Stress and Anxiety

Jeffrey Po


STRESS

Hans Seyle was the first to research and define stress and maintains that it is a non-specific response of the body to a demand. Carson however expands stress to mean, "the adjustive demands placed on an organism and to the organism's internal biological responses to such demands. " In short, it simply means the body responding to actual or anticipated difficulties in daily life and "organism" is looked upon as any living organism - not only the human organism.

The adjustments required are referred to as stressors and the effects the stressors create within an organism are referred to as stress. Wilder and Plutchik states that some stressors produce good stress, or eustress, and others produce bad stress, or distress. 


The Natures of Stress: 

There are various types of stress. They include: 

a. Everyday stress : a process of ongoing adaptation by a person in any situation that requires adjustment, whether the adjustment is positive or negative and creates stress. 

b. Cumulative stress : adaptation becomes diminished due to prolonged high arousal and anxiety (i.e. the person finds difficulties to adjust). 

c. Critical incident stress : adaptation is temporarily disabled due to the impact of a critical incident (person about to give up). 

d. Burnout : adaptation is diminished due to prolonged disillusionment, leading to collapse both psychologically and physically (the person gives in). 

e. Post-traumatic stress disorder : adaptation is over whelmed as the person is severely traumatized and 

f. Critical incident stress disorder: coping is disabled due to prolonged critical incident stress (the person requires assistance). 


Sources of Stress: 

Carson suggests that the sources of stress arise from three basic categories. They are: 

a. Frustration occurs when a person is striving toward a desired goal and an obstacle blocks his progress, or when there is an absence of an appropriate goal. Frustration can lead to feeling of devalued self, failure or incompetence. 

b. Environment obstacles may pressure the person to decide and act in ways that lead to internal conflict or external conflict with others. 

c. Internal conflicts can arise when choices have to be made. Carson states "the key element in conflict is often the frustration that will result from either choice" 


Types of Stressors: 

There are 5 major types of stressors. They are: 

a. Biological variables : such as illness and physical exertions 

b. Environmental circumstances : forces in the person's surroundings (e.g. noise, overcrowding, poverty, natural disasters) 

c. Life situations : death of close friends, children going away 

d. Behaviors : smoking, poor eating habits 

e. Cognitive Activities : sitting for exams, mental challenges 


Factors Influencing the Severity of Stress: 

a. The Nature of Stressors : 

The impact of stresor depends on its nature, which is comprised of its perceived :

i) Importance : loss of job against loss of promotion

ii) Duration : length of time unemployed

iii) Cumulative effect : lousy boss, quarrel(s), loss of job

iv) Multiplicity : loss of job PLUS illness PLUS accident

v) Imminence : how soon can the stress situation be removed


b. Individual Stress Tolerance and Inner Resources:

i) Perception of the threat - how threatening is it?

ii) Tolerance to stress - how long can I bear this?

iii) Inner resources - how much "inner" strength do I possess?


c. Stages in the Stress Syndrome:

i) An alarm stage : the body begins to response

ii) A stage of resistance : the body fights

iii) A stage of exhaustion : the body gives up

How stress affect the person (body) :


Under stress the body set off the "alarm reaction" that activates the hypothalamus gland (located at the base of the brain) to release certain chemical substance called "hormones" that in turn triggers the pituitary gland (also located in the brain) to release "adrenocorticotropic hormones" (ACTH) into the person's bloodstream. ACTH travels to the adrenal gland (above the kidneys) that releases other type of hormones call "glucocortiocoids" and " adrenaline". The latter increases the heart rate and blood pressure. Those hormones supply immediate energy to the body and suppress the activities of the body's immune system. The person is now said to be under "stress". 


Methods for Adjusting to Stress Developed from Clinical Psychology: 

Methods developed from clinical psychology for adjusting to stress includes: 

i) Progressive relaxation techniques, which involve the tightening and relaxing various muscles groups throughout the body in a progressive manner. 

ii) Behavioral modification techniques, which involves that construction of a stress hierarchy which lists in order of rising concern (i.e. situation the offers the lowest stress to the highest stress) the degree of stress felt with each step in the perceived event (this procedure may not succeed in eliminating all fears but will enable the individual to function and maintain control)

iii) Cognitive techniques, which concentrate upon the individual thinking about his problems and the ways in which this thinking style may be changed or adjusted to improve coping. 


Alternative Techniques in Stress Control: 

Guided imagery, various forms of concentrative meditation, yoga and other forms of breath control can be utilized to control stress. Clark identifies thress forms of guided imagery for therapeutic use: 

* Receptive : this assists the person to become more aware of the causes of his bodily and psychological discomfort, 

* Healting : this relives the effects of perceived stresses and enhances general well being, 

* Problem solving : this enhances the mind's capacity to generate solutions. 


ANXIETY

Evans and Judd (1991) defines Anxiety as: 

"... a common and normal emotion essential for effective function. It is generally experienced as upleasant and has a subjective feeling of foreboding. Any situation, which threatens well-being, may produce anxiety. Examples include personal conflicts, any type of frustration, threats of physical harm, threats to self-esteem and pressure to perform beyond one's capabilities. In such situation, anxiety is often protective, resulting in adaptive behavior, to overcome or avoid the threat".

Used by psychiatrists and psychologists it means the same as "fear" or "worry". Excessive anxieties are termed as "phobias". 

Anxiety Disorder: 

The NSW Association for Mental Health (1994) defines Anxiety Disorder as: 

"...disorders in which fear or tension is over-riding and the primary disturbance and include: Phobic disorder; the anxiety states, which are panic disorder, generalized anxiety disorder and obsessive-compulsive disorder: and post-traumatic stress disorder".

In a broad sense, the chances of developing an anxiety disorder involves a combination of: 

a. life experiences i.e. stressful events 

b. psychological traits : learned and acquired experiences 

c. genetic factors : genetic inheritance 

Segal and Swallow (1993) indicate that people who suffer from anxiety disorders have deficits in: 

a. processing task-relevant information 

b. storing and retrieving processes 

c. self-focused attention 

Treatment of Anxiety Disorder 

Vitkus (1996) estimates that over half of those who suffer from anxiety disorder do not seek treatment either through ignorance, shyness or thinking that they can cope. However in treating anxiety disorder the treatment usually begins with the following medical tests:

a. EKG's 

b. Blood pressure tests 

c. Chest X-rays 

d. Cardiologic evaluation 

e. Pulmonary function tests 

f. Gastric and colonic evaluation 

Those tests should rule out or confirm an organic condition origination. 

After a diagnostic evaluation and medical workup, an analysis of the person's problem areas is undertaken. They may seek to understand: 

a. The problems suffered by the client 

b. Ways the problems express and manifest in the congnitive-emotion, physiological and behavior realms 

c. Whether the problem has organic causes or complications 

d. The factors which maintain the problem 

e. The psychological and possibly physiological mechanisms which contribute to the development of the problem and 

f. The relevance of diagnoses other than anxiety disorder. 

Buddhism's Perspective To Stress And Anxiety: 

Buddhism acknowledges the emotional expressions of stress and anxiety. The First Noble Truth of the Four Nobles Truth declares the existence and manifestation of Dukkha (the state of unsatisfactoriness; suffering - stress, anxiety, tension, problems, etc). 

Though it is undeniable that close interactive and interdepentdent relationship exists between the mind-matter (nama-rupa) of the person, Buddhism regards the human mind - its unimaginable capacity to perform multifunction tasks - as the influencing factor that ultimately determines well-being of the person himself. 

From the Mahayana's Avatamsaka Sutra: 

" If one wishes to understand. All Buddhas of all times. He should contemplate the nature of the Dharma Realm. Everything is made from Mind alone. 

"One wholesome thought is the condition for the creation of Buddha-lands. One errant thought is the very cause of the nine realms of Samsara" 

Buddhists therefore place close attention to the study on the nature and behavior of the mind so as to harness its potentialities and to finally employ its tremendous powers for his betterment. 

The Anguttara Nikaya (I, 10) mentions: 

"The mind is luminous, but it is stained by defilements that come from without. Ordinary folks do not realize this, so they do not cultivate the mind. The mind is luminous, but it can be cleansed of defilements that come from without. This the noble disciples understand, so they cultivate the mind". 

With regards to the alleviation of Stresses and Anxieties, the Buddhist approach and treatment is mind therapy that involves readjusting the person's perception of the realities external to him. Medications are not used, as it is believed that along with the therapy and through the engineering power of the mind itself, relevant glands located in the brain can secrete chemicals that bring about therapeutic effects. 

The main trust in the Buddhist approach is through the various techniques of meditation coupled with counseling therapy (usually befriending and advising). through meditation, the human emotions that mainly stem from beliefs, evaluations, interpretations (all mind-born) and reactions to life situations, are readjusted. the practitioner therefore learns new coping skills that eventually assist him to identify and question his own irrational beliefs. He discovers methods to replace those faulty ways of thinking with new rational cognition and finally change his emotional reactions to situations. 

Burton Watson in "The Zen Teachings of Master Lin-Chi" writes:

"The mind... 'creates' the world in the sense that it invests the phenomenal world with values. The remedy to this situation according to Buddhism, is to still and calm the mind, to stop it from making discriminations and nurturing attachments toward certain phenomena and feelings..."

Buddhists are taught that two extremely important mental expressions greatly influence their behaviours. They are one's "internalized verbalization and visualization". Internal verbalizations are the talks and chatters that constantly invade the human consciousness while internal visualizations are mental pictures that are reproduced in the human mind. Both needed taming. One method of "taming" internal verbalizations is to overwhelm them with Buddhist chants and studying as well as listening to Dhamma talks. The Lord Buddha Gotama in many of His suttas suggested the cultivation of "good companionships and suitable conversations". The "taming" of internal visualization is to constantly hold in one's mind the Buddha image or any other "holy" images the person is comfortable with. With the taming of the "swinging monkey" one is drawn back to the present instead of living in the past or the future. Stresses and anxieties can then be reduced when one accepts events as they are rather than as what one would like them to be. It is also worthwhile to investigate the cause(s) that had lead to the stress or anxious situation(s) in the first place placing oneself as the reference. Did the situation(s) arise because of the anger, jealousy, envy, hatred, pride, sense of attachment, selfishness, impatience, intolerance that has arisen in us? It will be useful to reflect. 

Can we really remove stresses and anxieties completely from our lives? The words of Ven. Dr. Sri K. Dhammananda (Why Worry? 1967) maintain, "Man has to pay the price of fear and worry in order to be a man. Our susceptibility to anxiety is the soil of our human growth". We grow spiritually each time stress and anxiety is conquered.