. The populations of Western societies are increasingly experiencing more stress than any other time in history. While it can be said that society has always had to deal with stressful events (wars, famine, depression etc.) the last 40 years or so have seen unprecidented change within the world through technology. Standards and values are now set by power, status, competition, achievement and success and people are socialised into the ever increasing pace of the modern world with very little support on how to deal with the effects on the body, mind and soul.
For the majority of the time it is not viable to fight the stressors or flee from the stressors. The energy from the body’s natural response often becomes pent up inside with no place to go. Each time the body triggers the fight or flight response, for situations that are not truly life-threatening, this is in effect a false alarm. Accordingly to Glue et al. (1983) there are no symptoms that are truly unique or specific to stress. However, too much stress or exhaustion from repetitive stress can lead to stress-related disorders like: high blood pressure, migraine headaches, insomnia, anxiety, sexual dysfunction, immune system disorders, heart disease etc. Indeed, suffering from any of these ailments can also lead to further stress for the individual.
As humans, we have to adapt to our environment and learn how to manage our bodies reaction to stress. If we don’t, stress can cause many health problems and in extreme cases be life threatening. Many therapies concentrate on prevention and encourage us to lead health, relaxed lives. More and more work is being done with the younger generation to encourage healthier lifestyles when they grow up. However, no matter how much we implement a lifestyole people do get stressed and do suffer health complications from stress. It is extremely difficult to implement the counterbalances of stress while you are in the middle of a stressful episode. Prevention, where possible, is better than the cure.
Stress is a state of tension produced by all kinds of forces and pressures and can be either psychological, physical or social. Stress can be caused by trauma (natural disaster, health issues etc), life changes (marriage, divorce etc) or from everyday hassles (commuting, work related issues etc.).
Julian Rotter developed a concept in 1954 known as the locus of control which refers to the extent to which individuals believe that they can control events that affect them. Stress is a relationship between the person and the environment in which the person appraises the demands of the situation to be greater than their resources. So if the person has control, that is, can make clear decisions and take effective action they can reduce stress. If something is beyond the control of the individual then this is likely to be seen as stressful. Smith 1978 showed that this was the case. Smith used the number of stress related illnesses as a measure of stress and found that jobs which had a high level of demand and a low level of control were the most stressful. Further studies by Karasek in 1988 showed that people in jobs, which had high psychological workloads and low decision making capacity, had a much higher risk of heart attacks. However, lack of control is not the only factor for work related stress. Different jobs will have different sources of stress: noise, pollution, social isolation, and role ambiguity are all possible sources of stress depending upon the job.
Langer 1976 provided evidence that a sense of control is important in dealing with stress in a field experiment. She gave one group of elderly residents of a nursing home increased control over their lives; they were, for example, allowed to rearrange their furniture. Surprisingly such a small increase leads to short-term mental and physical improvements and in the long-term a lower death rate. It is quite striking how such simple changes made such a difference. However, it is possible that there was an experimental bias. The nurses knew which residents were in which group so they had different expectations of the two groups and thus treated them differently. For ethical reasons you cannot experiment on humans to see if lack of control damages people’s health
The predicatbility of a stressor; knowing when a stressor will occur and how long it will go on is much less stressful than not knowing. . Research and development studies by Lars Andersen conductied over a 10 year period to 2001 identified that lack of predictability is the single biggest stressor in Norwegian working life. Perception of stress and the reaction to a stressor can be altered with predictability. One can mentally prepare allowing themselves time to relax and put into place therapies to deal with the situation beforehand.
Some situations are contrlable and predictable but self concept sets its own limits. If something pushes us to the limit and changes the way we see ourself then this can have a damaging effect on the way we see ourself creating a stress response. For example, having a baby may be seen as a positive change and the woman has nine months to predict the outcome. However, if the situation does not proceed as expected then the woman can suffer from low self-esteem and can result in long term stress disorders. The feelings caused by a stressor cvary greatly from one person to the next because eof varaiability of the curcimstances, interpretation, goals, personality, values, coping strategies and social resouses.
Individual personality can impact on the stress response. Freidman and Rosenman 1974 believed, on the basis of their clinical observations, that people who were competitive, rushed and angry were more likely to suffer heart attacks. On the basis of a structured interview they divided people into Type As who were competitive, rushed and angry, and Type Bs who were non-competitive, laidback and friendly. The Type As were twice as likely to have died of a heart attack in the following eight years. Sarafino reports that dozens of studies have been done using the structured interview and they have provided good evidence that Types As are more likely to have a heart attack.
However it is possible that the difference is physiological. It is suggested that Type As show greater reactivity. Reactivity refers to the amount the person’s arousal increases when they are put in a stressful situation. Matthew 1986 harassed his participants while they were playing a video game and showed that the arousal of Type As did indeed increase more than Type Bs when they were harassed. So Type A and Type B might not really be a personality difference but a physiological one and are likely to be an innate differences.
Response to a stressor is individual and we react differently to events and the techniques used to deal with stress. Indivudally people need to expieriment with the stress relief techniques to see what works for them. Once you discover what works then one needs to practice with the technique to ensure that this works when the body naturally reacts to stress. There are basically two forms of strategies for dealing with stress. Problem solving strategies attempt to change the situation whereas emotional strategies attempt to accept the situation. Folkman 1980 suggested that women use more emotional strategies than men and men use more problem solving strategies.
Meichenbaum 1983 argued that people could be trained in advance to deal with stress. That is, they can be inoculated by being trained in some skills, which will help them cope better with stressful situations and he developed his stress inoculation as a method for preparing people.
Novaco 1978 showed, using outcome research, that the stress inoculation technique was effective in reducing patients’ anger and feelings of stress as measured by self-report and blood pressure when provoked. Novaco’s study has the advantage of combining both subjective – how it feels to the patient – and objective measures. And this method avoids the side effects of drugs. Most drugs used to treat stress make the patient drowsy. These drugs are potentially addictive and they can also be dangerous.
However, this programme has a rather behaviourist emphasis on sub vocalizations – the way the patient talks to him/herself – and thus it plays down the importance of the way the person thinks.
Counselling and psychotherapy are interchangeable therapies that overlap in a number of ways and the definition of each can often be blurred. Neither provide cures; what they do provide is a process to help people to discover or create the capacity to cope more effectively from within themselves. Generally counselling usually refers to a brief treatment that centres around behaviour patterns. Psychotherapy focuses on working with clients for a longer-term and draws from insight into emotional problems and difficulties.
The aims are to help people into gaining an insight into their difficulties or distress, establish a greater understanding of their motivation, enabling them to find more appropriate ways of coping or bring about changes in their thinking and behaviour. There is a general understanding that a psychotherapist can work with a wider range of clients or patients and can offer more in-depth work where appropriate.
Work is undertaken with trained people not connected personally to you and provides the opportunity to talk about yourself and your life and to self reflect in a way that often does not happen with friends or family. Councillors/therapists are non-judgemental and help people to accept situations and work with the sufferer to improve well being. They do not, make decisions for the person but facilitate an improvement over time. This is a very personal process and you can experience a period of feeling worse before things improve. It is also very personal and does not work for everbody. It is not a cure. It requires commoment from the participant.
Cognitive therapists have produced a lot of evidence that the way a person thinks can actually be the problem and that changing the way the patient thinks about the problem can be very beneficial. For example, the cognitive therapist Ellis directs a lot of effort at getting his patients to reframe the problem. This means that the client is encouraged to see the problem in a different way that will make it less stressful. This is rather oversimplified. It ignores individual differences. A programme that is tailored to the personality of the patient might well be more successful. There is substantial evidence that a person’s personality affects the way they experience and deal with stress. For example, Kobasa 1986 did a study of executives who were in highly stressful situations. Some developed physical illnesses, whereas others did not. The ones that did not become ill had a greater sense of control as well as a greater sense of commitment and of treating new, potentially stressful situations as challenges
There are differences in the way men and women respond to stress. Brannon 1996 says the source of these differences could be cultural or it could be innate. It is most likely that there is an interaction between innate differences and what society expects. Men are much more at risk from heart attacks and from Brannons results, part of the reason for this lies in men’s behaviour: they smoke more, drink more, etc. These risky behaviours are part of what is expected of men and are cultural – part of the social role. Type A behaviour is much more common among men than women. Frankenhauser 1991 also pointed out that there are gender differences in the response to stress, for example, men release more adrenaline under stress. So the reason for men being more prone to heart attacks might be an innate physiological one. However, this difference may be cultural, arising from gender roles and not from physiology as women who occupy senior positions show the male stress response and release more adrenaline.
Men and men and women also differ in their coping mechanisms. Brannon 1996 reports that women’s friendships are much more likely than men’s to include emotional intimacy and thus the possibility of emotional support. There is a lot of evidence that having a good social support network reduces the damaging effects of stress. There are also a number of factors that suggests the difference between men and women is not to do with their response to stress but due to other factors: women’s sex hormones protect them against heart attack – after menopause women are as much at risk from heart attacks as men, women visit their doctors far more than men, men smoke much more than women. All of these factors would make men more likely to get ill and thus any difference between men and women in the stress response might be illusory.
It was believed until the 1960’s that the autonomic nervous system could not be consciously controlled but in 1969 Neal showed that it could be conditioned. This suggested that the arousal system of the body could be directly taught to relax which led to the development of biofeedback which aims to help stress related illnesses. The technique is to give feedback to the patient about one of the body’s indicators of stress, for example muscle tension or blood pressure. So the person sees an indicator showing, say, their blood pressure and if they do the right thing, then their blood pressure goes down. By practicing controlling the indicator the person learns to reduce it and be more relaxed. This gives the person a method to use in everyday life to reduce stress. Budzynski 1973 showed that people suffering from tension headaches who were trained to relax their foreheads had fewer headaches and this lasted over a three month follow up period.
However, although lots of studies show that biofeedback works, it works indirectly, that is, it works through the voluntary muscles; it is simple muscular relaxation. Brannon 1992 did a review of the effectiveness of biofeedback and she suggested the possibility of individual differences. She wrote that the evidence suggests that some patients would respond better to biofeedback as a second method of treatment. Rice 2002 suggested that it might work by giving people a sense of control. One study tricked people into believing their muscles were being relaxed when they were not. This still led to a reduction in tension headaches.
But, if Rice is correct, then you can say that training in muscle relaxation is not only cheaper it also is something that is more under the patient’s control. They do not need to feel that their success is due to expensive equipment. This means their sense of control and self-esteem is enhanced. And the person is more able to use the method of simple muscle relaxation in everyday life.
So stress is not solely and simply a biological phenomena: it is not something that automatically happens to a person but depends upon the way the person perceives the situation. And psychologists
have shown that psychological methods which change the way the person thinks and, in particular, increase their sense of control, reduce the effects of stress. So it can be suggested that psychological methods might be preferable as they put the patient back in control of their lives.
Drugs are very easy to give and take and do not require an investment of a long period of time for patient and therapist. Drugs might be used by a doctor for a temporary measure, against the adverse effects of stress, for example to help the patient in a crisis but other techniques should be used to help the patient learn some psychological strategy for coping. There are two classes of drugs used both of which reduce arousal. Benzodiazepines reduce activity in the midbrain structure involved in emotion and Beta-blockers block neurons in the sympathetic nervous system that respond to adrenaline.
Psychological methods which change the way the person thinks and, in particular, increase their sense of control, reduce the effects of stress. Psychological methods are methods which will continue to work after the patient stops coming for treatment. So as a long-term measure psychological techniques which directly target the source of the problem, namely the patient’s thinking, seem preferable.
On a historical view children model their parents’ behaviors, including those related to managing stress. Parents who deal with stress in unhealthy ways risk passing those behaviors on to their children and this will impact future generations. Alternatively, parents who cope with stress in healthy ways can not only promote better adjustment and happiness for themselves, but also promote the formation of critically important habits and skills in fture generations.
Creating a healthy environment at home, work and in your social environment can influence your behaviors and stress levels. The correlation between health, obesity and unhealthy choices is strong so people need to make a conscious decision to take care of themselces by getting adequate nutrients, physical activity and sleep.
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