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Monday 16 June 2014

Why is stress such a big deal?

The life raft that sinks us.

The other day someone raised a question that I think lurks on the edges of a lot of people’s minds when they think about stress.

Why is it such a big deal?

We hear about it constantly, it’s implicated in any number of diseases, it supposedly contributes to premature mortality – and it’s designed to help us. How is it, exactly, that the lifeboat on this ill-designed ship we call a body causes us such trouble?

I think there are three main reasons for this.

Fad

The word “stress” has gradually crept away from the meaning normally assigned to it by researchers: a shorter form of the term “stress response” - by which we mean a specific set of bodily changes that tend to co-occur in response to a perception of threat (or the external circumstances capable of eliciting such a response.

Stress has come to mean anything we don’t like. Unpleasant people, disappointing workplaces, boredom, disillusionment, anything at all that we might place in the “minus” category of human experience. If it’s bad, it’s stress. The boundaries have blurred and grown over time.

As well, our culture seems to have shifted away from the acceptance of discomfort as a natural component of life. Everything we don’t like has become pathologized. If we can’t pin a diagnostic label on an experience (social phobia on shyness, ADHD on distractibility, depression on sadness) then we tend to use the catch-all term stress.

But even if we take a sharp knife and cut away all the extras, chronic elevation of the stress response remains a major problem for the human body. So there has to be more than just sloppy usage involved.

Frequency

When we talk about stress, it is de rigueur to say that the stress response in not necessarily a bad thing. It’s a helper response that will almost certainly prove useful at some point in most people’s lives. We will need to run quickly from an assailant or fight hard if he catches us. The problem is that the response switches on in many situations where it is not needed – indeed, where it may actually degrade our ability to cope.

While undoubtedly true, this soundbite of therapyspeak tends to beg the question. If the stress response is going to be useful once every 30 years or so, the advantages seem likely to be outweighed by the risks of heart disease, diabetes, depression, and the array of other ailments and dissatisfactions that stress is thought to bring on.

We reply to those questions by pointing out that the response evolved in primitive environments that were more – well, exciting than the present day. This is usually enough so that people nod and allow us to move on to a litany of stress reduction techniques.

But we probably don’t go quite far enough. Life in the natural world is far from a Disney movie, where occasional bursts of violence are isolated by long stretches of interspecies harmony and inspiring Phil Collins songs. Nature really is red in tooth and claw. Survival is not a matter of once-a-generation tiger attacks. It is a daily struggle involving an oscillation between attack and withdraw (the ratio being determined in part by the species in question). In the natural world, the stress response is not the emergency lifeboat. It is the only boat.

The Human Brain

The stress response appears to have developed long before the appearance of humans, and it spread throughout the animal world. We inherited it along with the appendix, male nipples, and a spine questionably suited to bipedal locomotion. Doubtless in a primitive environment the advantages of the stress response still far outweighed the disadvantages. But the development of the brain brought with it an additional challenge, nicely laid out by Robert Sapolsky in his popular book Why Zebras Don’t Get Ulcers (1994).

Dogs, cats, and other familiar animals seem to have a fairly elaborate emotional system and clearly have a stress response. This response is readily activated in the presence of clear and present danger, just as it is in humans. But cats don’t seem preoccupied with memories of past humiliations, and dogs don’t seem concerned about tomorrow’s trip to the vet. They may have strong associations of threat with certain stimuli. For example, a dog that has been mistreated by a male human will show a stronger fear response around males than to females, but it does not appear to be brooding on the evils of men when none are present.

Humans, on the other hand, have a well-developed capacity to react emotionally not only to events in the present, but also to memories of the past and fantasies of the future. The armed robber in the bank lineup ahead of us will surely cause our heart to race, but so will memories of the robbery last week or fears of the same thing happening when we go to the bank tomorrow. Although there may be some adaptive advantage to the stress response in some immediately threatening situations, there is no point whatsoever in mounting a full stress response when we are away from all threats.

This feature of human emotional life means that we are capable of activating any and all of our emotions simply by calling to mind mental representations (images, memories, fantasies) of events that are not actually occurring at the moment. We don’t know to what extent this sets us apart from the animal world. It’s possible that our closest animal relatives have some capacity for forethought or episodic memory, but this likely diminishes substantially as we move down the brainpower scale.

The present emphasis by psychologists on mindfulness is largely a response to this capacity of the human brain. Much – almost certainly most, at least in the wealthy parts of the world – of our misery in life arises from our tendency to detach our attention from the present moment and focus instead on past and future. And not just any past and future, but the most exciting bits we can come up with.

In our mental film festival we ignore the pastoral scenes and family comedies and relentlessly play the horror movies over and over again. In so doing we inadvertently rehearse our unhappiness until we have honed it to a fine art, losing much of the capacity for reflection, appreciation, equanimity, and gratitude.

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Are there other factors accounting for the frequency with which we dwell on the topic of stress? Probably. But those are some of the biggest.