Stress is no illness
Angela Patmore on the dangerous myths of 'stress management'
'Stress management' - the theory that stress is a disease that should be 'managed' - is based on an often wilful misinterpretation of the clinical literature, which shows that the stress response is actually a survival mechanism of some importance. Triggered when we face challenges to our wellbeing, this 'fight or flight' response is designed to galvanise us into action. For a short time it enhances our mental and physical skills, and it is associated with brainwaves, focused attention and creativity. Ignoring this helpful mechanism and doing nothing about a serious threat, as, for example, when one stands upon the burning deck eating a banana, is maladaptive.
It is precisely because the stress response aids adaptation and survival by upgrading mental and physical resources that it is celebrated and rehearsed in leisure activities from sport and adventure challenges to classical music, fiction and horror movies: emotionally educating hobbies designed to make us aroused, tense or frightened. Common sense suggests that emotional competence is best achieved not by learning how to relax, but by learning how to function under pressure or when faced with upsetting circumstances.
The 'fight or flight' mechanism may be physically unpleasant, but it is not an illness, simply a response to a perceived threat at home, at work or elsewhere. The research shows that in all cases the threat should be addressed, rather than the response manipulated. Failure to exploit the stress response and deal with threats is a kind of death wish, the scientific term for which is 'learned helplessness'. It is this resignation which is responsible for morbid physiological changes that place the individual at increased risk of disease and death.
As a research fellow I worked with scientists at the centre for environmental and risk management at the University of East Anglia, a World Health Organisation collaborating centre. We reviewed hundreds of studies on 'stress', and we were shocked to find that a term originally used to describe a survival mechanism has been turned into a 'lurgie'. The generalised term 'stress', so popular in women's magazines and on prescription pads, is not actually a scientific or medical word at all, any more than 'nerves' or 'chill'. It can be used to mean cause, effect, stimulus, response, interaction, transaction, nasty feelings (as, for example, when your lawnmower is stolen), and the 'eebie-jeebies'. Stress management research strives to prove that this 'stress' is bad, and a killer, chiefly by examining rat hormones.
The effect of all this non-science nonsense has been to promote an industry seeking to convince us that we have a dangerous psychological disease not suffered by our predecessors (despite their world wars, soup kitchens and workhouses, and the fact that at 14 they were mostly up chimneys or down mines). Worse, this pseudoscientific research has had the effect of villainising the physiological response to threat that is normal to human and animal 'survivors'.
During the summer I organised a conference to debunk the stress management industry. Speakers included very eminent people from the worlds of medicine, psychology, the social sciences and the emergency services, as well as actors and writers. The conference was a huge success, and the worried stress management industry is now seeking to calm itself down by means of benzodiazepines and relaxation exercises.
During our seminar we were trying to think how the stress management industry got started. I came up with an explanation which I think is as good as anybody's.
Dr Jekyll and Mr Hyde revisited - the birth of a monster
Dr Jekyll is down on his luck. His latest experiments have been a bit controversial and his funding is up for review. 'Really, Hyde', he says. 'I feel I'm wasting my time in that laboratory. I want something big.'
'You want some big scare about people's 'elf. Convince 'em they're about to drop dead or they're ready for the Rubber Ramada. Then you can cure it, make your pot and retire to Brighton.'
'You mean something psychological? Voodoo perhaps?'
'Voodoo could come into it, yerst. What you really want is a lurgie. You want people to have this lurgie, and then you turn round and cure it.'
'But my good man, I can't invent a disease. You can't convince people they've got a disease if they haven't . They're going to want to see some symptoms.'
At this point Mr Hyde becomes quite subdued; he scratches his low forehead. And then his ratty eyes brighten. 'What you do is you pick something that the body does already, and you turn it into a disease. You say them's yer symptoms!'
'You mean like temperature? Every time somebody's temperature goes up, they have this condition?'
'Yerst. But you can do better than that.'
'Hmmmm. There is actually a mechanism, Hyde, that people experience every day. A survival mechanism, the response to threat. It's not very pleasant either, so that would add to its charm, hwa hwa.'
'Assit, guvnor! You tell 'em every time they get that mechanism they've got our disease. Then you just come cross with the cure.'
'But how would I cure a natural mechanism that's designed to galvanise them into action? I suppose I could tell them to calm down. That would dampen it down a bit. But I'd need some kind of scientific backing - the medical community would never buy this.'
Hyde, deep in thought, runs his fingers through his face. 'I got it. I know how you get the scientific backing. You pay 'em. You pay some researchers. They'll prove whatever you tell them to prove.'
'Good lord, Hyde: you might be right. We could set up experiments using animals. They can't talk - you can prove whatever you like with them, and we could expose them to various tortures, which would inevitably have a bad effect on the little wretches. And then we could say this research proves that our lurgie is very dangerous, and every time people feel the signs they had better look sharp and call us for help!'
'Well what's the name of this there mechanism?'
'Actually it's called stress, the stress mechanism.'
'Right - you can say you're "stress-doctoring" or "stress-boshing", somefing like that, couldn't yer?'
'I like that. I do. Mr Hyde, I believe I'm going to mix you a drink.'
Monstrous, isn't it?
Angela Patmore is a consultant in 'stress competence' and author of the University of East Anglia's 'Stress report'
Jan Lenica. Poster for Wozzeck, 1964
Reproduced from LM issue 116, December 1998/January 1999