BASIC CONCEPTS OF STRESS HANA SUHAIL MASOOD STD. XI A I. MEANING AND DEFINITION:- We generally use the word “stress” when we feel that everything seems to have become too much – we are overloaded and wonder whether we really can cope with the pressures placed upon us. Anything that poses a challenge or a threat to our well-being is considered as stress. Stress is defined as our response to events that disrupt, or threaten to disrupt our physical or psychological functioning.
It is an internal state which can be caused by physical demands on the body or by environmental and social situations which are evaluated as potentially harmful, uncontrollable, or exceeding our resources for coping. Like pain, stress is a common human experience. We are all familiar with stressful events: your heart races as you sit down to write a test; or the boss wants to see you now about the last quarter’s sales figures; or you go to bed, only to hear a neighbour’s stereo blaring away. The pulse-pounding, gut-wrenching sensations that result from such moments are common in modern life, and are definitely very stressful.
It is important to consider the impact of individual differences in the creation of stress because we all have different definitions of what we consider to be a stressor – a cause of a stress. Stressors are also defined as any event, real or imagined, cognitive, environmental or biological, that leads to stress. Stressors vary for different people (e. g. dogs are warm and friendly for some, for others they are a source of anxiety) but the body can also respond to stress of which it is not conscious, like suppressed memories.
Stress, therefore, is a deeply personal experience, and it shares with emotion the three components of subjective interpretative experience – physiological reaction, cognitive reaction and behavioural expression. Despite the wide range of stimuli that can potentially produce stress, it appears that many events we find stressful share characteristics: (i) They are so intense that they produce a state of overload – we can no longer adapt to them. () They evoke incompatible tendencies in us, such as tendencies both to approach and to avoid some object or activity. i) They are uncontrollable and beyond our limits of control. . TYPES OF STRESS:- (i) Eustress (Positive Stress) Eustress stress occurs when your level of stress is high enough to motivate you to move into action to get things accomplished, e. g. stress experienced during a wedding, sudden and unexpected promotion. Much of the research on eustress has focused on its presence in the workplace. In the workplace, stress can often be interpreted as a challenge, which generally denotes positive eustress. Relationships have been shown between how one appraises an occupational stress and how one chooses a coping style.) Distress (Negative Stress) Distress stress occurs when your level of stress is either too high or too low and your body and/or mind begin to respond negatively to the stressors, e. g. stress experienced during a funeral. Distress is an aversive state in which a person is unable to adapt completely to
stressors and their resulting stress and shows maladaptive behaviors. It can be evident in the presence of various phenomena, such as inappropriate social interaction like aggression, passivity or withdrawal. I. MODELS OF STRESS:- i) General Adaptation Syndrome Scientist Hans Selye (1907-1982) introduced the General Adaptation Syndrome model of stress in 1936, showing in three phases what the alleged effects of stress has on the body. In his work, Selye, ‘the father of stress research,’ developed the theory that stress is a major cause of disease because chronic stress causes long-term chemical changes. He observed that the body would respond to any external biological source of stress with a predictable biological pattern in an attempt to restore the body’s internal homeostasis.
This initial hormonal reaction is our fight or flight stress response – and its purpose is for handling stress very quickly. The process of the body’s struggle to maintain balance is what Selye termed, the General Adaptation Syndrome. Pressures, tensions, and other stressors can greatly influence your normal metabolism. Selye determined that there is a limited supply of adaptive energy to deal with stress. That amount declines with continuous exposure. Going through a series of steps, your body consistently works to regain stability.
With the general adaptation syndrome, a human’s adaptive response to stress has three distinct phases: a) Alarm Stage Your first reaction to stress recognizes there’s a danger and prepares to deal with the threat, i. e., the fight or flight response. Activation of the HPA axis, the nervous system (SNS) and the adrenal glands take place. During this phase the main stress hormones cortisol, adrenaline, and noradrenalin, is released to provide instant energy. If this energy is repeatedly not used by physical activity, it can become harmful.
At this stage everything is working as it should – you have a stressful event, your body alarms you with a sudden jolt of hormonal changes, and you are now immediately equipped with enough energy to handle it. b) Resistance Stage The body shifts into this second phase with the source of stress being possibly resolved. Homeostasis begins restoring balance and a period of recovery for repair and renewal takes place. Stress hormone levels may return to normal but you may have reduced defenses and adaptive energy left.
If a stressful condition persists, your body adapts by a continued effort in resistance and remains in a state of arousal. Problems begin to manifest when you find yourself repeating this process too often with little or no recovery. Ultimately this moves you into the final stage. c) Exhaustion Stage At this phase, the stress has continued for some time. Your body’s ability to resist is lost because its adaptation energy supply is gone. Often referred to as overload, burnout, adrenal fatigue, maladaptation or dysfunction – Here is where stress levels go up and stay up!
The adaptation process is over and not surprisingly; this stage of the general adaptation syndrome is the most hazardous to your health. The progressive stages of the general adaptation syndrome clearly show where having excessive stress can lead. /GAS Diagram from Guidelines () Cognitive
Appraisal Model Lazarus stated that cognitive appraisal occurs when a person considers two major factors that majorly contribute in his response to stress. When confronted with the same potentially stress inducing situation, some person xperiences stress while the other does not. The reason involves the individual’s cognitive appraisal. These two factors include: 1. The threatening tendency of the stress to the individual, and 2. The assessment of resources required to minimize, tolerate or eradicate the stressor and the stress it produces. Lazarus and Folkman, 1984, also said that the person thinks that they will be unable to cope with the dangers or demands posed to them. In general, cognitive appraisal is divided into two types or stages: primary and secondary appraisal.) Primary Appraisal The initial evaluation of the situation comprises an assessment of the threat in the present situation. The situation is labeled as ‘threatening’ or ‘safe’ towards the goals. Three kinds can be distinguished: •Irrelevant •Benign-positive •Stressful – harm or loss, threat, challenge b) Secondary Appraisal Evaluation of the individual’s ability to cope with a situation and of whether or not the individual has the materials to deal with the stimulus causing the stress is called secondary appraisal.
Secondary appraisal interacts with the primary appraisal to determine the emotional reaction to event. This further appraisal is made in regard to: •Harm: The assessment of the damage that the event has already caused. •Threat: Possible future damage that the event may cause. •Challenge: The potential to overcome and even profit from the event. During secondary appraisal if the individual finds that they do not have the materials to cope with the stimulus causing stress, it determines the level of stress that is experienced.
An example of this would be the reaction to snakes, which shows a great variation. A harmless garter snake might cause fear in some people and nothing in others. Afterward, reappraisals occur: a continuous re-evaluation of the situation based on new information. A study by Tomaka and his colleagues in 1993 illustrates the point of cognitive appraisal. Participants in the study were told that the researchers were interested in measuring their physiological responses while they performed a mental task, i. e., counting backwards from 2,737 by sevens – like 2,730, 2,723, 2,716, and so on.
The researchers predicted that those who perceived the task as a threat and believed that they could not perform the task at the outset would experience stress. In contrast, those who were more confident in their abilities might perceive the task as a challenge. The second group would not experience stress, and would in fact exhibit greater physiological arousal as they prepared to meet the challenge. All predictions were confirmed. The “threat group” reported feeling greater stress, while the “challenge group” scored higher without feeling stressed. /Cognitive Appraisal flow-chart diagram (Fig. 3. 2 Baron, Page 496) IV. CAUSES OF STRESS:- What causes stress depends, at least in part, on the individual’s perception of it. Something that is stressful to one person may not faze someone else; they may even enjoy it. For example, your morning commute may make you anxious and tense because you worry that traffic will make you
late. Others, however, may find the trip relaxing because they allow more than enough time and enjoy listening to music while they drive. (i) Internal Factors a) Personality Types There are two different types of personalities: 1. Type A Personality:
Type A personality is characterized as highly competitive, achievement oriented, impatient, excessively time conscious, insecure about their status and incapable of relaxation. They seek recognition and advancement and take on multiple activities with deadlines to meet and are unhappy about the smallest of delays. They tend to be more verbally aggressive and easily aroused to anger. They are more prone to stress and are likely to develop coronary disease. When placed in long stressful situations over which they have little control, Type As tend to give up, show helplessness and become less responsive and effective.. Type B Personality: Type B personality is characterized by low levels of competitiveness, time urgency and hostility. People with Type B personalities are easy going, relaxed people. These individuals are more cooperative, far less competitive, not especially time oriented, and not usually aggressive, competitive or hostile. In long stressful situations, they tend to cope better without giving up easily and are more successful than Type A personalities in these situations. b) Hardiness Hardiness is a personality type that is resistant to stress.
It involves a commitment to personal goals, a sense of purpose and involvement, having a personal view of being in control and viewing change as a welcome challenge and as an opportunity for advancement and growth. c) Optimism/Pessimism Optimism is the extent to which a person sees life in relatively positive terms whereas pessimism is where a person sees life negatively. Optimists, who have general expectancies for good outcomes are more stress resistant than pessimists. A person’s outlook towards life and consequently its challenges and stressful situations plays an important role in how prone to stress he/she is.
A pessimistic person always thinks of failure before performing the task hence increasing stress, whereas an optimistic individual always finds ways to counter obstacles and reach the ultimate goal, avoiding stress. d) Other Factors Other factors such as uncertainty, worries, self-criticism, unrealistic expectations or beliefs, perfectionism, low self-esteem, lack of assertiveness and resilience (the ability to bounce back after a stressful event) also determine how prone to stress a person is. () External Factors) Major Life Changes Death of a spouse, injury to someone close, war, failure in academics or professional life, an unplanned pregnancy and so on are the cause of major life changes for an individual. Holmes and Rahe (1967) studied the effect of major life changes on stress by asking people to assign arbitrary points (on 100) to various life events according to how much readjustment each situation or event required. It was reasoned that the greater the number of points given, the more stressful it was for the person experiencing it.
The greater the number of “stress points” people accumulated, the greater the likelihood of them becoming seriously ill. b) Hassles of Daily Life Daily life is filled with countless minor annoying sources of stress called hassles, which seem to make up
for their relatively low intensity by their much higher frequency. Lazarus and his colleagues developed a Hassles Scale on which individuals indicated the extent to which they have been hassled by common events during the past month.
The events included were everyday situations, like shopping, concerns over money, studying and so on. Although such events seem relatively minor, the more stress people report as a result of daily hassles, the poorer their psychological well being. c) Work Related Stress /Sources of Work Related Stress flow chart (Fig. 13. 3 Baron, Page 499) Stress at work is a relatively new phenomenon of modern lifestyles. The nature of work has gone through drastic changes over the last century and it is still changing at whirlwind speed.
They have touched almost all professions, starting from an artist to a surgeon, or a commercial pilot to a sales executive. With change comes stress, inevitably. Professional stress or job stress poses a threat to physical health. Work related stress in the life of organized workers, consequently, affects the health of organizations. Job insecurity, high demand for performance, sexual harassment, responsibility for others and similar factors lead to work related stress. V. EFFECTS OF STRESS:- (i) On Health
Some authorities estimate that stress plays a role in at least 50-70% of all physical illnesses (Frese, 1985). To list just a few, stress has been implicated in the occurrence of heart disease, high blood pressure, hardening of the arteries, ulcers and even diabetes. By draining our resources and keeping us off balance physiologically, stress upsets our complex internal chemistry. It may interfere with out immune system, which normally is nothing short of amazing: each day it removes many potential threats to our health.
However, prolonged exposure to stress seems to disrupt this system, where the production of antibodies is lessened. The exact effects of stress on a person’s health in its entirety are: a) Physical Effects Physical effects of stress include headaches, digestive disorders, muscle tension and pain, sleep disturbances, fatigue, chest pain, irregular heartbeat, high blood pressure, weight gain or loss, hair loss, asthma or shortness of breath, skin problems, periodontal disease, jaw pain, missed or irregular periods, reproductive problems, immune system suppression and sweatiness.) Cognitive Effects Cognitive effects of stress include problems with memory, difficulty making decisions, inability to concentrate, shortened attention span, confusion and disorientation, repetitive or continuous thoughts, misunderstanding of outside stimuli, poor judgment, thoughts of escaping, inability to slow down thought process and loss of objectivity.) Emotional Effects Emotional effects of stress include frustration, restlessness, oversensitivity, anxiety, depression, apathy, overreaction to situations, uneasiness, mood swings, and an increased fear of failure, inadequacy, reduced self-confidence, low self-esteem, unwarranted jealousy and fits of rage. d) Behavioural Effects
Behavioural effects of stress include appetite changes, isolation, staying away from work or staying at work for too long, substance abuse, engaging in activities like nail biting and pacing, grinding of teeth, losing temper, arguing with people, violent tendencies, laughing at inappropriate times and in some extreme cases even self-harm. () On Task Performance Psychologists once believed that stress actually improves performance on a wide range of tasks.
that the relationship between stress and task performance takes the form of an upside-down U; at first performance improves as stress increases, presumably because the stress is arousing or energizing. Beyond some point, though, stress becomes distracting and performance actually drops. As we become uncomfortably stressed, distractions, difficulties, anxieties and negative thinking begin to crowd our minds. This is particularly the case where we look at our definition of stress, i. e. that it occurs when a person perceives that “demands exceed the personal and social resources the individual is able to mobilize. These thoughts compete with performance of the task for our attention capacity. Concentration suffers, and focus narrows as our brain becomes overloaded. Other research has shown that stress reduces people’s ability to deal with large amounts of information. Both decision-making and creativity are impaired because people are unable to take account of all the information available. This inability accounts for the common observation that highly stressed people will persist in a course of action even when better alternatives are available.
It also explains why anxious people perform best when they are put under little additional stress, while calm people may need additional pressure to produce a good performance. (i) Burnout The term “burnout” is a relatively new term, first coined in 1974 by Herbert Freudenberger, in his book, “Burnout: The High Cost of High Achievement”. He originally defined ‘burnout’ as, “the extinction of motivation or incentive, especially where one’s devotion to a cause or relationship fails to produce the desired results. While burnout isn’t a recognized clinical psychiatric or psychological disorder, there are some similar features between burnout and diagnosable conditions such as depression, anxiety disorders or mood disorders. However, burnout is much more common; for example, it is estimated that 25%-60% of practicing physicians experience burnout. It’s also less severe, more temporary in duration, and clearly caused by situational stressors rather than a biologically mandated chemical imbalance. Classic symptoms include the following: a) Depleted physical energy b) Emotional exhaustion) Lower immunity to illness d) Less investment in interpersonal relationships e) Increasingly pessimistic outlook f) Increased absenteeism and inefficiency at work g) Cynicism VI. STRESS CYCLES (i) Distress Cycle The distress cycle can be described as the following: • You get negative moods or emotions caused by problems in at home, workplace, traffic, or friends. This ultimately led to generation of negative stress. • This negative stress increases the biological demand on the body. This causes changes in blood circulation and weakens body immune system.
The most common physical manifestations of stress are high blood pressure, allergies, regular headaches, common cold, fever, digestive problems, memory problems, sleep problems, weight gain, concentration problems, sexual difficulties, hair fall, skin problems (acne, lack of glow on the skin). • Since the root cause of Stress is never treated, these aliments keep recurring over a short period of time. • The presence of negative stress along with recurring physical aliment, introduce change in your personality. This gives rise to negative attitudes and behaviors towards others. The realization that your behavior towards others has altered leads to further increase in
negative stress and generation of anxiety. • This newly added negative stress and anxiety reinforce your negative moods or emotions resulting in a full circle of stress. Most stress sufferers can identify this stress cycle in their lives, but find themselves helpless to prevent it or battle it. /Distress Cycle flow chart from Morgan, page 324 () Wellness Cycle It is the opposite of the distress cycle, wherein stressors are viewed positively to create a sense of wellness in the individual. /Wellness Cycle flow chart from Morgan, page 324
V. COPING WITH STRESS (i) Effective Methods a) Relaxation Training Progressive muscle relaxation, visualization facilitated by images of peace and relaxation and yoga are effective ways of dealing with stress. b) Coping Mechanisms Lazarus and Folkman suggested two types of coping with stress. They are: 1. Problem-Focused Coping: A response aimed at reducing, modifying or eliminating a source of stress which attempts to modify the stressful problem or source of the stress. These strategies aim to alleviate or eliminate stressful situations through taking control and weighing up pros and cons.
Problem-focused coping targets the causes of stress in practical ways which tackles the problem or stressful situation that is causing stress, consequently directly reducing the stress. These strategies involve: oTaking Control – this response involves changing the relationship between yourself and the source of stress. Examples: escaping from the stress or removing the stress. oInformation Seeking – the most rational action. This involves the individual trying to understand the situation (e. g. using the internet) and putting into place cognitive strategies to avoid it in future. Information seeking is a cognitive response to stress. Evaluating the pros and cons of different options for dealing with the stressor. 2. Emotion-Focused Coping: Emotion-focused coping involves trying to reduce the negative emotional responses associated with stress such as embarrassment, fear, anxiety, depression, excitement and frustration. This may be the only realistic option when the source of stress is outside the person’s control. Drug therapy can be seen as emotion focused coping as it focuses on the arousal caused by stress not the problem. Emotion-focused strategies include: oKeeping yourself busy to take your mind off the issue oLetting off steam to other people Praying for guidance and strength oIgnoring the problem in the hope that it will go away oDistracting yourself (e. g. TV, eating) oBuilding yourself up to expect the worse c) Maintaining a Healthy Lifestyle Exercise has been proven to have a beneficial effect on a person’s mental and physical state. For many people exercise is an extremely effective stress buster. The use of alcohol, drugs and excessive consumption of caffeine reduces one’s immunity to stress. Therefore, cutting down or stopping consumption of these items is a good way of coping with stress. d) Organization of Daily Life 1. Division of labor
Delegating responsibilities at work, or sharing them with peers as well as dividing responsibilities reduces stress. 2. Time Making sure a person sets aside some time each day just for himself and uses that time to relax, and pursue his/her own interests. e) Building Support Network Reaching out to the people a person feels close to and
building relationships based on emotional honesty, where members of that person’s ‘inner circle’ know how to listen without judging that individual and basically having a great support system to fall back to in times of need and worry is the best way to cope with stress.
Nobody understands people like other people do. () Ineffective Ways a) Defense Mechanisms When the ego is unable to strike a balance between the impulses of id while adhering to the strict moral code of the superego, the ego uses defense mechanisms in order to deal with the anxiety and guilt stored in the unconscious mind. Thus defense mechanisms, as intellectual bequest from the dynamic theories, are generally accepted as a useful way of looking at how people handle stressful situations and conflicts. 1. Repression:
Repression is the unconscious blocking of unacceptable thoughts, feelings and impulses. According to Freud, it is the fundamental technique people use to allay anxiety caused by conflicts. The key to repression is that people do it unconsciously, so they often have very little control over it. “Repressed memories” are memories that have been unconsciously blocked from access or view. But because memory is very malleable and ever-changing, it is not like playing back a DVD of your life. The DVD has been filtered and even altered by your life experiences, even by what you’ve read or viewed.. Denial: Denial is the refusal to accept reality or fact, acting as if a painful event, thought or feeling did not exist. It is considered one of the most primitive of the defense mechanisms because it is characteristic of early childhood development. Many people use denial in their everyday lives to avoid dealing with painful feelings or areas of their life they don’t wish to admit. For instance, a person who is a functioning alcoholic will often simply deny they have a drinking problem, pointing to how well they function in their job and relationships.. Regression: Regression is the reversion to an earlier stage of development in the face of unacceptable thoughts or impulses. For an example an adolescent who is overwhelmed with fear, anger and growing sexual impulses might become clingy and start exhibiting earlier childhood behaviors he has long since overcome, such as bedwetting. An adult may regress when under a great deal of stress, refusing to leave their bed and engage in normal, everyday activities. 6. Projection:
Projection is the misattribution of a person’s undesired thoughts, feelings or impulses onto another person who does not have those thoughts, feelings or impulses. Projection is used especially when the thoughts are considered unacceptable for the person to express, or they feel completely ill at ease with having them. For example, a spouse may be angry at their significant other for not listening, when in fact it is the angry spouse who does not listen. Projection is often the result of a lack of insight and acknowledgement of one’s own motivations and feelings.. Reaction Formation: Reaction Formation is the converting of unwanted or dangerous thoughts, feelings or impulses into their opposites. For instance, a woman who is very angry with her boss
and would like to quit her job may instead be overly kind and generous toward her boss and express a desire to keep working there forever. She is incapable of expressing the negative emotions of anger and unhappiness with her job, and instead becomes overly kind to publicly demonstrate her lack of anger and unhappiness. 8. Displacement:
Displacement is the redirecting of thoughts feelings and impulses directed at one person or object, but taken out upon another person or object. People often use displacement when they cannot express their feelings in a safe manner to the person they are directed at. The classic example is the man who gets angry at his boss, but can’t express his anger to his boss for fear of being fired. He instead comes home and kicks the dog or starts an argument with his wife. The man is redirecting his anger from his boss to his dog or wife.
Naturally, this is a pretty ineffective defense mechanism, because while the anger finds a route for expression, it’s misapplication to other harmless people or objects will cause additional problems for most people. 9. Intellectualization: Intellectualization is the overemphasis on thinking when confronted with an unacceptable impulse, situation or behavior without employing any emotions whatsoever to help mediate and place the thoughts into an emotional, human context. Rather than deal with the painful associated emotions, a person might employ intellectualization to distance themselves from the impulse, event or behavior.
For instance, a person who has just been given a terminal medical diagnosis, instead of expressing their sadness and grief, focuses instead on the details of all possible fruitless medical procedures. 10. Rationalization: Rationalization is putting something into a different light or offering a different explanation for one’s perceptions or behaviors in the face of a changing reality. For instance, a woman who starts dating a man she really, really likes and thinks the world of is suddenly dumped by the man for no reason.
She reframes the situation in her mind with, “I suspected he was a loser all along. ” 11. Sublimation: Sublimation is simply the channeling of unacceptable impulses, thoughts and emotions into more acceptable ones. For instance, when a person has sexual impulses they would like not to act upon, they may instead focus on rigorous exercise. Refocusing such unacceptable or harmful impulses into productive use helps the person channel energy that otherwise would be lost or used in a manner that might cause the person more anxiety. 12. Assertiveness:
Assertiveness is the emphasis of a person’s needs or thoughts in a manner that is respectful, direct and firm. Communication styles exist on a continuum, ranging from passive to aggressive, with assertiveness falling neatly in between. People who are passive and communicate in a passive manner tend to be good listeners, but rarely speak up for themselves or their own needs in a relationship. People who are aggressive and communicate in an aggressive manner tend to be good leaders, but often at the expense of being able to listen empathetically to others and their ideas and needs.