Where Stress Comes From

Bill really loved his work. He was an engineer, and very good at his job. Because of this he had done very well in his profession and worked on major construction projects. He tended to work fourteen to sixteen hours a day as a matter of course, sometimes working longer if "necessary". He felt that he had to be on the spot when any important work was being done but did not mind the time commitment because he found his work so satisfying.

Bill came to see me after he became physically sick and then later discovered that he could not go back to work. It was not that he was too sick, though his illness had hung on for much longer than usual. He just found that he had the most awful nausea-producing dread of going back to work. It took a long time to convince him that a stress reaction was the problem but he agreed to learn self-hypnosis (deep relaxation) anyway. As he began to sleep better and lose the headaches and look forward to working again, he began to believe what I was saying.

A few years ago an American research team began investigating the effects of various life stressors on people's health. Their theory was that people would get sick more often if they faced a lot of difficult life events. Many of the events they were interested in were ordinary. Events like Christmas. When they gave people scores according to how many stressors they had encountered, they found that high scores were associated with a very high likelihood of quite serious illness.

Of course Christmas is not the worst thing that can happen to people. Other sorts of events are likely to be more stressful. So what sorts of things are stressful, and how much exposure is safe, before our health is threatened? Generally speaking, any life event that seriously disrupts normal patterns of living and which requires time and effort before we adjust to it, is potentially health threatening. A list of such events might include:

The death of a child; starting a new job; moving to a new home; divorce; illness of one's spouse; having a baby; Christmas; getting married; the death of a close relative; leaving home.

Of course such things are not equally distressing to everyone because their psychological importance varies. For instance, sometimes divorce is a relief for both parties and if they handle it without antagonism, it might have little damaging effect. Sometimes the process can be a long drawn out battle that scars the combatants emotionally for years to come. So it is not enough simply to come up with a list like this. We must know how much distress each event causes.

If enough different life change events occur, events that we have to make decisions about, some kind of harmful health effect seems much more likely. Stressors in which there have been losses of some kind, especially the loss of a loved one, have been most reliably associated with such health problems.

Useful though it is, this kind of analysis diverts attention away from equally important but less dramatic aspects of our lives. Usually the items included in life events scales pay little attention to the work situation. Often work stressors are more subtle and take effect over a long period of time but problems at work can have equally serious physical and psychological consequences. An understanding of this fact can help employers in creating a safe and healthy work place, and can help employees to take action to counteract the effects of work induced stress.

Commonly stress responses occur in work situations that require frequent decisions, particularly if there is time pressure. The stress reaction is greater if some courses of desirable action are unpredictably blocked. Engineers, lawyers, doctors, and installers of swimming pools might face this kind of stressor. Interaction with people who complain or criticise can make the problem worse. So we might add to this list, policemen, salesmen, social workers, teachers, prison officers and telephonists. What I am saying is that any job can have conditions that create stress reactions.

Sometimes the stress caused by work can create a virtual phobia of the work situation, so that going to work actually causes an acute stress attack with effects such as high blood pressure, uncontrollable trembling, feelings of dizziness, strange visual effects, physical helplessness and constant crying. I have seen this work phobia develop in people who found their work situation very uncomfortable as well as in people who basically liked their work.

There is an important message in these reflections. When people develop such phobic reactions effective treatment requires extended separation from the work place. It is much better to manage the stress reaction before it comes to this. Just as it is much better to manage the stress effects of other life events before they affect our physical health. Prevention is better, and cheaper, than cure.

More readings will be added to my blog from time to time. Have a quick look now to see the first posting on my blog PSYC1PLUS