Learning outcomes Describe stressors. Discuss physiological, psychological and social aspects of stress. Evaluate strategies for coping with stress.

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1 Revision notes 7.2 Section 7.2 Stress Learning outcomes Describe stressors. Discuss physiological, psychological and social aspects of stress. Evaluate strategies for coping with stress. According to Selye (1956) stress refers to a failure to respond appropriately to emotional or physical threats. The key aspect of Selye s definition is that the threats can be real or imagined but would usually be accompanied by physiological, cognitive and behavioural changes. Any challenging event can cause stress and, therefore, stress can be the result of imagined realities. Any cause of stress is a stressor, imagined or otherwise. Physiological aspects of stress Gender: Frankenhauser et al. (1976) reported boys have adrenaline rushes in exams that take longer to return to normal, whereas girls had a gentler, lower increase and returned to normal much quicker. Children who have had been exposed to significant stress in their home life (e.g. marital discord, alcoholism and child abuse) had impaired growth due to a lowering of the production of growth hormone in the pituitary gland (Powell et al., 1967). Stone et al. (1987) report a correlation between a change in mood and a change in antibody concentration in bodily fluids suggesting good moods contribute to a healthy immune system. Gross (1996) argues people often catch colds soon after periods of high stress (e.g. exams) and cites Goetsch and Fuller (1995) who refer to studies that show decreases in the activity of lymphocytes (white blood cells that fight viruses) among medical students during their final exams. Cohen et al. (1991) gave participants nasal drops containing a mild cold virus and found those who had experienced negative life events in the preceding weeks were twice as likely to develop colds than those who reported lower levels of stress. 1

2 Psychological aspects of stress Lazarus (1966) argued that, for a situation to be stressful, it must be considered or appraised as such by the person concerned. Therefore, there is a clear cognitive component to stress because any event or phenomenon, real or imagined, can be considered or perceived as stressful. Kagan (2007) outlines how humans have complex semantic concepts for imagined events and creatures that do not exist (e.g. elves or trolls). Expectations of physical health have been shown to have an impact on health outcomes. According to Reed et al. (1999) HIV-positive men who are bereaved stay healthier longer if they remain optimistic about their own future. These researchers argue that hope serves as a vital asset for the long-term survival of infected men who have lost a partner to AIDS. Social aspects of stress Humans are social animals and as such we are acutely sensitive to changes in our social environment. Holmes and Rahe (1967) suggest a major cause of stress is some form of change. They compiled the Social Readjustment Rating Scale (SRRS) to rate social events out of 100 for their potential to lead to stress. For example, the death of a spouse was given a rating of 100; change of school was given a rating of 20. People who scored over 300 were viewed as high risk for stress-related health problems. However, this can be seen as a reductionistic approach to a complex and personal problem; caution should be used when quantifying personal and social events in this manner. According to The National Institute for Occupational Safety and Health (NIOSH) (1999), workplace stress can be defined as the harmful physical and emotional responses that occur when there is a poor match between job demands and the skills and resources, or personal needs, of the worker. Personality types and general coping skills are the main predictor of whether an individual will experience workplace stress some people are not suited to the job they have chosen, or been forced to accept. Hochschild (1983) argued the mere pressure of needing to conform to work expectations can lead to negative effects such as emotional dissonance were the person feels false and hypocritical and this leads to stress and anxiety. Alienation occurs as a result of conforming to emotional expectations that are not genuine in the service of an employer there is lack of emotional autonomy. Exploitation occurs when the employee realizes they do not own or control the source of profit generation emotional regulation is in the hands of the employer and employees are expected to conform to emotional displays. De-individuation occurs when people feel they lose their identity as they work for large corporations that demand they express themselves in a certain way (Ovisignkina, 1976; Perrow, 1984). This 2

3 prompted Foegen (1988) to call for hypocrisy pay for those service agents who are expected to display emotions they do not actually feel as part of their work. Rutter and Fielding (1988) positively correlated the suppression of emotions in the workplace with stress, and negatively correlated the suppression with job satisfaction. Job autonomy in a managerial sense can also affect stress levels workers with less job autonomy and therefore less facility to make decisions about their work lives, have been shown to experience greater levels of stress. Marmot et al. (1997) found clerical and office-support employees in the civil service were four times more likely to die of a heart attack than those in the most senior grades. Theorell et al. (1985) found greater blood pressure in high-demand low-control occupations such as waiters and cooks. Strategies for coping with stress Stress inoculation training (SIT) Developed by Meichenbaum in the 1970s and gradually improved since, it takes a cognitive approach to treatment with the underlying aim of changing thought processes to combat the effects of stress. Meichenbaum saw the therapy in the same light as a medical inoculation and therefore believed training should come before the onset of extreme anxiety, not after a stressful event, if it is to be most effective. SIT is designed to be individually tailored to the needs of the person suffering stress and comes under the banner of cognitive-behavioural therapy as it changes thought and behaviour. According to Meichenbaum (1996), there are three distinct phases to SIT. Conceptualization phase A collaborative relationship is established between the client and the therapist using Socratic-type exchanges with the aim of educating clients about the nature and impact of stress. Re-conceptualization then takes place: After interviewing, psychological testing, client self-monitoring, and reading materials, the clients stress response is re-conceptualized. The specific re-conceptualization is individually tailored to the client s specific problem but it may involve identifying the sources of anxiety and identifying ways to combat them a new model must be agreed on, one that lends itself to specific intervention and is characterized as hopeful and helpful for the client. Skills acquisition and rehearsal phase Skills for coping with the stress are rehearsed (e.g. emotional self-regulation, self-soothing and acceptance, relaxation, self-instructional, cognitive restructuring, problem-solving, interpersonal communication skills, attention diversion procedures, using social support systems and fostering meaning-related activities). Application and follow through phase This provides opportunities for the clients to imagine stressful events and apply the variety of coping skills across increasing levels of stress. Such 3

4 techniques involve imagery and behavioural rehearsal, modelling, role playing. Evaluation Positives SIT accepts the stress an individual experiences is often unavoidable such as a work environment. SIT tailors therapy to the needs of the client with the active cooperation of the client. The client-centred approach inherent within SIT promotes equality between client and therapist and empowers the individual to take control of their stress management. SIT posits emotional and cognitive awareness at the forefront of the therapeutic environment thereby increasing the chances of long-term success. Negatives Individuals vary in how they respond to treatment and some may not be able to cope with the stressors present in their environment regardless of the training they undertake. SIT takes time and money and is not suited for the lifestyles of everyone. If carried out properly, SIT is a rigorous programme requiring high levels of commitment and motivation. SIT requires a discussion of feelings and personal thoughts, this makes it more suitable for some cultures than others. Yoga Yoga means to yoke, or to join two things together and hatha means sun (masculine, active) and moon (feminine, receptive) energy. Therefore, hatha yoga means to join these two powerful forces together. Hatha can also mean forceful, therefore hatha yoga intimates the notion that powerful work must be carried out to purify the mind and body. Hatha yoga is the most commonly practised for mental and physical health. Yoga represents a holistic approach to stress reduction and incorporates physical, cognitive and spiritual concepts with the aim of making the individual more self-aware and more aware of the universe around them. Cosmic awareness in this way is thought to reduce stress and promotes physical and mental well being. Evaluation Yoga is an expansive term and so it is difficult to give precise evaluations for the whole practice. However, some generalizations can be made: 4

5 Positives Yoga can be said to improve quality of life (Cohen, 2006). It provides exercise, relaxation and self-awareness as well as putting the individual in touch with like-minded people with regular social interaction. Most yoga classes consist of a combination of physical exercises, breathing routines, and meditation. These activities make yoga beneficial for people with health conditions such as hypertension, asthma, and back problems. Hartfiel et al. (2010) used a randomized controlled trial in the UK with a yoga group and a control group. Results showed the yoga group reported significant improvements in feelings of clearmindedness, composure, elation, energy, and confidence. In addition, the yoga group reported increased life purpose and satisfaction, and feelings of greater self-confidence during stressful situations. Negatives Stress often has a very specific source relative to the individual (e.g. marital, occupational) that may need specialist counselling or therapy. Yoga is often a holistic lifestyle choice for its practitioners and incorporates many sensible ways to take control of one s life and live a more peaceful and healthy existence such as adopting new food habits therefore the Yoga itself cannot be specifically said to produce exacting health benefits. The physical exertions are not suitable for everyone. 5