How can we define stress?
Stress as a concept has become so over-used as to be meaningless. In the original sense used in the 1950s by the founder of stress studies, Dr. Hans Selye, it meant a failure to adapt to life problems, such as unemployment, financial hardship and family break-up. This led, in turn, to brain mechanisms that triggered a variety of physical ailments: insomnia, medically unexplained headaches and muscle pain, digestive problems, high blood pressure, skin rashes, and weakened immune responses. It may be the case that the word ‘stress’ is a mistranslation from Selye’s German, as in his explanations of symptoms he seems to be pointing to ‘physical distress’ rather to some abstract cause. I have explored the history of stress in more detail in my book on Reverse Therapy.
Problems in talking about ‘stress’
Now that the idea has entered folk culture, the word ‘stress’ is used to refer to a variety of problems, some of them contradictory to each other. For example:
- I have a stress-related illness. (This is close to Selye’s meaning).
- This job is stressful. Meaning: “Work conditions are a strain on me.”
- I am stressed. Meaning: “I have too many problems I can’t resolve.”
- I am stressed. Meaning: “I am feeling agitated, upset, anxious, or overwhelmed.”
- These people are so stressful. Meaning: “Their behaviour upsets me.”
- I am so stressed I’m going to explode. Meaning: “I can’t cope any more.”
- The stress is so bad I’m having panic attacks. Meaning: “I now have an anxiety disorder.”
- You are stressing me out. Meaning: “You are going to have stop doing that thing you do.”
- That is one of the stressors. Meaning: Events like this could make you ill.
- There is a difference between ‘good stress’ and ‘bad stress’. Meaning: Some arousal is good, too much is bad.
The problem with a fuzzy concept like ‘stress’ is that it can be hard to define exactly what the cause is, and what exactly is being treated. For example: is the cause related to poor working conditions, family upheavals, relationship breakdown, financial problems, discrimination, legal actions, illness, etc? Or is something inside the person that makes it difficult for them to cope with life problems?
Similarly, in therapy are we treating stressful thoughts, anxiety, physical illness, over-arousal, or a variety of personality traits that make it hard for people to adapt to testing circumstances?
The worldwide stress management in the workplace industry was worth over $10 billion in 2022. This refers just to stress relief programs at work. It excludes worldwide stress management courses for individuals (online and elsewhere), books, podcasts and phone apps. Not to mention the cost of medical and psychotherapy treatments for people deemed to be suffering from ‘stress’. Yet there is a strong argument that all these programs and interventions are actually treating different things.
The majority of stress management courses are not treatments at all. What they offer are a collection of panaceas: breathing exercises, yoga classes, positive thinking, time-management, relaxation techniques, dietary advice, and mindfulness programs, etc. While all these can help, they don’t get at the root cause (whatever that may be – it varies from one individual to another, and from one organisation to the next).
Stress: the brain and related systems
One useful thing that emerged from Hans Selye’s research is that, after 80 years of intensive study, we now know quite a lot about what happens to the human body when people fail to cope with life. Most especially, the role of the Hypothalamic-Pituitary-Adrenal (HPA) axis. Under threat the hypothalamus releases corticotropin-releasing hormone (CRH), which signals the pituitary gland to release adrenocorticotropic hormone (ACTH). ACTH then stimulates the adrenal glands to release adrenalin, noradrenalin and cortisol into the blood. These hormones go on to produce complex changes in the heart, sympathetic nervous system, the immune system, the gut, muscles and lungs. Leading to hyper-arousal, energy release and changes in the rest-activity (sleep) cycle.
With few exceptions, nearly all the classic physical reactions to ‘stress’ can be traced back to this alarm mechanism. However, we still do not have a medical solution for this. Which is why calming techniques are so widely employed on stress management courses. Ultimately, the solution to ‘stress’ is a multi-faceted approach, tailored to the individual, that encompasses changes in attitude, thought processes and self care, while also addressing the life events that triggered the problem.
Stress refers to a variety of problems
If we break ‘stress’ down into the mental health problems people actually describe we get a list something like this:
- Negative thoughts
- Low self-esteem
- Chronic frustration
- Panic disorder
- Substance abuse (eating, drinking and drugs)
- Insomnia (actually a physical problem, but often treated in psychotherapy)
Breaking down the most common psychological ’causes’ of stress we get a list like this:
- Over-thinking and worry
- Unable to cope
- Avoidance and procrastination
- Hopeless thoughts
- Low resilience
If we add to these two lists the list of physical problems described in the first paragraph we come to a fuller picture, in which ‘stress’ can be defined as a combination of:
- Unresolved life-problems, plus
- Negative thinking patterns, plus
- Weak coping/resilience skills, plus
- Two or more chronic physical symptoms
However, it might be easier for all – sufferers, therapists and medical advisors if a different term were found to replace the outdated word ‘stress’. In my professional experience the vast majority of stress cases I see are actually anxiety disorders. However, the anxiety is always related to concrete life problems which clients find too hard to handle. So whatever word we use it comes down a breakdown in resilience.
Resilience training and stress
Another problem with the traditional theory of stress is that you can put two people in exactly the same ‘stressful’ situation and, while one person will become anxious and overwhelmed, the other will thrive under challenge. Clearly, adverse life events cannot be the only cause of stress; there must be something in the make-up of the individual that leads to mental and physical illness.
That ‘something’ can be defined as resilience – the set of coping skills that enable us to handle setbacks, misfortunes and disasters. First identified as a key factor in differential reactions to stressful events by positive psychologists twenty years ago.
Resilience skills include any of the following (click on links to go the relevant article on this blog)
Neutralising worries and other types of negative thinking
Effective treatments for stress encompass all the four dimensions described in this article: negative thinking patterns, low resilience skills, physical distress and the concrete life-problems associated with the disorder. However, the aim of therapy should not just be to get clients through a temporary crisis: it should be to enable them to handle any crisis. In short, we have to teach them the life skills they require if they are to become more resilient.
For more information on our resilience coaching service, see this page here.