The condition of stress has two components: physical, involving direct material or bodily challenge, and psychological, involving how individuals perceive circumstances in their lives. These components can be examined in three ways. One approach focuses on the environment: stress is seen as a stimulus, as when we have a demanding job or experience severe pain from arthritis or a death in the family. Physically or psychologically challenging events or circumstances are called stressors. The second approach treats stress as a response, focusing on people’s reactions to stressors. We see an example of this approach when people use the word stress to refer to their state of tension. Our responses can be psychological, such as your thought patterns and emotions when you ‘‘feel nervous,’’ and physiological, as when your heart pounds, your mouth goes dry, and you perspire. The psychological and physiological response to a stressor is called strain.
The third approach describes stress as a process that includes stressors and strains, but adds an important dimension: the relationship between the person and environment. This process involves continuous interactions and adjustments—called transactions—with the person and environment each affecting and being affected by the other. According to this view, stress is not just a stimulus or a response, but rather a process in which the person is an active agent who can influence the impact of a stressor through behavioral, cognitive, and emotional strategies. People differ in the amount of strain they experience from the same stressor. One person who is stuck in traffic and late for an important appointment keeps looking at his watch, honking his horn, and getting angrier by the minute; another person in the same circumstances stays calm, turns on the radio, and listens to music.
We will define stress as the circumstance in which transactions lead a person to perceive a discrepancy between the physical or psychological demands of a situation and the resources of his or her biological, psychological, or social resources.
Components of the Definition of Stress
Resources: Stress taxes the person’s biopsychosocial resources for coping with difficult events or circumstances. These resources are limited. as we saw when Vicki had depleted her ability to cope with her problems, became ill, and sought counseling.
Demands: The phrase ‘‘demands of a situation’’ refers to the amount of our resources the stressor appears to require.
Discrepancy: When there is a poor fit, or a mismatch, between the demands of the situation and the resources of the person, a discrepancy exists.
Transactions: In our transactions with the environment, we assess demands, resources, and discrepancies between them. An important point to keep in mind is that a demand, resource, or discrepancy may be either real or just believed to exist. As an example, suppose you had to take an exam and wanted to do well, but worried greatly that you would not. If you had procrastinated and did not prepare for the test, the discrepancy you see between the demands and your resources might be real. But if you had previously done well on similar exams, prepared thoroughly for this one, and scored well on a pretest in a study guide yet still thought you would not do well, the discrepancy you see would not reflect the true state of affairs. Stress often results from inaccurate perceptions of discrepancies between environmental demands and the actual resources. Stress is in the eye of the beholder.
APPRAISING EVENTS AS STRESSFUL
Transactions in stress generally involve an assessment process that Richard Lazarus and his coworkers call cognitive appraisal. Cognitive appraisal is a mental process by which people assess two factors:
(1) Whether a demand threatens their physical or psychological well-being and
(2) The resources available for meeting the demand. These are called primary and secondary appraisal.
Primary and Secondary Appraisal
When we encounter a potentially stressful circumstance. For example, feeling symptoms of pain or nausea—we first try to assess the meaning of the situation for our well-being. This assessment process is called primary appraisal. This appraisal seeks answers to such questions as, ‘‘What does this mean to me?’’ and ‘‘Will I be okay or in trouble?’’ Your primary appraisal regarding the pain or nausea could yield one of three judgments:
It is irrelevant—as you might decide if you had had similar symptoms of pain and nausea before that lasted only a short while and were not followed by illness.
It is good (called ‘‘benign-positive’’)—which might be your appraisal if you wanted very much to skip work or have a college exam postponed.
It is stressful—as you might judge if you feared the symptoms were of a serious illness, such as botulism (a life-threatening type of food poisoning).
Circumstances we appraise as stressful receive further appraisal for three implications: harm-loss, threat, and challenge.
Harm-loss refers to the amount of damage that has already occurred, as when someone is incapacitated and in pain following a serious injury. Sometimes people who experience a relatively minor stressor think of it as a ‘‘disaster,’’ thereby exaggerating its personal impact and increasing their feelings of stress. Threat involves the expectation of future harm—for example, when hospitalized patients contemplate their medical bills, difficult rehabilitation, and loss of income. Stress appraisals seem to depend heavily on harm-loss and threat. Challenge is the opportunity to achieve growth, mastery, or profit by using more than routine resources to meet a demand. For instance, a worker might view an offer of a higher-level job as demanding, but see it as an opportunity to expand her skills, demon- strate her ability, and make more money. Many people are happiest when they face challenging but satisfying activities.
Secondary appraisal refers to our assessment of the resources we have available for coping. Although these assessments occur continuously in our transactions, we are especially aware of our secondary appraisals when we judge a situation as potentially stressful and try to determine whether our resources are sufficient to meet the harm, threat, or challenge we face. Examples of secondary appraisal judgments include:
- I can’t do it—I know I’ll fail.
- I’ll try, but my chances are slim.
- I can do it if Ginny will help.
- If this method fails, I can try a few others.
- I can do it if I work hard.
- No problem—I can do it.
When we judge our resources as sufficient to meet the demands, we may experience little or no stress; but when we appraise demands as greater than our resources, we may feel a great deal of stress.
DIMENSIONS OF STRESS
Anyone who has experienced a very frightening event, such as a near accident or other emergency, knows that there are physiological reactions to stress for instance, almost immediately our heart begins to beat more rapidly and more forcefully, and the skeletal muscles of our arms and legs may tremble. The body is aroused and motivated to defend itself, and the sympathetic nervous system and the endocrine system cause this arousal to happen. After the emergency passes, the arousal subsides. The physiological portion of the response to a stressor or strain is called reactivity, which researchers measure by comparison against a baseline, or ‘‘resting,’’ level of arousal. Genetic factors influence people’s degree of reactivity to stressors. People who are under chronic stress often show heightened reactivity when a stressor occurs, and their arousal may take more time to return to baseline levels.
The distinguished physiologist Walter Cannon (1929) provided a basic description of how the body reacts to emergencies. He was interested in the physiological reaction of people and animals to perceived danger. This reaction has been called the fight-or-flight response because it prepares the organism to attack the threat or to flee. In the fight-or-flight response, the perception of danger causes the sympathetic nervous system to stimulate many organs, such as the heart, directly, and stimulates the adrenal glands of the endocrine system, which secrete epinephrine, arousing the body still further. Cannon proposed that this arousal could have positive or negative effects: the fight-or-flight response is adaptive because it mobilizes the organism to respond quickly to danger, but this high arousal can be harmful to health if it is prolonged.
General Adaptation Syndrome
What happens to the body when high stress levels are prolonged? Hans Selye, the father of stress, studied this issue by subjecting laboratory animals to a variety of stressors—such as very high or low environmental temperatures, X-rays, insulin injections, and exercise—over a long period of time. He also observed people who experienced stress from being ill. Through this research, he discovered that the fight-or-flight response is only the first in a series of reactions the body makes when stress is long-lasting. Selye called this series of physiological reactions the general adaptation syndrome (GAS). The GAS consists of three stages:
- Alarm reaction. The first stage of the GAS is like the fight-or-flight response to an emergency—its function is to mobilize the body’s resources. This fast-acting arousal results from the sympathetic nervous system, which activates many organs through direct nerve connections, including the adrenal glands, which when stimulated release epinephrine and norepinephrine into the bloodstream, producing further activation. Somewhat less quickly, the hypothalamus–pituitary–adrenal axis (HPA) of the stress response is activated, and this component of the stress response was Selye’s novel and main emphasis. Briefly, the hypothalamus triggers the pituitary gland to secrete ACTH, which causes the adrenal gland to release cortisol into the bloodstream, further enhancing the body’s mobilization.
- Stage of resistance. If a strong stressor continues, the physiological reaction enters the stage of resistance. Here, the initial reactions of the sympathetic nervous system become less pronounced and important, and HPA activation predominates. In this stage, the body tries to adapt to the stressor. Physiological arousal remains higher than normal, and the body replenishes the hormones the adrenal glands released. Despite this continuous physiological arousal, the organism may show few outward signs of stress. But the ability to resist new stressors may become impaired. According to Selye, this impairment may eventually make the individual vulnerable to the health problems he called diseases of adaptation. These health problems include ulcers, high blood pressure, asthma, and illnesses that result from impaired immune function.
- Stage of exhaustion. Prolonged physiological arousal produced by severe long-term or repeated stress is costly. It can weaken the immune system and deplete the body’s energy reserves until resistance is very limited. At this point, the stage of exhaustion begins. If the stress continues, disease and damage to internal organs are likely, and death may occur.
Four factors are important in the overall amount of bodily activation or physiological stress
- Amount of exposure. This is obviously key: when we encounter more frequent, intense, or prolonged stressors, we are likely to respond with a greater total amount of physiological activation.
- Magnitude of reactivity. In response to any particular stressor, such as taking a major academic exam, some individuals will show large increases in blood pressure or stress hormones while others show much smaller changes.
- Rate of recovery. Once the encounter with a stressor is over, physiological responses return to normal quickly for some people, but stay elevated for a longer time for others. Continuing to think about a stressor after it is over, revisiting it mentally, or worrying about it recurring in the future can delay physiological recovery and add to the accumulated toll through prolonged physiological activation.
- Resource restoration. The resources used in physiological strain are replenished by various activities, and sleep may be the most important of them. Sleep deprivation can be a source of stress, and contributes to allostatic load directly. What’s more, poor sleep quality or reduced amounts of sleep predict the development of serious health problems, such as heart disease.
Three Main Types of Conﬂict
Approach/approach or double approach: Choice involves two appealing goals that are incompatible. For example, individuals trying to lose weight to improve their health or appearance experience frequent conﬂicts when delicious, fattening foods are available. Although people generally resolve an approach/approach conﬂict fairly easily, the more important the decision is to them, the greater the stress it is likely to produce.
Avoidance/avoidance or double avoidance: Choice between two undesirable situations. For example, patients with serious illnesses may be faced with a choice between two treatments that will control or cure the disease, but have very undesirable side effects. People in avoidance/avoidance conﬂicts usually try to postpone or escape from the decision; when this is not possible, people often vacillate between the two alternatives, changing their minds repeatedly, or get someone else to make the decision for them. People generally ﬁnd avoidance/avoidance conﬂicts difﬁcult to resolve and very stressful.
Approach/avoidance: A single goal or situation has attractive and unattractive features. This type of conﬂict can be stressful and difﬁcult to resolve. Consider, for instance, individuals who smoke cigarettes and want to quit. They may be torn between wanting to improve their health and wanting to avoid the weight gain and cravings they believe will occur.
COPING WITH STRESS
Coping is the process by which people try to manage the perceived discrepancy between the demands and resources they appraise in a stressful situation. It indicates that coping efforts can be quite varied and do not necessarily lead to a solution of the problem. According to Richard Lazarus and his colleagues, coping can serve two main functions. It can alter the problem causing the stress or it can regulate the emotional response to the problem.
Emotion-focused coping is aimed at controlling the emotional response to the stressful situation. People can regulate their emotional responses through behavioral and cognitive approaches. Examples of behavioral approaches include using alcohol or drugs, seeking emotional social support from friends or relatives, and engaging in activities, such as sports or watching TV, which distract attention from the problem. Cognitive approaches involve how people think about the stressful situation. In one cognitive approach, people redefine the situation to put a good face on it, such as by noting that things could be worse, making comparisons with individuals who are less well off, or seeing something good growing out of the problem.
People who want to redefine a stressful situation can generally find a way to do it since there is almost always some aspect of one’s life that can be viewed positively.
Other emotion-focused cognitive processes include strategies Freud called ‘‘defense mechanisms,’’ which involve distorting memory or reality in some way. For instance, when something is too painful to face, the person may deny that it exists. This defense mechanism is called denial. In medical situations, individuals who are diagnosed with terminal diseases often use this strategy and refuse to believe they are really ill. This is one way by which people cope by using avoidance strategies. But strategies that promote avoidance of the problem are helpful mainly in the short run, such as during an early stage of a prolonged stress experience.
People tend to use emotion-focused approaches when they believe they can do little to change the stressful conditions. An example of this is when a loved one dies in this situation, people often seek emotional support and distract themselves with funeral arrangements and chores at home or at work. Other examples can be seen in situations in which individuals believe their resources are not and cannot be adequate to meet the demands of the stressor. Coping methods that focus on emotions are important because they sometimes interfere with getting medical treatment or involve unhealthful behaviors, such as using cigarettes, alcohol, and drugs to reduce tension. People often use these substances in their efforts toward emotion-focused coping.
Problem-focused coping is aimed at reducing the demands of a stressful situation or expanding the resources to deal with it. Everyday life provides many examples of problem-focused coping, including quitting a stressful job, negotiating an extension for paying some bills, devising a new schedule for studying (and sticking to it), choosing a different career to pursue, seeking medical or psychological treatment, and learning new skills. People tend to use problem-focused approaches when they believe their resources or the demands of the situation are changeable. For example, caregivers of terminally ill patients use problem-focused coping more in the months prior to the death than during bereavement.
Can problem-focused and emotion-focused coping be used together? Yes, and they often are. For instance, a study had patients with painful arthritis keep track of their daily use of problem and emotion-focused coping. Most often, they used the two types of coping together; but when they used only one type, three-quarters of the time it was problem focused coping.
REDUCING STRESS REACTIONS: STRESS MANAGEMENT
The term stress management refers to any program of behavioral and cognitive techniques that is designed to reduce psychological and physical reactions to stress.
Sometimes people use pharmacological approaches under medical supervision to reduce emotions, such as anxiety, that accompany stress.
MEDICATION: Benzodiazepines, which activate a neurotransmitter that decreases neural transmission in the central nervous system. Beta-blockers, are used to reduce anxiety and blood pressure. They block the activity stimulated by epinephrine and norepinephrine in the peripheral nervous system. Beta-blockers cause less drowsiness than benzodiazepines, probably because they act on the peripheral rather than central nervous system. Although many people use drugs
for long-term control of stress and emotions, using drugs for stress should be a temporary measure. For instance, they might be used during an acute crisis, such as in the week or two following the death of a loved one, or while the patient learns new psychological methods for coping.
BEHAVIORAL AND COGNITIVE METHODS
The opposite of arousal is relaxation, so relaxing should be a good way to reduce stress. ‘‘Perhaps so,’’ you say, ‘‘but when stress occurs, relaxing is easier said than done.’’ Actually, relaxing when under stress is not so hard to do when you know how. One way people can learn
to control their feelings of tension is called progressive muscle relaxation (or just progressive relaxation), in which they focus their attention on speciﬁc muscle groups while alternately tightening and relaxing these muscles.