Believing in Stress Could be as Dangerous as Believing in Voodoo

ID-10020846Photo by Danilo Rizzuti

Stress is probably the most commonly used psychological term. We talk about stress in the working place, about managerial stress, school stress, we read about influence of stress on traffic safety, about its damaging influence on the process of decision making, about the role of stress in arising conflicts and most of all about the severe impact of stress on our health. Whole journals are devoted to stress. However, there are also many doubts concerning the phenomenon of stress (Doublet, 1999). It is time to consider them with the attention and respect they deserve.

The history of the concept of stress starts at the turn of the XIX and XX centuries when Walter Cannon discovered that the blood of animals which were repeatedly frightened during experiments always contained adrenaline. This hormone was known before but nobody had suspected that it had any connection to emotions and psychological phenomena. Soon after this discovery Cannon formulated his concept of the fight or flight reaction and consequently described the mechanism of homeostasis. Cannon’s research showed for the first time in the history of science, that emotions happen not only in our heads but also in the whole human body.

The fight or flight reaction as well as the concept of homeostasis was soon adopted by physician and endocrinologist Hans Selye who had ineffectively searched for an unknown female hormone in the body of animals. During autopsies of dead animals used for experiments he noticed that there were three common symptoms: stomach ulcer, enlarged adrenal glands and shrunken tissue of the immune system. Selye came to the conclusion that this could be an effect of the negative stimulus applied to the animals during experiments. Following this conclusion Selye started a series of experiments in which he exposed rats to many different aversive stimuli. No matter what kind of stimuli he applied the effects were as observed before and a high level of adrenaline was always present. To describe this nonspecific reaction he borrowed a term from metallurgy – stress. Using Cannon’s discoveries and his own observations in 1956 he published his book The Stress of Life where he conceptualized the physiology of stress as having two components: a set of responses which he called the general adaptation syndrome, and the development of a pathological state from ongoing, unrelieved stress.

Unfortunately, his theory did not meet with the approval of endocrinologists and physiologists. Incorrect categorization of the reaction and the lack of precise theoretical definition of stress were the most frequently used arguments against his concept. Moreover, Selye claimed that a certain quantity of stress is necessary for life  and he complicated things by introducing the terms eustress and distress. This meant that every emotion met the criteria of stress and therefore could be call stress, but this was also a cause of subsequent criticism of his theory. This overgeneralization was severely criticized. At the very beginning of the concept of stress even Walter Cannon was very sceptical about it.

In the situation of such massive criticism a scientist has only two ways, either to strengthen his efforts and work hard until his theory got a descriptive and predictive power or to abandon it. But it seems that Selye found his own third way. Against hostile criticism he started to popularize his theory and put a lot of effort in its marketing. For years he used to give lectures about the stress, took part in radio and TV shows, tried to interest physicians, military psychiatrists and the general public.

His strategy appeared to be very effective. Selye became known as Dr. Stress, and was nominated ten times for the Nobel Prize. Even though the term of stress is commonly and wildely used not only by the public but also by scientists, almost every emotional reaction could be called as stress and the disadvantages of his theory were never removed. What is even worse, the claim about the negative influence of stress on our health in spite of many controversies in this field, has become a common dogma.

Serge Doublet (1999) in his book The Stress Myth presented a devastating critique of the concept of stress and its impact on our health:

There is no evidence to support the view that stress causes disease. To invoke the much weaker position that stress is a cofactor or a contributing factor may be an attempt to hide the lack of evidence by confounding stress with other factors(p. 225).

A well-known expert in the field of stress Robert Sapolsky (1994) seems to share this opinion:

Everything bad in human health now is not caused by stress, nor is it in our power to cure ourselves of all our worst medical nightmares merely by reducing stress and thinking healthy thoughts full of courage and spirit and love. Would it were so. And shame on whose who would sell this view(p. 154).

Hinkle (1987) after reviewing the available evidence, concluded that:

So far as I am aware, the data that would allow one to obtain a quantitative answer to this hypothesis about the relation of ‘stress’ to illness in modern society do not exist (p. 566).

In this post there is not enough space to present even a small part of these arguments which contradicts the dogma about negative influence of stress on our health, but as an example of how this conviction could be harmful, I will present one case.

The study by Keller, Litzelman, Wisk, Maddox, Cheng, Creswell, et al. (2012) tracked 28,753 adults in the United States for eight years. To do this, the researchers linked data from the 1998 National Health Interview Survey to prospective National Death Index (NDI) mortality data through 2006. The participants of this study among others were asked questions like: “During the past 12 months, would you say that you experienced a lot of stress, a moderate amount of stress, relatively little stress, or almost no stress at all?” or “During the past 12 months, how much effect has stress had on your health – a lot, some, hardly any, or none?” Keller et al. examined the factors associated with current health status and psychological distress. Next they used NDI records to find out who had died. This procedure enabled them to determine the impact of perceiving that stress affects health on all-cause mortality.

The results were astonishing. 33.7% of nearly 186 million U.S. adults perceived that stress affected their health a lot or to some extent. Both higher levels of reported stress and the perception that stress affects health were independently associated with an increased likelihood of worse health and mental health outcomes. The amount of stress and the perception that stress affects health interacted such that those who reported a lot of stress and that stress impacted their health a lot had a 43% increased risk of premature death. People who experienced a lot of stress but did not view stress as harmful were no more likely to die. In fact, they had the lowest risk of dying of anyone in the study, including people who had relatively little stress.

The researchers estimated also that over the eight years they were tracking deaths, 182,000 Americans died prematurely, not from stress, but from the belief that stress is bad for their health. That is 20,231 deaths a year. If that estimate is correct, that would make believing stress is bad for your health the 15th largest cause of death in the U. S., killing more people than skin cancer, AIDS and homicide. These numbers show clearly that the thoughtless repetition that “stress is harmful to your health” could be deadly dangerous for people who are prone to believing it. Doesn’t  it resemble the voodoo death?

References

Doublet, S. (1999). The stress myth. Chesterfield MO: Science and Humanities.

Hinkle, E. Jt. (11987). Stress and disease: The concept after 50 years. Social Science and Medicine, 25, 561-566.

Keller, A., Litzelman, K., Wisk, L. E., Maddox, T., Cheng, E. R., Creswell, P. D., et al. (2012). Does the perception that stress affects health matter? The association with health and mortality. Health Psychology, 31, 677–684.

Sapolsky, R. M. (2004). Why Zebras Don’t Get Ulcers. New York: Henry Holt.

Selye, H. (1956). The stress of life. New York: McGraw-Hill.

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3 responses to “Believing in Stress Could be as Dangerous as Believing in Voodoo

  1. I realize this post is 7 months old, but I just became aware of your website (and new book). I appreciate that the definition of “stress” is quite vague, but here’s an important quote from the Keller, et. al. study that you may have missed:

    “In addition, reverse causality may partially explain the findings in this study. Adults who reported poor health may have been more likely to report that stress impacts their health simply due to their poor health status; moreover poor health status could also have influenced the amount of stress reported. The cross-sectional nature of these data precludes us from examining the direction of causality among the amount of stress, the perception that stress affects health, and health outcomes.”

    I’m interested in your opinion on Post Traumatic Stress Disorder. Would you say that PTSD only occurs in people who expect it to happen to them?

    Also, parrots kept in isolation for long periods of time (a stressor) develop behaviors similar to OCD and trichotillomania, and dogs kept in isolation can develop behaviors similar to panic disorder. SSRIs have been successfully used to treat parrots and dogs in these situations. Surely animals aren’t susceptible to something like “voodoo death”?

  2. Lack of control is generally the source of a negative feeling. A concept,like stress, implies such lack of control (One supposedly can only manage stress). So, in effect, a belief is stress can only but cause the very feeling the concept is meant to explain. Incidentally, I share you views about Psychology. A large amount of the research and studies in Psychology investigate objectified abstractions.

    • Dear Serge Doublet,
      thank you very much for your comment. I appreciate your work and your opinion very much. Your book “The Stress Myth” is very inspiring and should be a compulsory reading for all psychology and medicine students. About two years ago I wrote an email to you but without an answer, maybe it was out of date address.
      Best regards,
      Tom

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