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Kind Words

“A scientifically-based integrative approach to dealing with stress, written in the most accessible way! The best of both worlds!” – Dr G. Sideridis, Harvard Medical School

“Your books have been monumental readings to me.” – G. Kyriakides, Training Director, Human Asset Ltd.

“You made me laugh aloud several times. I keep thinking about the cartoons and smile inside me. Congratulations for your wonderful book. You have done an amazing job!” – T. Maria, Lawyer

“A book for a lifetime! I have thought of a few dozens of friends that absolutely need to read it.” – C. Vovori

“A friend recommended that I should follow the Ro therapy. Thank you for your contribution in making our life more beautiful.” – V. Anthoulakis, Army Officer

“This is the first time that a book motivates me to contact the author. It is really a great piece of work. Well organized, combines theory and practice with a lot of humour. It can serve as a guide.” – S. Athina, Lecturer, Aristotle University

“I really enjoy readings your books! They improve my mood. They were exactly what I needed and have helped me in my personal and professional development. Keep writing in the same spirit.” – T. Elissavet

“Incredible writing style, with so much humour that someone may indeed consider changing his or her habits. Check it out. I do not know the author; I was impressed and just wished to express it.” – Andria’s blog

“If you could cast a spell on Angelos Rodafinos, what would it do? … Make him write a third book!” – P. Megremis

Prologue to the English edition

Those who read the title of my book Idiots are Invincible, nod condescendingly in agreement: “Indeed, the author is right, they really are invincible,” thinking most probably of people other than themselves. I do not know who they are thinking of, but no one, until now, has happened to come across my book and agree: “Indeed, the author is right, we really are invincible.” I am beginning to think that perhaps idiots are mythical creatures, as I have yet to meet a single one!

The truth is that when I started writing the book, I also had “the others” in mind: the boss, the professor, the referee, the inept driver, the rude employee, the clumsy waitress, the delayed colleague, the annoying salesperson, the mother-in-law and generally anyone who doesn’t behave “properly,” i.e., “the way we would like them to behave!” [Obviously, I do not refer to mental retardation but to people who simply have a different outlook and behaviour to us].

At some point, however, I realized that as a manager, professor, driver, co-worker, I am often the idiot in other people’s lives. In their opinion I do not always behave properly, i.e., “as they would want me to!” Later, I also realised that more often I was the “idiot” for myself! Irrational thoughts and beliefs such as: “everyone must love me,” “my house must always be clean,” “I must be a good husband, lover, manager, father, son, friend …” create problems and imbalances for us and those around us.

If some books can change your life, I am confident that the present book will change, if not the conditions in your life, at least the way you think and how you see your life – and for the better.

At least this is what several hundreds of the thousands of readers of Idiots are Invincible who have contacted me in the past few years have claimed.

If what you have tried so far has not produced the desired results, and if your approach to life is not working out the way you would like, it may be time to try something new – absorb the ideas described in the following pages and test the “Ro” method for yourself. You have absolutely nothing to lose but a little time.

In fact, if my prediction is right and the claim many readers have made is valid, the immediate benefits of reading this book are likely to include the following:

– More effective problem solving

– Better decisions and choices

– Improved interpersonal relationships

– Less tension, anxiety, worry and guilt

– A stronger immune system

– A feeling of control

– Increased self-esteem

– A healthier body

– A more pleasant and satisfying life

Enough with the promotion.

At www.rodafinos.weebly.com you will find the … Idiots’ Club a.k.a Boneheads’ Academy Blog, where you can share your stories and your ideas for dealing with idiots and adverse situations. Research (e.g., Pennebaker et al., 1988) showed that talking about the problem or confiding, even in the form of a diary or on a simple piece of paper – even if we just throw it away and never show it to the person who caused our emotions – is connected to more efficient operation of the immune system and better overall health. Arm yourselves with pen and paper and … move over Anna Frank!

Record your stories concerning the town planning committee supervisor, the grumpy newsagent, your school teacher, the tax office clerk, your boyfriend or girlfriend, etc. Remember to add what you did to feel better and view things differently. Do not forget that we are often the ‘idiots’ for others (and that maybe at this moment they are writing about us) … and even for ourselves.

Enjoy!

Dr Ro

Preface: The End

I think the most unfair thing about life is the way it ends. I mean, life is tough. It takes up a lot of your time. What do you get at the end of it? A death! What’s that, a bonus? I think the life cycle is all backwards. You should die first; get it out of the way. Then you live in an old age home. You get kicked out when you’re too young, you get a gold watch, you go to work. You work for forty years until you’re young enough to enjoy your retirement! You go to college, you do drugs, alcohol, you party, you have sex, you get ready for high school. You go to grade school, you become a kid, you play, you have no responsibilities, you become a little baby, you go back into the womb, you spend your last nine months floating … You finish off as a gleam in somebody’s eye. – Reverse cycle life, Sean Morey

WHAT A NICE way to start … from the end. Kind of unusual for a book. But this is an unusual book, for unusual people. I am confident that its content will mark the end of a period in your life and the beginning of another, becoming an important aid in reducing negative thoughts and emotions, and living healthier and happier. Now, off we go!

Story: Some escape!

On a cold and rainy winter’s afternoon at an airport, a 12-year-old boy observed several passengers at an airport, waiting for an update on their flight. The flight was delayed, and they looked worn out and glum.

“How come those people look so tired?” he asked his father.

“Perhaps because adult life is tough,” replied the father.

“You mean I will also become like that when I grow up?” the twelve-year-old asked.

Taking a minute to think, his father responded:

“Some people manage to escape.”

Is this how I’ll be when I grow up? I think I’ll pass!

Who manages to “escape?” What kind of coping strategies do people implement when faced with life’s challenges? Why is it that some individuals never seem to be able to cope while some others appear to face less adversity in their lives?

These are the questions that intrigued a number of distinguished researchers, including Paul Stolts, the University of Pennsylvania professor who shared the preceding story, and, of course, myself!

To begin to answer these questions, though, the first thing is really to understand, well, how you are doing.

How are you doing?

When asked this question, participants at my lectures and workshops are unenthusiastic. Many of them sound very frustrated. A common response is “Blah, I am constantly running around, too much stress!” As the conversation starts rolling, questions on the topic start falling along these lines.

“What is stress?”

“Is it normal?”

“Can stress be useful?”

“What are the health consequences of excessive stress?”

“I don’t have stress. Is this dangerous?”

To find answers to all of these questions, you will have to read the following chapters. To get us started, though, I will answer just a couple, selectively, right here.

The first thing to know about stress, really, is that many people believe that feeling stressed day and night is normal. Partially true. Excessive stress is like suicide. Negative emotions secrete hormones that affect our body. These same hormones may, in the long term, have negative effects on our health. Too little stress, on the other hand, may also be harmful!

When I ask “Who in this group thinks has the most problems to deal with?” most individuals put their hands up – they think it’s them.

Here are some more brief answers / teasers to frequently asked questions.

Q.: “Are there some “lucky individuals” who were born with superior resistance to stress? Is it possible to be completely “insensitive?” What can one do to reduce (or increase) stress?”

A.: “Yes. No. A lot.”

Q.: “If I read this book, will I be able to get rid of stress for good?”

A.: Okay, I will answer this one as well, for the sake of marketing the book. I guess the answer is similar to the one for the question “If I take a bath will I smell nice forever?” or “If I eat a lot, will I feel hungry again?” The reduction or, rather, the management of stress needs to be a continuous, life-long process.

Q.: “What’s in it for me if I reduce stress?”

A.: The benefits of stress management include, among other things, better interpersonal relationships, a stronger immune system and fewer diseases, making a significant step towards the realization of one’s full potential (if this can ever be achieved …), and, obviously, wellbeing and a more pleasant and satisfying life.

Isn’t it strange? When we have a headache or a stomach ache we share our problem with everyone around, visit the doctor, follow the prescription, try “alternative or complementary medicine,”¹ we even follow the advice of quacks.

On the other hand, when we suffer from excessive stress or are dissatisfied with our lives, we often do nothing but complain to people who are, overall, unable to help us resolve the actual stress problems.

At the same time, there is so much talk about stress on a daily basis without anyone ever saying enough. I sincerely hope that the content of this book will become a significant aid for the rest of your life.

In this relatively simplified manual, I have tried to summarize a series of theories and techniques alongside a number of everyday serious and funny applications. I have, as much as possible, avoided numerous references and academic citations to scientific studies. My goal is that everyone should understand the material. I assure you however, that (most of) what you are about to read is cross-referenced, with evidence and results from legitimate scientific research; apart, perhaps, from the folk wisdom that stems from the short tales cited. These proffer a common knowledge that has been available through the ages.

Q.: “Do you practice what you preach?”

A.: I was a champion at 15, a champion-worrier. I had received extensive training by that age. My parents were champions too! Apparently, the Greeks have a great national worrying team. Unfortunately, worrying never became an Olympic event.

“Do this, don’t do that, you haven’t eaten enough, wear this, watch out, you’ll hurt yourself, be careful, you’ll catch a cold …”

This lasted for years. In fact, I went through the first 24 years of my life having no idea about the psychological theories and applications described in the following chapters. I certainly wish I had been exposed to them earlier! Truth is that although my life has improved a lot since I have read and mastered the related materials, I often neglect to apply them when under pressure. But they certainly have made a huge difference in the way I see the world and deal with challenges.

–Spiderman, are you going out? –Yes Mom. –Put your robe on, you will catch a cold.

How our mind … runs

Al Oerter was an American athlete. He won four consecutive Olympic gold medals in the discus throw and has been in top physical condition for at least 16 years. According to Dr Dennis Waitley, when he was in his forties, Al made the following statement:

“By the time I realized that success is 90 percent the result for how our mind runs and 10 percent the result of how we run, I already had the body of a senior citizen! Oh, if only I could be young, if only I could have had this knowledge earlier in my life.”

Before we venture too far into this book, too, I suggest we engage in some training for our minds. Unfortunately, as I mentioned earlier, a single reading or a week of practice may not suffice to apply all of the good ideas that you will be exposed to here. They have to become habits and part of your way of life. You also need to hang out with the right people, those who will help you stay on the straight and narrow, when things get tough. Because, while I cannot guarantee that things will always run smooth, I can certainly guarantee that setbacks are inevitable.

Some of you may well wonder:

“Can we really learn psychological skills so as to feel better when things are not the way we would like them to be?”

I am confident that you will learn a number of valuable techniques and enjoy the reading. Go ahead, turn the pages, and flick through the book for a brief preview. No, do not read the end yet! For some reason, a lot of readers (including me) are tempted to do so. Resist the impulse!

THE WAY FORWARD

The book is divided into three parts. The first part is rather more theoretical, and as such, slightly “heavier” that the other two. All parts fit together though and, as I have already advised you, should preferably be read consecutively. More specifically …

Part I: A little theory

The first part offers a definition of stress, refers to the main sources of stress (which include “the idiots” in our life), and examines whether personality traits are related to the way individuals perceive and experience stress. The effects of excessive stress on physical and psychological health are discussed next.

Part II: Coping with stress

The second part distinguishes between healthy and unhealthy responses to stress and presents the basic principles of stress management.

You can’t stop the birds of worry from flying over your head – but you can keep them from building their nest in your hair. – Martin Luther King

Although we cannot get rid of anxiety and negative emotions, we can reduce their frequency, intensity, and duration.

This section introduces the “Ro”² method, a simple yet sophisticated problem-solving formula that can help you deal with annoying people, situations, and your own thoughts. Ro is an infallible method that can be applied to any type of problem you are facing today or may face in the future.

Part III: A day in the life of Don Stressote

Part Three of the book recounts a day in the life of Don Stressote – a modern-day Don Quixote.

The hero, who has just finished reading the theoretical section and is, therefore, a proud graduate of the Ro method, attempts to apply what he has learnt, from the moment he wakes up to the moment he returns home exhausted.

Armed with courage and stoicism, Don confronts the monsters and the dragons (the idiots)³ of the 21st century: his partner who got to the toilet first and is now studying Rodafinos’ book insensitive to the needs of others, the chubby guy in the tiny European lift who squeezes him into the corner, the traffic, his stupid boss, the disgruntled and impervious client, as well as the most difficult person of all – his own self and his irrational expectations!

Don differs from other mere mortals, thanks to his humour, his determination and commitment to his pledge “I won’t let any idiot ruin my day, because this is MY day!” and his careful preparation of an action plan on how to deal with both small annoyances and seemingly unconquerable summits.

This is MY day!

Don’s ability to maintain the appropriate distance from every problem is of the utmost importance. He can put things into perspective, offering every event the necessary attention and nothing more.

All this takes place in the final part. By that time, readers realize a) why they have read a few hundred pages of this book, b) who they really are, and c) what they are doing on this planet. They also get answers to several other philosophical and … metaphysical questions.

Tips for readers

I have always been impressed by scepticism and the ability (or inability) of the human brain for critical thought. People are quick to believe that there are 300 billion stars in The Milky Way, our galaxy, without insisting on counting them, but if you tell them that a wall or a staircase is freshly painted they need to test it with their finger. I admit, I used to be one of them, and made several mistakes, even when borrowing information for my lectures and my books. We are equally gullible to star signs, coffee-grind readings, psychics,⁴ and tarot cards without, for an instance, stopping to ponder the validity of every ridiculous and absurd theory we rush to embrace.

Some of the ideas presented in this book (much like my previous one Princes to Frog and Vice Versa), may initially appear slightly strange. Whichever way you perceive them, work to maintain a critical view. Do not accept everything you read. You are entitled to your own opinion.⁵ Think, question, and cross-reference the information.

The material in this book is suitable for readers with analytical thinking skills, those who are interested in stress and problem solving, and want to organize their thoughts or add more information to their existing knowledge.⁶ On the other hand, cognitive misers, those who wish to avoid spending a lot of time and effort reading everything there is to read about stress, may wish to skip the first part. In fact, if you happen to fit in the latter category and want to feel better now, make sure you read the Ro method (Chapter 8) and then go straight to the third part, which presents everyday applications of the theory described in the first two parts.

Test: True or False?

Before we begin, why don’t we – why don’t you – perform a test to check your knowledge on stress.

Grab pen and paper (if you still remember how to use them).

Now write T (True) or F (False) for each statement on a piece of paper (else on a file on your note pad, iBook etc.).⁷

– Too many good things in a row can make you sick.

– Traffic congestion can raise your blood pressure.

– Stress, behaviour, and certain personality traits can increase one’s chances of becoming ill.

– Most headaches are caused by muscle tension.

– Stress can affect the course of cancer.

– Stress is the best substrate for the activation and multiplication of various pathogenic microorganisms, as it decreases the effectiveness of the immune system.

– Individuals can moderate the frequency, intensity, duration and, as a result, the consequences or effects of stress.

– Personal development efforts, such as training in emotional management, health education, and behaviour modification (nutrition, exercise, and smoking cessation) contribute to better physical and psychological health.

– A sense of humour can buffer the effects of stress.

– Married people live longer and have 30 percent higher incomes.

I hope these questions have sparked your interest. The answers are … somewhere in this book.⁸ It seems that you will have to read on.

Let us begin!

PART I: A LITTLE THEORY

I want to move to theory. Everything works in theory. – John Cash

ARE YOU stressed? If yes, join the club.

Stress can be useful or detrimental. Many studies have shown, however, that excessive stress is harmful for just about anyone. The extent of the negative effects of stress depends on a number of factors, such as genes, general physical condition, diet and lifestyle, etc. Do not despair though, because there are a number of cognitive and behavioural stress management techniques and methods to help you deal with stress and reduce its negative effects.

In this Part we will answer the following questions:

What is stress?

What or who creates stress?

Is stress generated from the outside or the inside?

If you feel pressure and stress, what senses allow you to experience these feelings? Can you see stress? Hear it? Catch it and kick it away? Can you smell stress? Taste it and season it?

Are some people born “stressed?”

Is stress “necessary?”

Chapter 1: Stress? What is that?

Stress is when you wake up screaming … and you realize you haven’t fallen asleep yet! – Anonymous

ONCE UPON a time, in a small south European country, I gave a talk to Greek repatriates from Russia.

During the lecture, answering my questions they complained of numerous problems. They were unemployed, lived in basement apartments, had no health insurance for themselves or their loved ones, and were discriminated against and treated poorly.

I was stunned. I had just returned from my postgraduate studies in Australia, where living standards and the quality of life are comparably high, and certain things that in other nations are considered luxuries are taken for granted.

Since that day, I have talked to various audiences – several thousands of people in total. I have addressed entrepreneurs whose businesses were generating millions of Euros. They also told me they had numerous problems and a lot of stress because … they had lots of money! I came to think that money, or the lack of it, may not be the real problem.

Is this a problem or what: Which one should I buy?

I asked an old classmate how he was doing. He replied sadly that he had no work. On the other hand, I am constantly complaining that I have too much work. I realised that work may not be the main source of stress either.

Some people believe that if they had a car, their life would be easier. Those (at least in large and populated cities) who own a car start cursing the moment they have to use it and drive to their destination. They automatically think of the traffic and the stress related to searching for somewhere to park.

I was now officially confused.

HOW ARE YOU FEELING?

I always begin my talks by asking participants to evaluate their mood at that moment, using a Likert scale from 1 = excellent to 5 = lousy. As you can probably guess, replies vary substantially.

Story: I’ve got her/him to hug …

A couple of years ago, I was lecturing to my students at City College. “Well, how are they feeling?” you might well ask. On the other hand, you may not. Whether you ask or not, I will tell you. How would you expect them to feel? Poor students … Most of them stated that, other than the burden of studying, they were still single although they really wished they had a partner, someone to hug during those quiet or … restless … nights that seem to last forever. I must add at this point that some of the students confessed that they faced problems because they had too many partners to hug, and that their nights were not only not quiet, but they were never enough either.

“Relationships,” I thought, “what an important area! It might well be the most important facet in all of our lives. Besides, whenever I run a counselling session – irrespective of the nature of the problem that prompted the discussion – we almost always end up dealing with interpersonal relationships.” Isn’t that interesting?

Another group of people confirmed my theory about the importance of relationships, in an unexpected way. For a number of years, I taught on a lifelong learning program for 40 to 60-year-young teachers. I made the mistake of asking them about their lives.

“How are you guys doing?”

While my 20-year-old students moaned and groaned about not having anyone to hug, this group responded:

“How do you think we’re doing? Lousy!”

The married teachers eagerly added in an effort to explain:

“We’ve got him/her to hug,” pointing at each other.

I've got HER to hug …

Money, work, relationships … the major sources of stress. If not these, then what is it that makes us feel the way we do?

Continuing from the initial exercise, I collect all the “how are you feeling” answers and explain jokingly that those who scored high (1 = excellent, 2 = pretty good) are allowed to leave the class; the rest should stay … because they need me!

My next question relates to the cause:

“Why do you think you are feeling the way you do?”

Some look at me puzzled. Others rush to answer. Replies are usually attempts to offer reasons (excuses), such as:

“I haven’t had my first coffee yet. I haven’t slept well or enough. I have relationship problems. I am too busy/overworked, tired, drained, shuttered, wiped out, worn out, exhausted.”

To these complaints, I exclaim:

“Well, what about the weather? You forgot the weather! Doesn’t the weather affect our mood?”

“Of course,” they hasten to add, agreeing and nodding positively. And they wonder: “How could we have forgotten about the weather?”

Does the weather really affect us?

Well, I usually feel miserable and unhappy. However, when the weather is good my mood changes. I feel … unhappy and miserable. – Arkas

Personal observations indicate that the same individuals who whinge about the weather in winter “Damn! It is cold and it’s raining again. They promised me it would not rain!”, also complain in the spring and summer “Whew! I cannot stand the heat; I am fed up, what lousy weather! Must be the bloody greenhouse effect.”

As we will see later on, the weather can indeed affect our mood. Yet, those who complain have not realized that they can change the weather. Have you? No? Then hang on in there a while.

The next question I ask participants, and now you my dear readers, is:

“Okay, how long do you think you will remain in the present state and mood?”

“… Huh? … Well, I guess until the problems are resolved.”

“What if you never get the job you deserve, or the house, or the car of your dreams? Will you carry on complaining, being negative and unhappy for the next 10, 20, or 30 years? Let me know, so I can find someone else to hang out with.”

Dead silence …

The silence that follows gives me the impression that I have made my point. However, there is still work to be done. Stay with me.

Like you, I have often wondered about the real factors that affect the way we feel. I think I have come up with a good answer. You can read about it later on, in the section that refers to stress management techniques (Chapter 5).

WHAT IS MORE IMPORTANT?

Put your thinking hat on:

“What’s more important: how much money we have, how much knowledge we have, or how we feel?”

When I had to answer the above question while reading Dr Wayne Dyer’s⁹ book, I found myself thinking, mouth wide open:

“How true! What am I supposed to do with millions, if in the effort to acquire them, I lose my health, I allow my relationships to deteriorate, feel bad about myself, and have no fun and waste my life?”

What would you wish more for your kids and loved ones: money and knowledge, or the ability to live a good and healthy life, with wonderful relationships, festivities, fanfares, joy, laughter, and happiness?

Although the first two elements (money and knowledge) appear significant, it really does not matter how much knowledge and cash I accumulate if I cannot feel good about myself and the people around me. By the way, I believe that feeling good (psychologically and physically) can assist tremendously in acquiring both knowledge and money. For instance, children who feel good about themselves and others in class will be more motivated to study hard.

If we all agree that feeling good is more important than either money or knowledge outright, then where are the lessons, alongside geography, history, math, and all the other useful and useless classes we have to take, that teach us how to manage our emotions? Wouldn’t it be great if in school or at university, apart from all the skills and broad-scoped knowledge, they also taught us techniques on how to feel good when things are not going so well? Had we been taught what to do to manage stress and negative emotions, we would not need to rush to the nearest psychologist for support.

Anyone who goes to a psychiatrist ought to have his head examined! – Samuel Goldwyn

How high is Mount Olympus?

For a worrying number of years, I have been waiting for someone to ask me the height of Mount Olympus. I have chiselled this piece of knowledge deep into my memory, as required by my primary school teacher.

“Olympus is 2,917 meters high. You’d better remember that well!”

But, is it really so important to know the height of the famous Mount Olympus?

Possibly. General knowledge is at least … generally useful. Yet no one has yet asked me its height and I certainly cannot say that this piece of knowledge has proved useful so far. I am still waiting patiently though. Someone will eventually ask me, won’t they? Then I will be able to tell them:

“Ha! At last! I have been waiting for you all my life. It is 2,917 meters high, sir. Yes sir. That’s how high Mount Olympus is.”

It could happen soon; if not today then someday. My hopes were high in 2004, during the Athens Olympics.

“Maybe someone will make the connection,” I thought, “and ask me.”

Now that the Olympics have been and gone, I guess it has become even less likely.

Please do not misunderstand me. I am not arguing that encyclopaedic knowledge is useless. Far from it. Among other things I have learnt, the following not only assist me in putting things into the right perspective, but I still hold on to the belief that they could actually prove useful facts to know someday:

– The United States bought Alaska from Russia for $7.2 million, i.e., for less than two cents per acre, and Manhattan from the Indians for 24 dollars. We learn from history! (Perhaps I should invest in unexplored frozen territories. Who knows, maybe in 50 years I will be really rich.)

– When flocks of bats leave a cave, they always turn left before flying off. (I haven’t verified the validity of this statement, but just to be on the safe side, I suggest you enter the cave from the other side, just in case they fly in your face.)

– You share the same birthday with approximately 19.2 million¹⁰ other people around the world. (Bummer … I thought I was special. Happy birthday to us all! Perhaps we should organize a joint party, invite 10 to 20 friends each, and split the expense. We can meet each other and test the theory of astrology, which affirms that our personalities should be pretty similar. We are Leos after all.)

Useful information, isn’t it? I am, however, under the impression that we have overlooked certain rather important areas of knowledge. Perhaps we ought to re-examine the priorities and the aims and objectives of the traditional educational school curricula.

Yet, if we decided to teach people emotion management, has science discovered the necessary knowledge? If so, is it available for all? Can we learn to change the way we feel, even when external circumstances justify (or even “impose,” as many people think) feeling bad? I would argue that such knowledge is available, hitherto untapped by most.

SO, WHAT IS STRESS?

While everyone around us is talking about it and everyone appears to know a lot, it seems that no one really knows what it is. It is very much like the definition of love. Indeed, although most people seek love and wish to reduce stress, very few can define the terms. Watch closely. Here’s another exercise I enjoy doing in my seminars to support the argument I have just made.

Putting on my most serious face, I instruct participants:

“I’ll give you three minutes to think and record on a sheet of paper the answer to the question “What is stress?”. Then, I will select three of you to come up onto the stage and give us their definition. Next, you will judge them by awarding marks, and we will eventually decide on the best definition. By the way, the ratings you receive will count towards your final mark. Let’s go! Your time starts … now!”

Suddenly, participants remember that they have a pen somewhere in their briefcase and start looking for it. Others realize they need to use the bathroom. The rest are looking for handkerchiefs, shuffling papers on their desks, fidgeting around on their chair. Their reactions are typical; as I move closer, some avoid eye contact by looking down. Why? Because the level of stress in the room has increased significantly!

Way before the end of the three minutes, I peer over the seats of two or three individuals and stare into their eyes, as if I were testing their responses to decide whether to pick them to get up onto the stage.

The classic response is to look away and sink deeper into their seats. Occasionally, I get a straight look in the eyes from those confident enough to stand up and present their ideas or those who enjoy showing off.

When the three minutes are up, I try making eye contact with as many people as I can, slowly looking around the room from one side to the other …

Then, I tell participants

“Don’t panic, I am not going to examine anyone. You can relax. I used the exercise to help you experience a little of what we have been talking about, i.e., stress.”

“… Thanks mate, appreciated!” they reply and breathe a sigh of relief, packing up their notes.

I then ask for the definitions they recorded, but in a non-threatening tone.

Wait! Your turn first! Although I am not near you right now, stop arguing that you do not have a pen, or that it is time for a break, because it’s not, at least not yet. What would you tell your seven-year-old if she asked you?

Stress is …

Record your definition of stress above. Now!

Before we move on to your definition of stress, consider that one of the most common replies is that stress is something you feel.

“I am under a lot of pressure” or “I am feeling very stressed” are expressions used by most of us in everyday life.

If stress is indeed something we feel, then which of the five known senses do we employ to feel it? Can we see, touch, smell, taste, or hear it?

“Of course not!” I bet you would hasten to reply, were you here with me now.

However, even though we cannot feel it by using one of the known senses we all experience some form of stress in our everyday life. In this case, how can we argue that we feel stress? With which of our senses?11 Allow me to enlighten you.

The answer is that we can feel our body’s responses to stress, as well as its immediate effects. We can also observe how someone perceives and experiences stress.

As will be discussed later, both the perception and the responses to stress caused by identical events may vary substantially between two individuals.

“Real” stress

The midnight news on Uranus ended with the weather forecast.

“Tomorrow Monday the temperature will range between 18 and 23 degrees Celsius. The S.P.I. (Stress Particle Index) may exceed the 250 S.U. (Stress Unit) safety limits, while there is the chance of local storms.”

The citizens of Uranus prepared their anti-stress umbrellas for the following day and went to bed. You see, on Uranus, stress fell from the clouds in the form of visible yellow and blue polka-dot particles and was … quite painful!

If you are an earthling you may find this news strange, but it’s probably the inhabitants of Uranus who would be puzzled to find out that on Earth stress cannot be seen, felt, smelt, tasted, or heard. That lifts do not have special mechanisms that produce vibrations and sounds to terrify claustrophobic people. That, buildings don’t have hinges to move around and terrify people who suffer from fear of heights. Uranians would be surprised to hear that on Earth stress exists only between the ears of each earthling and not a foot away from under their very nose.¹²

According to the weather report, there will be a stress storm tomorrow. I must remember to take my anti-stress umbrella and … helmet!

So, what is stress? Here is one of the most popular definitions:

“Stress is the response of the body to any event that threatens – or is perceived to threaten – our well-being and exceeds (or at least we think it exceeds) our ability to cope with it” (Lazarus & Folkman, 1984).¹³

Good or bad?

Can stress be positive? Record your response to this question: Yes … No …

Pressure and stress is the common cold of the psyche. – Andrew Denton

There is a slight confusion in the use of the words stress and anxiety. Let us clarify the issue. Stress refers to the demands for adjustment, without necessarily distinguishing between the negative or positive emotions associated with it. Anxiety, on the other hand, refers to negative emotions only.¹⁴

The answer to the question above is “yes.” There is positive (eustress) and negative stress (distress). In fact, a certain degree of stress is necessary in life, as we will see further down, in order to experience what Dr Peter Hansen calls the joy of stress!

Does eustress also pose a threat?

Indeed! Except, these threats are less intense compared to the effects of distress. One could even argue that the physiological responses to positive and negative stress are similar, as illustrated in the example below.

A mother learns that her son has been killed in the Second World War (the letter with the bad news took some time to arrive, because it was mailed by regular and not express post). She is shattered, she shakes, her blood pressure rises, she wobbles, stutters and, considering her old age, potential consequences could include a stroke or heart attack.

If she recovers and survives until next week, she will offer us the opportunity to examine an example of positive stress. Let us assume (this is our story, we write the script) that mum survives.

Within the next week, her son, who was mistakenly presumed dead, returns (he walked all the way from Japan; that is why he was late) and, not having mum’s mobile number to inform her of his imminent arrival, rings the doorbell.

His mother, upon seeing her beloved son, reacts in a manner very similar to last week, when she was informed of his apparent death. She is shattered, she shakes, her blood pressure rises, she wobbles, stutters, she is a week older now and as such, a stroke or a heart attack could again be imminent.

Conclusion: any event, pleasant or unpleasant, that requires adjustment may cause a range of physiological and psychological responses. Hence, an alternative definition of stress by the late Austrian Dr Hans Selye, the “father” of … Stress-o-logy, states:

“Stress is the non-specific response of the body towards any demand for adjustment imposed, irrespective of whether the demand is placed by pleasant or unpleasant situations.”

Sitting in the dentist’s chair may be as stressful as a passionate kiss with your beloved, argued Selye. Who would avoid the latter because of the stress it generates?

Feel free to kiss me; I promise I can handle it …

By the way, if you do not have problems, raise your hand! Do you know someone who has no stress?

I know a several people, except … they are six-feet under! Only the dead have zero stress (although those who have caught the elevator to the “underworld,” may be in a slightly detrimental position!).

Excessive stress is the problem

Stress is not only unavoidable but also normal and, in a way, a necessary element of human existence. Yes, you have read correctly, stress is normal. The absence of stress is what ought to be considered abnormal and may, in fact, have consequences similar to those of excessive stress.

Stress does not necessarily produce negative consequences, unless a) it occurs quite frequently, b) lasts long, or c) has high intensity. The frequency, duration, and intensity of stress are the factors that make all the difference. People suffer and occasionally die not of excessive stress, but because of their erroneous perception of the stressful event and because of their poor coping responses.

Consequently, a certain degree of stress, what researchers call “optimal” level of arousal, is necessary.

Stress is the spice of life. – Hans Selye

Optimal level of arousal

According to the Law of Inverted U (Yerkes & Dodson, 1908), there is an optimal amount of stress, which energizes us and helps us bring out our best. The optimal level of arousal differs slightly between individuals and is dependent on the nature and the difficulty of each task. For instance, the optimal level of arousal required by a boxer or a 100-meter sprinter (high) is different to that of a volleyball player (average), and a chess player (low).

When the level of arousal exceeds the ideal (excessive stress), some or all of the symptoms of stress, such as reduced concentration, increased blood pressure, appear. If the individual remains in this state for a long time, burnout may occur. Conversely, when the arousal level is too low (little or no stress), a person may experience boredom and lack of energy. It is likely to “stagnate,” if there is no stimulation for a long period.

Therefore, a certain degree of stress is necessary to remain healthy, to be creative, and to feel satisfied. The aim, therefore, is not always to reduce but to effectively manage stress. Indeed, many times it is necessary to increase the degree of stress in our lives … so that we don’t feel as stressed! We will therefore discuss the conscious and effective adjustment (increase or decrease) of stress. In other words, “Hurray for stress!” – as long as we know how to adjust it at will.

You never will be the person you can be if pressure, tension and discipline are taken out of your life. – James Bilkey

There are many ways to manage stress, and awareness of these techniques and strategies helps regulate the three ever important variables: the frequency, the intensity, and the duration of our responses to stimuli. However, this will be the subject of discussion in a later chapter on problem solving and the effective regulation of stress. Let us first examine the sources of stress.

Chapter 2: Sources of stress

Contemporary stress: you have a list of 15 phone numbers to reach your family of three! – Anonymous

WHAT IS the primary cause of stress in your everyday life? What do you see yourself doing daily that you do not like? What is the problem? Your finances, other people, your relationships, your kids, your work and your boss, traffic, pollution, your health, the dessert in the fridge that is, without a doubt, going to end up in your tummy?

Exercise: What stresses me out

Recall and record a recent stressful experience:

Alternatively, complete the following sentences:

I get bored when …

I am tired of …

I get irritated by …

I can’t stand …

When I set this exercise, the most common answers by participants include the following:

– my relationships with others (their opinion of me, their lack of understanding and communication, their inconsistencies, their rudeness, the fact that I constantly need to nag them)

– my partner (e.g., when they do not call, wash the dishes)

– loneliness

– my relationship with myself

– failure

– traffic jams

– waiting

– lack of money, time, sleep

– office politics, job dissatisfaction

– noise, pollution, crime.

I worry when I have nothing to worry about! I know, it is rather worrying, isn’t it?

Strangely enough, what is extremely difficult or unbelievably boring for one person can be wonderfully enjoyable for another; and vice versa. For example, think of exercise, work, and fishing. Even activities such as travelling, sex, or sleep, which are considered pleasant and enjoyable by so many, are sometimes perceived as unpleasant or unwelcome by many others.

Modern sources of stress

What are the most common sources of stress these days? Are they different from the “Good old days?”

Consider the following:

– If the last 50,000 years of our existence were divided into lifetimes of approximately 62 years each, there have been about 800 such lifetimes. Of these 800, fully 650 were spent in caves. Only during the last seventy lifetimes has it been possible to communicate effectively from one lifetime to another – as writing made it possible to do. Only during the last six lifetimes did masses of men ever see a printed word. Only during the last four has it been possible to measure time with any precision. Only in the last two has anyone anywhere used an electric motor. And the overwhelming majority of all the material goods we use in daily life today have been developed within the present, the 800th lifetime.¹⁵

– In the last-but-one lifetime, the fastest mode of transport was the horse. The changes that have occurred over the last lifetime are dramatic. Today we are able to comfortably travel 10,000 kilometres in a single day!

– Every day we receive around several thousand times more stimuli than a hundred years ago and, as if that weren’t enough, existing knowledge doubles (in certain scientific fields) every five years.

– A hundred years ago, deaths from cancer or heart disease were almost unknown (mainly because people died earlier of other diseases, before they reach the age where cancer and heart disease developed). Today, half the fatalities associated with the 10 most serious causes of death are due, largely, to behavioural habits.

– According to a comparison of self-reported stress in three different time periods (1983, 2006, and 2009), levels of stress increased a little during the 2008-9 economic downturn, but increased more for certain groups, such as younger adults and those with low socioeconomic status (Cohen & Janicki-Deverts, 2012).

An American journalist once asked Hans Selye if, given the dramatic increase of stress levels, parents and teachers should teach us how to cope with it more effectively. Selye questioned the assumption about the elevation in stress levels and suggested that every stage of life has its own problems. A century ago we may not have had the threat of a nuclear war, but there was cholera and the plague, that wiped out entire towns and villages. Every age has its own uncertainty, as is the case during the lifetime of an individual: you may be healthy today and ill tomorrow; rich one day and poor the next.

A TAXONOMY

Several approaches have been used to categorize the sources of stress.16 Among others, these include categories according to the type of the problem that creates stress, the characteristics of the situation, time, internal or external factors, etc. As one would expect, these categories often have several common elements. Let us explore some of these in more detail. We will discuss:

A. Dilemma, pressure, frustration, and change (daily stressors and important life events)

B. Loss, guilt, entrapment, boredom

C. Sources of stress at work, and

D. Internal and external stressors.

See if you can identify your sources of stress and examine how they fit into the “boxes” suggested by the experts.

A. Dilemma, pressure, frustration, and change

According to a first distinction, sources of stress may fall into one of the above categories.

The first category is Dilemmas.

Conflicts of needs, decision-making, and having to choose between alternative options (even if both are positive or pleasant) can be quite stressful. This category includes three sub-sets:

a) Approach-Approach (as in caretta-caretta):17 When I have to choose between two similar and positive – or, at least, attractive – goals or choices. For example: “Shall I go on a date with Kate or Sue?” (“Both!” I hear my more dapper readers reply). “Shall I choose chocolate cake or apple pie?” (“Both!” answer my greedy and potentially chubby readers).

b) Avoidance-Avoidance: when I must choose between two negative (unattractive and/or unpleasant) goals, I wonder: “Which is the least bad, therefore the better?” For example, “I must go the dentist, which is unpleasant and painful, or shall I leave it … for another time?”, “Should I remain unemployed or should I accept a demeaning job?”

c) Approach-Avoidance: when there is one goal with both negative and positive aspects. For example, “I am going to ask Penelope out on a date, but what if she turns me down?”, “Double cheeseburgers are tasty, but what about the calories?”, “Shall I get a divorce or stay married?”.

The difficulty of choosing between two alternatives was one of Bob’s main sources of stress.

The second category is Pressure.

There are three sub-sets in this category as well. Pressure to perform or produce more, time pressure (very little time for the realization of disproportionally numerous tasks), and pressure imposed by “social dictates” (these require that we behave in a certain way and, as such, compromise or obey the dictates of society; traditions, fashion trends, behaviour protocols all find their place here).

The third category is Frustration.

In our efforts to achieve targets that are important to us (professional, familial or social), we often come up against unforeseen obstacles that block us from achieving our goals. Although we may have tried very hard, external factors such as other people (e.g., our boss, colleagues, family), a marriage, a pregnancy, or an unavoidable house move, often intercept our planned course. Similarly, a loved one’s chronic health problem can literally put the brakes on our career or personal development.

Another characteristic example is teenagers who often feel frustrated because their options are hindered by their age and related factors such as lack of money, parental control, differential treatment by other adults, etc.

One can significantly reduce the intensity and effects of this type of stress by examining and modifying his/her irrational expectations.18

The fourth category is Change.

According to the definition of stress above, changes are capable of generating stress because they place demands on the individual to adapt. Consequently, any event, pleasant or unpleasant, that necessitates change, can cause stress (occasional or chronic). This category is open to a new demarcation of the sources of stress into Everyday Life Hassles and, Major Life Changes. It appears that the former can be more stressful than the latter.

1) Everyday Life Hassles. Most of us believe that stress is an integral part of everyday life. “Minor” problems, that cause stress on a regular basis, can include: housework, health problems, time pressure, inner concerns (loneliness, insecurities), environmental problems, money worries, work issues, and others.

According to a survey of middle-aged adults in America, the top 10 daily hassles (in order of priority) are:

Concerns about weight, health of a family member, rising prices of common goods, home maintenance, too many things to do, misplacing or losing things, yard work or outside home maintenance, property/investments/taxes, crime, and physical appearance.

Similarly, sources of joy, always in evaluative order and always according to the same study, are:

Good relationship with spouse or lover, good relationships with friends, completion of a project, feeling healthy, satisfactory sleep, eating at a restaurant, fulfilment of one’s obligations, visits/phone calls/mail, spending enough time with one’s family, and pleasant living environment.

2) Major Life Changes. Certain events have a decisive influence on the life of the individual and are accompanied by – or necessitate – important changes and adjustments. Such sources of stress include “shared” disasters such as earthquakes, fires, and war, but also deaths, family of financial problems, imprisonment, as well as positive changes, such as a wedding, a birth, sudden improvement in finances, holidays and travel, etc.

Believing that the future will be just like the present (only … shinier and more comfortable, with less buttons) is absurd. In the words of Kelly Morgan, “Changes are inevitable and not always controllable. What can be controlled is how you manage, react to and work through the change.”

Holmes and Rahe (1970) developed the Social Readjustment Scale,19 a questionnaire in which respondents record the changes that have occurred in their life over the last six months.

The scale contains a points table ranging from 15 (Christmas holidays) to 100 (death of a relative) for every stress-inducing change. Marriage is positioned in the middle of the scale with 50 points! An overall score is produced by adding all points. The researchers found that 80 percent of individuals who scored over 300 points in their study went on to suffer from a serious health problem over the next six months. Only 33 percent of those with a total score below 150, that is with fewer changes in their lives, fell ill!

Critics of this particular study have pointed out several deficiencies, including the fact that the scale does not take into account important parameters such as each individual’s perception of the event, personality, or differing responses to the same event. Moreover, the number of negative events included in the questionnaire is disproportionally larger than the number of positive events.

Other researchers using this scale were able to demonstrate the correlation between psychological stress (positive or negative) and a significant number of physical symptoms and ailments. Yet, due to the nature of the studies (correlational data only) one cannot surmise any cause and effect.

Before you become totally stressed out, we should note that even if an individual attains a high score on the scale, people with a tendency for illness are usually in poor physical and psychological condition anyway. These individuals do not have at their disposal the techniques for dealing with stress that you will acquire if you choose to carry on reading!

Many will wonder: “Is it true that stress is cumulative?”

Most certainly. For example, traffic problems and poor transport conditions steadily increase our arterial blood pressure. Small, everyday problems (e.g., it is raining, the bus is late, a flat tyre, a problem at work, an interpersonal conflict), can often accumulate and end up being more stressful than other apparently more significant events.

Similarly, many positive events in a row can also … cause stress and make us ill! On the other hand, previous successful stress management experiences can help us deal more effectively with similar situations in the future.²⁰

B. Loss, guilt, entrapment, and boredom

Several therapists believe that the following four factors operate subconsciously and create chronic stress:

a) Loss. Examples of this source of stress are theft or damage to material goods (wallet, bicycle, car, etc.). Of course, a major form of loss is separation/divorce or the death of a loved one. Statistical data confirms that often the death of one spouse in an elderly couple is quickly followed by the deterioration in health and death of the other.

b) Guilt. An unpleasant emotion created when the individual believes that they have not behaved according to their own values and principles or those imposed by their social environment. For example, one may experience guilt when s/he considers him/herself responsible for adverse events, not living up to one’s values and standards, adopting bad habits, or for infidelity and deception.

c) Entrapment. An unpleasant feeling created when individuals consider themselves trapped because of circumstances difficult to escape. Examples include a feeling that one is married to the wrong person, in the wrong line of work, not utilizing their skills, stagnation in personal development, etc. Other conditions that can create a permanent feeling of entrapment are problems of financial (too poor or … too rich), social (lack of social life) or familial (single, divorced) nature, but also, problems with one’s physical appearance (too short, too tall, too … blond, etc.).

d) Boredom. According to Selye, boredom stems from a lack of motives, goals, and “meaning” in life, and can lead to psychological and physical wilting. A lack of purpose in life is, in my opinion, the worst form of stress and perhaps the greatest cause of dissatisfaction.

Although our brain occupies only two percent of our body mass, it consumes twenty percent of its overall energy. Just as our gastrointestinal system is in constant need of food and our respiratory system of oxygen, so our brain needs constant stimulation. How long do you think you could sit around doing absolutely nothing?

“Ha, easy, forever!” some will assert. (Et tu, Brute?).21 You’d be surprised! Student volunteers were paid a hundred dollars for every day they spent lying in a room, eyes closed, without any external stimuli.

“Just what I need!” they thought. “Instead of carrying boxes down at the vegetable market to make some pocket money, I’ll get down to some serious idle fun and cheers to the rest of you. Sweet!”

The results? Most students gave up after 24-48 hours. Following a period of inactivity, their brain started producing hallucinations – internal stimuli – to counterbalance the lack of external ones! They still can’t believe it …

Perhaps, in that case, “Hurray for stress” is not such an absurd statement after all!

C. Sources of stress at work: When work becomes slavery

This section is dedicated to people who are exposed to “high voltage” stress at work daily. Let us try to classify the main sources of work-related stress. These groups of stressors relate to the actual nature of their work: the task and its characteristics.

a) The first group relates to the Demands of Tasks. As noted earlier, the need for increased physical effort, repetitive or hard labour, unpleasant work conditions, increased and irregular work hours, the difficulty and volume of work that must be produced, unrealistic goals and pressure for their realization, an exhaustingly fast pace, decision and choices (e.g., between an emphasis on quality or quantity), all are stress-inducing factors.

b) The Structure/Relationships group relates to stressors connected to the relationship structures within the workplace (company, factory, office, or organization). Collaboration with colleagues, the way orders are phrased, negative criticism, misunderstandings, and unclear duties and responsibilities are all important sources of work-related stress.

c) Finally, the Career group relates to issues of professional development within the workplace, such as the lack or superfluity of promotion opportunities, financial insecurity and uncertainty (e.g., maintaining a position or the future of the company).

Who do you think experiences more stress? Directors and managers or lower ranking employees and workers? The answer, as always, is not clear-cut. It depends on several parameters such as the nature of the job, specific tasks, and the personality of the employee.

Among the factors that play an important role in one’s experience of stress is the ability to anticipate stressful events and the degree of perceived control over the event. Unpredictable events, lack of control, and negative feedback relate to increased levels of stress (Weiss, 1971).

“Do you believe in life after death?” the boss asked one of his employees. “Yes, Sir,” the recruit replied. “Well, then, that makes everything just fine,” the boss went on. “After you left early yesterday to go to your grandmother’s funeral, she stopped by to see you.”

D. Internal and external Stress

Finally, quite important is the distinction between external and internal sources of stress.

a) External sources of stress. Conditions such as excessive noise, heat, pollution, and cramped urban, home, or office space can produce physical and psychological stress.

b) Internal sources of stress. These are due to either physical causes (tooth, head, stomach ache or other ailments), or psychological (often self-generated) stress. For instance, an individual may experience excessive pressure due to increased responsibilities, lack of time or skills required to cope and perform according to high … self-imposed standards.

Hence, a large part of the daily stress we are subjected to exists only “in the eyes of the beholder,” i.e., the person experiencing it. This premise is supported by the fact that humans, in contrast to animals, can trigger the stress or fight or flight response (that will be described in detail later), simply by thought, i.e., without a real, objective, external threat. Nightmares are a helpful example: the bogeyman of your childhood, an imaginary stimulus, can cause psychological (e.g., fear, terror), and actual physical responses (palpitation, shiver, or even enuresis).

Cute joke: The feeble little ghost

“Doctor, every night I have the same dream: I am asleep, nice and happy, until a little ghost appears. It says hello, I say hello back. It smiles, I smile back … and then, it asks, have you peed? And at that point I wake up and find I have wet myself.”

“Hmm,” says the doctor, “nocturnal enuresis. Interesting!”

She looks up puzzled and scratches her head for a few seconds. She then comes up with the solution. “I know! Next time it asks you if you have peed, you answer: I have. That should do it!”

“Great idea, doctor! Why didn’t I think of that! Well done! I suppose you’re the one with all the degrees! That’s what I’ll do!”

The patient walks out the office, flying high. That night, as he gets into bed, he is full of anticipation, confident of the outcome of the night. It’s not long before the ghost appears:

“Evening …,” it says.

“Evening,” responds our friend with a smile.

“Have you peed?” asks the ghost.

“He, he … I have indeed!” he giggles, full of poise and enthusiasm.

“Hmm … I bet you haven’t pooed though, have you?”

Have you peed?

A point to remember, which will be particularly useful during the discussion on stress management later, is that we can trigger our body’s physical response in a moment and in the absence of imminent danger! All it takes is simply to think of something that we consider physically or psychologically threatening. The mere thought of riding in an elevator, airplane flying, our teacher picking on us to get up in front of the class, the blonde on the bus eyeing us up (what an obsession), is enough to raise our blood pressure and produce an adrenaline rush – just like that, out of the blue.

Appraisal of the situation

Consequently, the degree of stress caused by each event depends on our own evaluation of the event, which is based on the following factors:

a) How familiar the event is,

b) The level of control we perceive we have over the event,

c) Our ability to anticipate it and, therefore, be vigilant and appropriately prepared, and

d) The imminence of the danger.

The subjective perception of stress includes two stages:

The primary appraisal phase, during which the individual answers the question “what is happening.” As soon as the stimulus is perceived, we classify the event as a) benign to our survival, b) relative to our survival, but not threatening, c) threatening enough to demand immediate efforts to adapt.

The secondary appraisal phase, during which the individual assesses their personal ability to deal with the stressful stimulus, and answers the question “what can I do?” We then move on to act as we deem correct and in response to the facts available at the given moment. This is followed by a re-evaluation of the situation.

Gender and stress

At this stage, you may be wondering:

“Do men and women differ in terms of the sources, responses, and degree of perceived stress?”

Indeed, gender differences are evident. Bear in mind, though, that women are twice as likely to visit a psychologist or psychiatrist. Men rarely admit they are having problems and, therefore, avoid asking for help. A proposed explanation is that asking for help is considered as a sign of weakness in dealing with difficult situations. Hence, it comes into conflict with the socialization of males to be strong and independent; anything else is a sign of failure!

Age and sources of stress

Do younger or older adults experience more stress?

Much like happiness, the average level of stress experienced by an individual remains relatively stable throughout their life, although there are, as you can imagine, some ups and downs. What do change at various ages are the sources of stress, which are different during childhood in relation to adulthood and old age.

A situation that may be extremely stressful during an individual’s childhood could be completely insignificant and benign if experienced during adulthood, and vice versa: an exceptionally stressful event for an adult may be completely indifferent for a child or an adolescent. Experience or lack of it and perceived responsibilities colour our perceptions at various ages.

Health issues are not major concerns for younger individuals. Middle age adults, having stopped growing upwards and beginning to grow outwards, can start worrying excessively about their appearance and health.

Of course, I hear you say, being young is beautiful, but being old is comfortable and safe. Well, with such love handles it would have to be!

First, you forget names, then, you forget faces. Next, you forget to pull your zipper up. It gets even worse, when you start forgetting to pull it down! – George Burns

On the other hand, when you feel tired and old and think about how much you would love to return to your childhood years, remember Mrs Algebra and all those things you could not do even though you wanted to, or what you had to do even though you did not want to!

Our ways for dealing with the sources of stress change in a similar way. For instance, the older we get, the fewer things seem worth waiting in line for. Normally, our strategies for dealing with problems should improve with the passing of time. I say normally, because I have seen several older adults who, despite their experiences and ripe-old age, do not seem to have learnt much.

The following text illustrates the shift in the types of problems experienced by children and adults and the coping strategies used to deal with these.

A time-out from “Adult life”

Who wouldn’t want to return to the years when:

Important decisions were made using “eeny, meeny, miny, moe!”

Mistakes were corrected simply by “tearing up the sheet of paper and starting over!”

The worst punishment and chore was to write “I will never …” 100 times.

Disputes were resolved by playing “rock-paper-scissors.”

“I’ve got money” only meant that you could buy gum or an ice cream at recess.

Filling a bag with marbles was enough to keep you happy all afternoon.

It wasn’t strange to have two or three “best” friends.

The phrase “they are very old” referred to anyone over 18.

“Robbers and Policemen” was a game played only at recess … and it was more fun being the robber rather than the police officer.

The word “poisonous” referred only to types of “insects or forbidden liquids,” not to people.

To travel from earth to the sky all you needed was to become “Superman or an astronaut.”

It was great playing football without goalposts or volleyball without a net; and the rules didn’t really matter either …

The worst thing that could happen with the opposite sex was to be caught playing “doctors and nurses.”

“Bringing a weapon into school,” meant you had been caught with a catapult.

“Last one is a dork!” was the cry that made you run so fast you thought your heart was going to explode.

The “Tooth Fairy” left a coin under your pillow in exchange for your tooth. And if she left you a note … you really thought you’d reached the sky!

Discovering new skills was prompted by the phrase “I bet you can’t …”

“Disappointment” meant being the last to be selected for the school play or the football team.

“War” meant throwing pieces of chalk or paper balls during chemistry. War was something that had happened before we were born and was never going to happen again.

“Water bombs” were the latest, smartest and powerful weapons ever invented.

Ice cream and chocolate were the basic nutritional food groups.

In order to transform your bicycle into a powerful “motorbike” all you needed was a plastic bottle near the wheel and a lot of imagination.

There was no better way to spend summer afternoons than playing with the children in your neighbourhood or waiting to see your favourite neighbour, who really loved you, going by.

A “big brother” was the worst torturer, but also the strongest and most loyal protector.

– Attributed to Anne Geddes

We have so far examined possible sources of stress and their various categorizations, as well as gender and age differences. It is now time to examine the physical and psychological effects of stress. Bear in mind that some degree of stress is both necessary and useful. It is excessive stress we will be talking about next.

Stress and … excessive stress

Chapter 3: Symptoms and effects of stress

Every stress leaves an indelible scar, and the organism pays for its survival after a stressful situation by becoming a little older. – Dr Hans Selye

IS STRESS dangerous? What are the effects of excessive stress on our health?

The short answer is … numerous. I assume that, like most people, you are quite stressed. Read on!

– Studies have shown that 60 to 90 percent of visits to doctors are associated with stress (Perkins, 1994).

– A study of 2,465 Danish urban bus drivers showed that little social contact with colleagues, increased work pace, and heavy traffic were predictors of ischemic heart disease (Netterstrøm & Juel, 1988).

First, let us examine the symptoms of stress.

Stress symptoms

Although stress is not visible, either to the naked eye or via a micro- or telescope, we can feel its symptoms, document its effects (quite objectively), or even observe the above in others (i.e., our spouse, our boss, the taxi driver). We can, for example, recognise if we or those around us are stressed, by identifying some of the following symptoms.²²

a) Physical / physiology. Increased heart rate, perspiration, fatigue, blood glucose, adrenaline, brain activity, muscle tone, pupil dilation (mydriasis), frequent urination, tremors, shallow breathing and O2 uptake (tachypnea), dry mouth, etc.

a) Behaviour. Talking and walking fast, eating and substance abuse problems, hostility and losing temper, rapid, rhythmical and mechanically repeated movements (e.g., of the foot), rushed speech, scowling, broken voice, restlessness, yawning, flickering of the eyelids, nail biting, etc.

b) Emotions. Anxiety, worrying, anger, nervousness, irritability, fear, terror, grief, disappointment, depression, frustration, mood swings, lack of concentration, difficulty in decision-making, sensitivity to criticism, reduced attention, feelings of confusion, lack of control, etc.

As we will see later, behavioural responses to stressful events can also be classified as healthy or unhealthy. Unhealthy responses include resorting to smoking, alcohol, drugs, etc. On the contrary, healthy responses include problem solving, emotional regulation strategies, physical exercise, relaxation, healthy diet choices, etc.

Healthy die…t!

Yet, just how does stress manifest? The third category above, i.e., the body’s symptoms and reactions to stress offers a glimpse. Here is more on the subject.

Fight or flight

The famous fight or flight response goes back to the prehistoric era and was developed to assist humans (and animals) to either confront or avoid danger. It is the body’s normal and necessary reaction to any real or perceived danger. Our prehistoric ancestors had to deal with “life and death situations” almost daily. Although today people rarely have to fight off tigers and wild beasts, the body’s responses have remained unchanged. Prehistoric enemies have been replaced by real or imaginary monsters: your teacher, your boss, your wife, your monster-in-law are only some of these.

I would rather fight tigers all day than have to deal with my mother-in-law!

General adaptation syndrome

According to the General Adaptation Syndrome (G.A.S.), a mechanism proposed by the late Hans Selye (1956), the body’s response to each situation we perceive as threatening for our well-being and, hence, requiring adaptation follows three stages:

a) Alarm stage. When threatened, humans and animals mobilize their defences and literally become on guard and ready to attack or take flight. In this first stage, the body responds to stress by secreting certain hormones. Cortisol, which increases glucose in the blood system, and norepinephrine, which elevates blood pressure and boosts energy supplies. Their role is to prepare us to fight or fly. We need to arrive at a state of vigilance and readiness to deal with the event. At the same time, carbon dioxide levels increase in the blood stream causing higher respiratory and heart rate, raised blood pressure and blood density to carry more oxygen to muscles, sudden perfusion of large muscle groups (arms, legs, etc.). At the same time, the digestive process is disrupted. Who needs to digest when they are about to be eaten and digested?

b) Resistance stage. During the second stage, the individual confronts the enemy and will resist for as long as necessary and as long as available energy reserves are adequate. Although these changes are certainly positive in the short term as they protect us from dangers, prolonged stress responses may be deleterious for our health.

c) Exhaustion. The duration of stage two is critical. How long someone can remain at the resistance stage is decisive, because eventually the third stage, exhaustion, sets in. This is when the body’s energy reserves begin to dissipate, and fatigues emerges. It is like revving a car engine for too long. The car is preparing for a fast start, but its energy reserves are depleting at a rapid rate. When in the exhaustion phase, the individual is vulnerable to additional external dangers and to disease, because of the diminished resistance of the immune system.

Psycho-neuro-immunology

Our immune system serves to identify and destroy pathogenic microorganisms.

The hormones secreted while under stress (e.g., cortisol, adrenaline) prepare us to deal with events threatening our wellbeing. As mentioned, a certain degree of stress is normal and necessary. If, however, these intense conditions last long, the body’s resistance is impaired (Marx, 1985). Frequent activation of the autonomic nervous system affects the capability of the immune system.

Individuals who feel “down” psychologically (e.g., those suffering from mild depression) are twice as likely to become ill when exposed to bacteria and viruses, compared to others who are in a good psychological condition. This is due to a decrease in the ability of the immune system to fight back (Cohen et al., 1991, Kiecolt-Glaser et al., 1992). Indeed, stress has been connected to impaired immune system (Kemeny, 2003), lower production of antibodies, inflammation of white blood cells, and reduced response to the Epstein-Barr virus.

Hurray for stress!

Stress can affect individuals in different ways, depending on each person’s predisposition to develop ailments in particular organs or systems. When under stress, some get headaches, others develop skin rashes, etc. Each person may manifest the symptoms on the system that is the most sensitive or weak for him/her.

In a sense, stress makes you more vulnerable to disease. The disease, in turn, creates new stress because you are off work, you consume bland medicines of unknown effectiveness, you worry about following the appropriate treatment or if you have consulted the right doctor, and the list goes on!

Stress also affects our behavioural responses, which may in turn produce physical consequences. Vicious circle …

Illnesses hover constantly above us, their seed blown by the winds, but they do not set in the terrain unless the terrain is ready to receive them. – Claude Bernard

EFFECTS OF STRESS

“Don’t worry about catching a cold, because … you may double the chances of catching a cold!”

Although the above statement is not entirely accurate (germs induce colds, not worry), it does contain an element of truth. People who suffer from excessive, frequent, and long-lasting stress are also first on the list for developing a variety of ailments, including:²³

a) cognitive deficits, such as partial or complete loss of concentration, memory loss, reduced reaction ability, and loss of the sense of time and place;

b) psychological and behavioural problems, including anxiety, insomnia, drug use, depression, sleep problems, and nutritional abnormalities;

c) physiological problems, including pain of any kind, migraines, digestive problems, diabetes, obesity, asthma, flu, cardiovascular diseases, skin conditions such as eczema, autoimmune syndromes etc.

Excessive stress can affect performance levels (causing low productivity or even accidents). Chronic stress can lead to fatigue and burnout (emotional and physical exhaustion).

Exposure to traumatic events such as earthquakes, war, and rape can cause post-traumatic disorder, a severe anxiety disorder with symptoms that include traumatic flashback memories, night terrors, depression, etc.

However, stress can also have positive effects. For example, it can serve as a stimulus and a driver for personal development, self-improvement, and goal achievement. It can also preventatively “vaccinate” the individual with the ability to deal with similar situations in the future.

The good news is that stress management strategies can be taught and have satisfactory results (Rowe, 2000). Two ports for intervention include our perception of an event and our responses to any stressful situation.

Stress arrives … serenity departs.

Stress and heart disease

The secretion of corticoids (during the first stage of adaptation described earlier) increases heart rate and cardiovascular pressure, which if intense and prolonged, may in turn lead to hypertension, atherosclerotic plaques, and coronary artery problems. Severe responses to stress can cause heart attacks in people with heart disease (Kamarck & Jennings, 1991). Even “innocent” exam stress increases cholesterol levels.

The longer lasting and more intense the stress, the higher the levels of secreted hormones, and the potential for damage to the cardiovascular system. Emotional and physical exhaustion leads to fatigue, that, in turn, increases the possibility of cardiovascular problems (Krantz et al., 2000).

In short, to protect your heart and reduce hypertension and blood cholesterol levels, doctors recommend smoking cessation, weight control, attention to nutrition, physical activity, relaxation, etc. But you already know this …

Stress and cancer

Given that stress affects the onset and, possibly the course of a disease, it is only natural to wonder how, if at all, stress affects the course of cancer.²⁴ The reality is that stress can both directly and indirectly affect the course of illness, including cancer.

Indirectly, stress often leads to unhealthy behaviours such as smoking, drinking, and unhealthy diets. It can also reduce the number of lymphocytes that destroy malignant cells, because of the reduced production of interferon (Kiecolt-Glaser et al., 1986, 2002).

Despite the above, stress is not guilty of turning healthy cells into cancerous ones. Some research refutes the connection between stress and cancer. A longitudinal (1965-1982) study with 6,848 participants showed no connection between depression and cancer (Kaplan & Reynolds, 1988).

Findings of other studies show that individuals with a “fighting spirit” have a greater survival rate than passive individuals who confront the disease with “stoic acceptance” or “helplessness / hopelessness” (Pettingale et al., 1985).

Stress and headaches

The most common causes of headaches and migraines are muscle tension and arterial stenosis. These symptoms also accompany stress.

Even if there is a different causality, headaches can intensify and regress if there is tension in the muscle groups around the neck and shoulder blades. Massage and relaxation techniques can effectively help control stress and stress-related headaches.

Stress and ulcers

Ten percent of the people around us suffer from ulcers. Until recently, we thought that ulcers were caused by stress, hence the saying “ulcers are not so much the result of what you are eating, but what’s eating you.” Today, we know that 60 percent of all peptic ulcers are caused by a bacterial (Helicobacter pylori) infection. By the way, smoking has also been associated to the disease.

In cases of chronic stress, levels of hydrochloric acid in the stomach are often elevated. Combined with the corticoids secreted during the alarm stage of stress, they could contribute to gastric problems.

This was a very brief reference to the potential effects of stress. Our next topic is personality. We all know people who rarely get stressed and others who get stressed by everything or are constantly stressed. Which category do you belong in?

Chapter 4: Stress and personality

It is more important to know what sort of person has a disease, rather than know what sort of disease a person has. – Hippocrates

ACCORDING TO Aaron Beck, anxious individuals often have unrealistic fears and fight against imaginary problems. Specifically, they tend to:

a) Overrate the possibility of something bad happening to them, focus on potential negative scenarios, and worry about things that could happen to them in the future (e.g., “what if an airplane crashes on my house?”).

b) Overestimate the significance of an event (e.g., “if I do not get into university, my parents won’t love me; if they do not love me, I am worthless”).

c) Underestimate their ability to deal with events (e.g., “everything is predestined; it’s written in the stars and I am a Pisces, what do you expect from a minnow – or a … sardine”).

d) Underrate the possibility of support from their social environment (e.g., “no will ever help me” I do not have any friends …”).

Are these types of thought patterns “nurtured” and acquired or are they the result of biologically determined personality traits that predispose people to think in a certain way?

The issue of nature versus nurture has not been resolved yet. However, experts believe that the influence of genes and environment is usually about 50-50.

Are there certain personality traits useful in dealing with stress? Are some people better equipped to deal with stress?

The answer is yes. Certain individuals are genetically privileged and can endure more stress. The personality traits believed to buffer stress include explanatory style, self-efficacy, psychological hardiness, locus of control, sensation seeking, autonomic nervous system responses, and Type-A behaviour.

Explanatory style

Explanatory style refers to the way we explain events that happen to us in life (Seligman, 1989). It consists of three dimensions: internal – external, stable – unstable, and global – specific.

When faced with a negative event, such as a failure, individuals with a pessimistic explanatory style consider it:

a) Personal. They attribute the poor outcome to internal causes (e.g., “it was all my fault”).

b) Pervasive. They tend to generalize, thinking it will affect all areas in their life (e.g., “I failed Math; therefore, I am a failure in everything”).

c) Permanent. They consider it unchangeable (e.g., “this is how things will be in the future”).

Such attributions result in chronic negative feelings and, often, in low self-esteem, melancholy, and depression.

On the contrary, people with an optimistic explanatory style facing a negative event:

a) Attribute it to external and unanticipated factors (e.g., “the exam was difficult”), and expect better outcomes over future events.

b) Consider their failure as specific and therefore confine it (e.g., “I may have failed in my efforts in this field, but I am doing well in others”).

c) Regard the failure as temporary (e.g., “I did not succeed this time, but I will next time”).

The results of the optimistic explanatory style are temporary negative feelings followed by decision-making, redefinition of goals, and planning of future actions.

According to researchers, people with an optimistic explanatory style cultivate positive expectations, have a good self-image, succeed in academic fields and in sales, maintain a positive outlook of life, employ problem-solving and choose approach rather than avoidance strategies, seek social support, and adopt healthier habits in relation to diet, rest, and physical exercise (Buchanan & Seligman, 1995).

In contrast, individuals with a pessimistic explanatory style are vulnerable to learned helplessness25 and depression, isolation and loneliness, and often suffer from social anxiety.

Here is a word of caution: in its extreme, over-optimism is also maladaptive. Excessive positive thinking of the type “everything will be okay” or “that is never going to happen to me” may lead to deficient preparation and produce negative results. A classic example of over-optimism can be drawn from the area of health. In line with the “above the average phenomenon,” among other attributes (e.g., intelligence, driving ability, looks, and … modesty), most people believe that their health is better than the average health of other people and that they are at less risk for diseases. As a result, they underestimate the probability of negative outcomes, and in turn, the importance of sound nutrition, physical activity, rest, etc. The results are all too familiar …

Self-efficacy

This concept refers to a high degree of faith in one’s own skills and an “I can make it”-type convictions. Much like optimism, self-efficacy has been shown to relate to lower adrenaline levels, less work stress, and better self-regulation (e.g., maintaining a healthy weight, following a fitness exercise program, and quitting smoking for good). It has also been shown to assist in successful treatment of depression, overall wellbeing, success in sports, and drug-free birthing (see Holden, 1991; Myers, 2004).

Psychological hardiness

Those who can be characterized as psychologically hardy tend to:

a) Consider change a normal condition, a challenge, and an opportunity for growth, rather than a threat. They choose stress and, instead of getting annoyed, foaming at the mouth and becoming aggressive, they usually interpret stressors as interesting events.

b) Believe that they have control over their life.

c) Commit to and actively engage with the task or the problem.

The following real story illustrates something of a “give me problems” mentality in action.

Roll on today’s problems

George, a clothing manufacturing business owner, whose last name I will not disclose for obvious reasons, described a typical day at his office:

As soon as I arrive early in the morning (at around 10 am), a queue of staff and co-workers has already formed; they are all waiting to see me, often very stressed or even in a state of panic. Each of them has a very serious problem to discuss with me: their own. I make myself comfortable, smile and rub my hands together: Roll on today’s problems. Who is first? What do we have here? Yes, of course … what do you suggest? … Good idea, carry on! Next!

Often, I help my employees place situations in the correct perspective. For example, one day one of them came into my office in a state of panic:

“We’ve got a big problem. Stores have just returned a batch of faulty leather jackets. It’s a disaster! What are we going to do now?”

“Just a minute; what unit are you using?” I asked him. “How big is the problem? How many faulty jackets have been found?”

“Over 50!” he answered.

“What does that mean? 1,000 or 51?” I continued.

“Well, no, not 1,000! If I am not mistaken, there are about 53,” he informed me.

“Oh, okay. How many such jackets did we produce?” I asked him.

“Around 10,000” he determined, much calmer now.

“So, 53 in 10,000 had a problem? Hmmm … let’s see … [Bringing out the calculator]. Indeed: around 0.5 percent. What do you say we throw them out and replace them with new ones? Better still, give them away!”

“Good idea, Mr Nikolis! (Oops! How careless! I’ve given away the name …). “That’s what I’ll do” he answered and left, relieved.

“Every day, all day, that’s my job, dealing with problems,” George states, his eyes sparkling with enthusiasm. “Problem solving is my middle name. Thank God, I enjoy it!”

Locus of control

Individuals with an internal locus of control (term coined by Rotter, 1966) believe that they exercise a reasonable degree of control over the circumstances in their life. They also tend to assume responsibility for the outcome of their efforts and consider that they can influence their fate, to a certain degree, by their own actions.

Internal locus of control individuals are not consumed by blaming others or external conditions. They adopt a problem-solving approach and act to change the conditions, rather than wasting time and energy on negative feelings. They adopt healthier habits, precisely because they believe that they have a significant level of input over their health and success.

On the contrary, people with an external locus of control believe that their successes and failures are the result of external conditions, such as luck, fate, the position of the stars, and the choices and actions of others around them.

Sensation seeking

Certain individuals among us tend to seek intense experiences. They perceive stressful, for the average person, events as vaguely threatening, risky, or distressing. As a result, they report lower stress levels and fewer psychosomatic symptoms.

Cons include that, at a young age, these individuals find it difficult to join organized groups (school, sports teams) and socialise with their colleagues. Following their instincts, later they may adopt various unhealthy habits (such as smoking, drinking, driving at excessive speed) to satisfy their need for excitement.

Autonomic nervous system response

Individuals with an over-reactive autonomic nervous system are more susceptible and have reduced tolerance to stress, as they easily mobilise biological resources during “fight or flight” responses to stimuli they perceive as threatening.

The response of the autonomous nervous system depends on genetic construction and genes and differs from person to person. Men are predisposed to respond to stress immediately and with a higher intensity than women do, because their bodies secrete stress-related hormones and elevate their cardiovascular activity. Similarly, people who use stimulants such as coffee have lower tolerance and experience increased reactions to stressors. On the other hand, under similar conditions, individuals who exercise and are in good physical condition display lower responses and changes in their nervous system.

Type-A behaviour

As you have probably realised by now, there are different types of people in this life: rabbits or racehorses and turtles or snails. The first would consider merely lying on the beach or listening to music under a shady umbrella and having nothing to do as torture. A slow pace of life, peace, and tranquillity satisfies the latter.

According to Friedman and Rosenman (1974), Type-A individuals exhibit the following behaviour characteristics:

– They are competitive, impatient, aggressive, negative, and perfectionists.

– They pursue challenges.

– They feel pressured by time; they are always watching the clock.

– They eat, talk, and walk quickly.

– They dominate group discussions.

– They do not share power and responsibility with anyone and do not delegate jurisdiction to others.

Several instruments have been developed to assess perceived levels of stress. Some measure state or situational anxiety. Others measure trait anxiety, which is a stable tendency to respond with anxiety across different situations.

Questionnaires developed to assess Type-A behaviour include items such as:

If you have an appointment, you tend to: Be casual about when you arrive – Show up early.

You would say that you are: Not a very competitive person – A very competitive person.

You always tend to feel a bit rushed and under pressure: False – True.

You tend to: Take on as many tasks as you can handle – Do one task as a time.

If you are frustrated, you: Should not be provoked – Are likely to withdraw a little.

Imagine you are ready to go but have to wait for people in your group to be ready: It’s not that big of a deal, you’ll amuse yourself in the meantime – You are probably going crazy with impatience.

Do you typically wear a watch? Yes – No.

You: Have trouble falling asleep – Sleep like a baby.

When someone takes a long time to express his or her thoughts, you: Get frustrated – Listen patiently.

According to older studies, Type-A behaviour individuals are twice as likely to suffer cardiovascular problems. It appears, however, that Type-A behaviour does not tend to be a strong predictor of coronary heart disease. Later research (Smith, 1992; Williams, 2001) has shown that sarcasm and aggressiveness in response to frustration and failure are the only behaviours that relate to cardiovascular disease.26 Yet Type-A is only one of the factors associated with the development of heart diseases; others include heredity, diet, exercise, and smoking.

Hardy Type-A individuals do not seem to be at any greater risk from stress than Type-B individuals. In other words, you may be running around all day doing chores. If you are enjoying it, you should not worry that much about the potential negative health effects associated to Type-A behaviour.

OTHER MEDIATORS

Social support

There is a lot of evidence confirming the buffering effects of social support. Social scientists consider it best “medicine” for divorcees, for instance, significantly reducing the impact of the stress involved in a separation.

Research has indicated that people who have good social support networks are less likely to suffer from genital herpes and AIDS. In addition, female cancer patients with a social support group live two years longer than those who do not receive any social support (Spiegel et al., 1989).

According to other research27 on patients diagnosed with leukaemia, 54 percent of those with social support were still alive two years later, compared to only 20 percent of those without social support.

Why and how does social support reduce stress? The following pathways have been proposed to explicate the buffering effect of social support:

– It offers emotional support, by providing a sense of being listened to and understood.

– It involves material resources and practical assistance with pending issues.

– It provides information and/or advice (e.g., brainstorming in the direction of problem resolution).

– It supplies necessary feedback, reflections on the question “how am I doing?”

– It meets a social need, the need for company.

– It increases the production of a type of antibodies (immunoglobin-a) that help combat gastric, urinary, and respiratory system infections.

Sense of humour

A good sense of humour relates to better health and less stress (Anderson & Arnoult, 1989). By contrast, people with aggressive or derogatory humour are less healthy (Caroll, 1990). Even the babies of cheerful mothers suffer fewer respiratory system infections, possibly because they receive more antibodies through their mothers’ milk (Dillon & Totten, 1989).

Humour is thought to buffer stress in the following ways:

– It can mitigate the impact of stress either through the secretion of endorphins or by diverting attention (Martin & Lefcourt, 1983).

– It short-circuits negative events and makes dire circumstances appear less threatening.

– It attracts social support (Nezu et al., 1988).

Apparently, large USA companies send their top executives to laughter therapy clinics. A sense of humour is difficult to teach in the traditional sense of the word. However, it may be cultivated through reducing social anxiety, learning to accept and welcome change, building self-confidence, and not taking one’s self too seriously. The joy of life endows people with a sense of humour!

Oops. I wonder if I need private lessons …

Let us now move on to Part Two and stress coping strategies.

PART II: COPING WITH STRESS

There must be quite a few things that a hot bath won't cure, but I don't know many of them. – Sylvia Plath

I FIRMLY believe we have a far greater ability to control our mood and emotions than we think. If this is true and some of us live in stress, then perhaps we are suffering unnecessarily, simply because we are not taking the time to develop our knowledge and coping skills. In this part, we will do exactly that.

Before we move onto every day practical applications for dealing with stress, which is what Part III is all about, I think it is important for us to agree on certain basic points, such as what determines how we feel, and what can we do about it.

Chapter 5: How are you feeling?

If you wish to improve your mood, pay attention to two basic factors: a) the chemicals that run in your body and b) the thoughts that run in your mind.28

YOU MAY well have problems to deal with. You may also believe that your problems are more serious than the rest of us, which may be very true!

Unfortunately – or perhaps fortunately – most of us fight minor or “imaginary” problems on a daily basis. The truth is, some of our fellow humans, including those suffering from difficult or incurable diseases (e.g., cancer, Alzheimer’s, multiple sclerosis) or dealing with serious physical disability or mental disorders, and the people who care for them, face immense challenges that demand constant adjustment. By comparison, I assure you, our own everyday problems pale into insignificance and appear quite unimportant.

Most people, including you I imagine, believe that their mood depends on their problems and that while these problems remain unresolved, they will continue to feel accordingly. If this is true, then a significant number of people, such as those suffering from serious health problems, are condemned to a chronic and unpleasant state. This is the theory. Because, in practice, it seems that the ability of humans to adapt – even in the most difficult situations – is unsurpassable.

For example, people who have lost limbs report similar levels of happiness as their able-bodied counterparts. Surprisingly enough, on the other hand of the continuum, six months after winning the Lottery, the lucky winners stated that they were as happy as they were before they won the money.

Apparently, we not only get used to negative events that affect our everyday conditions, but we also lose the initial excitement that those new material possessions or accomplishments generated. Our new car does not smell the way it did when we first sat behind the wheel in the dealer’s store. We now need two new pairs of shoes, a new Gucci bag, or a new partner. Our graduation, a promotion, a golden medal feels so good, but only for a short while. The adaptation level hypothesis, getting used to new conditions, is therefore both a blessing and a curse.

Two important factors that affect our mood

Have you ever thought about what affects how you feel? If you are interested in learning how to change your mood to feel better (you should be), pay attention.

How we feel at any given moment depends on two basic factors: our chemicals and our thoughts.

Let us examine each one in more detail.

A. OUR CHEMICALS

The biochemical makeup and the physiology of our bodies (chemicals such as hormones, neurotransmitters and trace elements that circulate inside our brain and body), directly affect the way we feel at any given moment. Our thoughts, memories, feelings, mood, and a whole series of important processes – our entire existence one could say – store up in the brain, that peculiar organ located inside our skull.29 We are nothing but one-and-a-half kilos of grey matter surrounded by an electrochemical solution!

How can we feel good without the necessary chemical balance in our brain and body? How can we feel good when we are not rested or have not slept well; when we are weakened by the lack or the poor quality of the necessary fuel, glycogen in the blood, water, oxygen, nutrients, or vitamins?

The reasonable next question to ask, of course, is …

Can I control my chemicals?

We have significant control over the chemicals circulating around the avenues and alleyways of our brain and body. We can, for example, eat or drink something, change our breathing, our posture, and our movements and – as if by miracle – formulate our body’s chemistry to produce the desired psychosomatic condition.

If, at this moment, you are not feeling particularly good, it may be due to the fuel with which you have stoked your engine – not just a few hours ago, but over the past several weeks or months. Hence, our current mood may be affected by what we have eaten lately. (Some scientists even suggest that you do not catch a cold you actually eat a cold.)

Any biochemical changes in hormones and neurotransmitters affect our emotions, our behaviour, and our health overall. Hence, our “chemicals” are quite important.

Good to see you pay attention to your diet.

At this point, we should also mention rest, which is extremely important for recuperating physical and mental strength. Some days the best move someone can make is to go home early to rest and enjoy some valuable, good quality sleep.

If you want to feel better immediately, take the first step in the right direction by making changes to your physiology. How are you sitting right now? Check your posture. Are you slouched in the armchair or are you sitting on a chair with a straight back? Sit straight on your seat and stretch your arms up.

To relieve some of the pressure of the day, change your breathing. Take 10 deep diaphragmatic breaths every hour. Breathe in for four counts, exhale slowly, hold your breath for two counts, and inhale again. Repeat this process as many times as you like. I recommend 10 deep breaths in the morning with a glass of water, 10 at lunchtime, and 10 in the evening before you go to bed. If people around you are wondering, tell them that you are following doctor’s orders!

The first factor that determines how we feel at any given moment is our body’s biochemistry. It is the most powerful means we have to change our mood in any situation. It works immediately and successfully.

Why do people take drugs, smoke, drink coffee, drink alcohol, or eat too much? To alter their physiology and change their mood. However, you do not have to go to these lengths. You can change the way you feel instantly, by changing your posture, your breathing, your diet. You can even change the way you feel just by some form of physical activity, or by just cuddling someone else.

Are we allowed to engage in intercourse?

Is sex allowed, teacher?

Of course! As much as you can. If, however, you smoke after sex, you are doing it … too fast!

The second factor that influences how we feel at any given moment is …

B. OUR THOUGHTS

Like you, I believe that external events and conditions influence our mood. At the same time, however, I believe that what happens is not as important as how one views it, and how one responds to what is happening (what one does about it).

If our thoughts at any given moment are pleasant, then we feel good. Therefore, if we train ourselves to control or direct our thoughts, we will also be able to control our mood.

Every good thought you think is contributing its share to the ultimate result of your life. – Grenville Kleiser

Our thoughts also affect our body’s physiology – it is a bidirectional relationship. In other words, there is a constant interaction between thoughts and chemicals. As much as I may try to change my thoughts, I will never manage to improve my mood if my body does not have the appropriate physiology. How can I feel good if I haven’t eaten and I have a stomach ache or if I haven’t slept and I have a headache? Conversely, even if my chemicals are in excellent condition, I should really learn to control my thoughts.

We all need to feel good, at least for some periods during each day, especially if we are experiencing difficulties and face tough situations. In their attempt to change their mood, people with a poor repertoire of stress management strategies often resort to unhealthy means, such as excessive food intake, alcohol, smoking, or even drugs.

This second section of the book focuses on describing a series of cognitive and behavioural techniques that we can consciously employ to manage our thoughts and our emotions. It aims to help you expand your stress management strategy repertoire and offer techniques to change the way you feel inside when things on the outside go wrong.

Ideally, the most effective way to deal with a stressful situation is to deal with the cause and resolve the problem. Yet, as we noted earlier, we do not always have control over the external parameters upon which an event is dependent. Hence, although sorting out the problem should normally be the first priority, rather than altering external conditions, most cognitive techniques focus on changing one’s emotions by changing the way we think about it.

Thoughts play an extremely important part in our experience of the world. What is going on in our mind can be a creative, constructive, or disastrous force. As we will see, we can choose our thoughts. Choose to think happy thoughts to experience happy moments. Many happy moments make up a happy hour, a happy week, a happy life!

In the words of Aristotle, “happiness is the meaning and the purpose of life, the whole aim and end of human existence.” More than anything, people seek happiness and, although happiness is the purpose, every other aim only has value because we expect it to make us happy.

The concept of felicity, according to Aristotle, correlates happiness with creativity. Happiness, therefore, is a feeling experienced when a person is developing his/her skills and engaged in meaningful and important activities.

Others consider happiness as the satisfaction that stems from the balance between a person’s needs and their desires.

Success is getting and achieving what you want. Happiness is wanting and being content with what you get. – Bernard Meltzer

Controlling our thoughts, changing our appraisal of situations, and regulating the emotions generated by events are all effective strategies, particularly when we have exhausted all possibilities of resolving the problems ourselves.

Alas, let us take things from the beginning. As you well know, the best approach to disease is not cure but prevention. Before we talk in more detail about responses to stress from the moment an unpleasant event has become a reality, let us invest some time to the “pre-match” or “preparation” period, i.e., the period prior to the manifestation of a problem. To prepare for the sporting demands of the upcoming season, athletes begin training months ahead. How about you?

Chapter 6: Prediction and prevention

If people are constantly falling off a cliff, you could place ambulances under the cliff or build a fence on the top of the cliff. We are placing all too many ambulances under the cliff. – Denis Burkitt

IDEAS TO help us prepare to deal with all types of stressful situations are presented below.

Take good care of yourself

Pay attention to your overall physical and psychological health. As mentioned, individuals who are in good physical condition have better resistance to stress. If you are envisaging an improvement in your ability to manage stress, build your physical condition and your body, so that you can comfortably resist situations of intense emotional gravitas.

Health is merely the slowest possible rate at which one can die. – Samuel Johnson

A well-balanced diet and some form of daily physical activity enhance our ability to resist enduring stress. Pay attention to your diet. At the same time, take up some form of intense physical activity for 30 minutes at least three times a week.

Doctors and psychologists agree that exercise is one of the best antidepressant and anxiolytics. At the same time, exercise boosts our self-confidence, possibly via the following mechanisms: a) increasing our sense of self-control, b) improving our general physical condition, c) hormone secretion (adrenaline, endorphins), which in turn produces an overall feeling of wellbeing, the so-called “runner’s high,” d) increasing body temperature, e) distracting our attention away from problems, and f) assisting social contact.

For some, of course, exercise is like “lifting something that does not need lifting and running when no one is chasing you.” You suggest going for a run and they answer: “You must be joking. My team is playing today. In any case, when I feel the urge to go running, I lie down and wait for it to pass.” Clearly, watching sports is not the same as participating.

Find a sport or activity that suits you and offers you enough satisfaction for you to want to invest and participate in it. To find it, however, you must try it. Team up and go running with an “eagle,” a high-performance individual who will pull you out from under the duvet next time it feels too heavy to move.

Things do not always turn out the way we want

Got a car? According to statistical data30 the moment you buy a car you enter a lottery with a jackpot of three accidents in your lifetime.

Things do not always turn out the way we want. Setbacks are an integral part of life. You will do well to accept this and be as prepared as possible for “dark winters” and lean seasons. As we have said, it is not what happens to you but how you react to it and what you do about it.

Make copies of your keys (especially the car keys). Keep them in strategic places, so that they are handy at any given moment. Always have in mind an alternative Plan B or rescue plan. – Dr Ro

Tolerate uncertainty

Someone once said that uncertainty is the price of freedom. A degree of uncertainty is inevitable in every situation. Uncertainty is usually the product of a lack of knowledge and information, particularly when the situation is unexpected, and conditions are unfamiliar. Aim to reduce uncertainty by collecting information and acting accordingly.

Allow me to suggest that it is best to abandon the “I have to be certain” rule. Instead, tell yourself, “Why not? A little uncertainty adds colour to my life. If everything was predictable, it would be very boring.”

One of the most common areas of uncertainty is human relationships. People are unpredictable and often react completely unexpectedly. Other times they send mixed messages. Accept the fact there are no good-working-order guarantees for relationships, not even … for the first three years or the first 100,000 kilometres. Even the happiest couples may have to accept the fact that both partners will grow, sometimes in significantly different directions.

To reduce or resolve misunderstandings, ask the other person how they feel, what exactly they mean, what they want and what they are expecting from you. Then listen and try to understand the other person’s point of view – preferably putting aside pride and biases, withholding judgment, and avoiding rushing to conclusions.

Let us examine an example of an uncertain and, for many, unfamiliar situation. Public speaking is first on the list of people’s most common phobias and ranks higher than spiders and snakes. What is the recommended plan of action?

If you cannot avoid a problem, accept it, and admit that it may be one of your most thorny experiences. Do your research and prepare your notes. The better prepared you are, the less stress and uncertainty you will experience.

To illustrate the point, if you were required to talk about a topic of your expertise, or to submit a single thing you know very well – let us say, your name – I do not think it would be quite as agonizing.

Train for your exposure to an audience by talking in front of a mirror, to your cat or your dog, your grandpa – who cannot hear without his hearing aid – or anyone else you want. Demosthenes, the ancient Greek orator, who could not pronounce the letter “R,” managed it with a pebble in his mouth; you, mighty Ro method students, will not be beaten!

At the same time, try to change your frame of mind: “Given that I have decided to do this, I am going to enjoy it!”

Then go for it. If it goes well, all is good. If it does not, that’s okay too. What have you learnt? What will you do differently next time? In the worst-case scenario, you will never be invited to speak again (all the better for you, unless you have decided to become a professional public speaker).

Improve your self-awareness

If we can identify our stressors, the types of situations that create stress for us and find out when they occur, we can actively prepare for them. By applying specific techniques, we can then tackle them successfully. Go back and re-read the relevant chapter on the sources of stress. Examine and record, if you haven’t already, the stressors you encounter regularly. Identify your ineffective emotional and behavioural responses. Practice challenging your self-destructive thoughts and habits and replacing them with positive ones.

Check-up reminders

The following exercise can help you identify moments of intensity during the day and help you act and confine them.

Set the timer on your watch or the alarm clock on your mobile phone to chime every hour.31 If you do not own one of these devices (very unlikely), take advantage of the steadily recurring signals in your environment. The aim is to identify a signal, an audio or visual stimulus that will remind you to monitor your condition at regular intervals.

Every time you hear or come across one of these signals, take a deep breath; relax from the tension, and check, “Where am I? Am I in ‘the comfort zone?’ Am I enjoying what I am doing?” If not, ask yourself, “What could I adjust or improve and make this activity more enjoyable?”

Where am I?

Using stress for self-development

Stress is good for us! According to motivational speakers (and US presidents), to describe “crisis” Chinese use two characters that translate as “opportunity blowing in a dangerous wind.” ³²

When written in Chinese, the word “crisis” is composed of two characters. One represents danger, and the other represents opportunity. – John F. Kennedy

Although the translation may not be that accurate, truth is that every problem does bring with it an opportunity for growth.

Ask yourself, “What does this problem have to teach me?”

When you think about it, our worst experiences have taught us the most valuable lessons in life.

Work on your skills

A saying goes “If you want more out of life, make yourself more useful.” Ensure that you devote a minimum of half-an-hour per day to your self-development.

Useful skills that can be improved include time, stress and anger management, assertiveness, negotiation, communication, manners and social skills, and general knowledge on various conversational subjects. Self-improvement will be further discussed in Chapter 15.

Reduce the demands made by others – and yourself

People spend unimaginable amounts of time trying to become what others are telling them to become:

– Make something of your life.

– Do not become better than me.

– Study and become a doctor.

– Become a civil servant.

– Get married.³³

– Don’t you dare get married! Stay here and take care of me.

Does any of this sound familiar?

The secret of failure … is to try to please everyone!

Do not do it. You need balance here as well. At the same time, reduce self-imposed demands:

– Help others.

– Be good at everything you do. Be perfect.

– Do not waste your time.

– Don’t get angry.

– Don’t get stressed. Argh!

There is no need to be impeccable at everything you do. It is not possible to be perfect at everything. Being an excellent manager, a great husband, a model parent, a valuable friend, an eloquent speaker, a well-trained athlete, and a tireless lover is just unworkable … You are wearing too many hats! Accept yourself, even if you do not completely fit the high standards that you have set yourself.

Satisfy your needs

Some of our most important needs are physical, social, and psychological and emotional (love, physical and emotional cuddles).

Often our mood is “sub-zero,” without us knowing why. Other times, we have a feeling that our needs or desires are not being satisfied. The problem, though, is that we do not devote any time in consciously planning and attending to them.

To identify your paths of joy, try the following exercise.

Exercise: My top desires

List five of your desires (and think of five ways to satisfy them):