The psychology of stress

At the start of psychologist Kelly McGonigal’s TED talk, the Stanford University lecturer relays an unsettling statistic from a recent research paper: in the past year, McGonigal says, people who experienced a large amount of stress had a 43 percent increased risk of dying during the course of the study. The study McGonigal adduces tracked 30,000 adults in the United States for eight years and asked them two main questions:

1) “How much stress have you experienced in the last year?”

and

2) “Do you believe that stress is harmful for your health?”

In this second question lies the rub. McGonigal notes that the increased risk of death, during the time participants were observed, brought on by stress was only true for people who perceived stress as harmful. You see, people who experienced a lot of stress but did not view stress as harmful were not only no more likely to die during this time but, even more surprisingly, had the lowest risk of dying early, of anyone in the study, including people who had relatively little stress.

What this signifies, McGonigal claims, is that stress is not necessarily harmful, but the way we perceive it can be. As the stoic philosopher Epictetus said: “It’s not what happens, but the view we take of it that matters.”

The Epictetian power our perception has over our physical wellbeing is evident in the effects inert substances can have – be it beneficial (placebo) or harmful (nocebo) – on a patient’s health and wellbeing. But it is also corroborated by modern neuroscience, which offers insight into how our perception leads to physiological change. Research shows that our perception of events controls their valency, potency, and associative encoding. This is important because it reveals that a wide range of variables – which we are often unaware of but can learn to exert control over – influence our response to incoming data, events and experiences. A few important variables are:

1) Mood state: whether we are feeling anxious, sad, or happy will influence what we pay attention to and how we process the information, altering the lens through which we see the world.

2) Trait: personal traits, such as optimism or pessimism, can change how we perceive the same event and thereby influence our reaction to it.

3) Context: the environment in which an event occurs also shapes our response; for instance, seeing a snake at the zoo will produce a different reaction as would seeing a snake in your bedroom.

4) Peer group: the responses of those around us powerfully influence our own response by implicitly setting certain ‘cultural display rules’ that indicate the appropriate reaction to an event.

5) Social support: because studies have shown that good social support can reduce stress and positively alter our neurobiology, improving our levels of oxytocin and endorphins, social support exerts a great influence on our interpretation and reaction to events.

Our initial interpretation can be crucial in forming our response. Whether an event is perceived as good, bad, or indifferent will determine the neural pathways that will be activated in the brain, how the experience will be encoded on the amygdalae, and the epigenetic impact the experience will have. Moreover, this whole integrative perception will powerfully predict how we interpret the same stimulus next time. Associative learning can predict whether we normalise the stimulus and habituate to it (as many athletes habituate to pain), or whether we sensitise, which can serve to increase our sensitivity to the same stimulus or trigger. Emotions like dread, fear, and anxiety can lead to increased sensitisation, altering the structure of our brains through neuroplastic processes and increasing our tendency to react negatively to stressful circumstances. This is why in McGonigal’s talk she argues that thinking about stress in a more positive way – that is, priming ourselves to habituate to it – can actually reduce its adverse effects on our physical health and psychological wellbeing. As William James recognised, “the greatest weapon against stress is our ability to choose one thought over another.”

Ordinarily, when we are placed in a stressful situation we exhibit physical symptoms: our bodies flood with the stress hormones adrenaline and cortisol, our hearts pound, our palms moisten, and we breathe rapidly. This ancient, evolutionary response to threat was designed to help us survive in a hostile environment and stay in the gene pool by triggering a fight or flight response that primes us for action. However, the anxiety this causes is also known to trigger distorted and catastrophic thinking. We are more likely to interpret a noise in the night as caused by an intruder if we are anxious than if we are calm. Similarly, anxiety can prompt us to interpret normal physical symptoms as signs that we are ill, in danger, or not coping well under pressure.

This automatic, irrational, and sometimes catastrophic thinking was adaptive when facing a potential predator thousands of years ago. In the 21st century, however, it is often unhelpful, only compounding our anxiety and, in some cases, precipitating a vicious cycle of worry and rumination that can jeopardise wellbeing. What research shows is that if we assert cognitive control (what psychologists often call our executive function) and reframe or rethink what is happening, we can not only modify the anxiety but also beneficially channel our stress.

This was demonstrated in a study at Harvard University, cited by McGonigal. Participants in the study were taught to rethink their stress response by perceiving, for instance, their pounding heart as preparing them for action, or their increased breathing rate as getting more oxygen to their brain. Ultimately, those who learned to view the stress response as helpful for their health and performance were less stressed out, less anxious, and more confident. By controlling their thinking style, participants changed their physiological response: their blood vessels, which naturally restrict under stress, stayed relaxed and, although their hearts still pounded, they did so in a manner that resembled the rhythm produced by joy or happiness, not anxiety. Because the repeated constriction of blood vessels has been linked to cardiovascular disease, practicing this reframing, as McGonigal says, “could be the difference between a stress-induced heart attack at age 50 and living well into your 90s.”

There is a pitfall that must be avoided when changing our attitude towards stress as McGonigal advises. Many individuals assume that persistently worrying or stressing about some issue or predicament can be useful. But studies show that this belief can promote rumination, a dangerous and maladaptive meta-cognition that can amplify the unpleasant emotions associated with the issue at hand (Cartwright-Hatton & Wells, 1997; Wells & Cartwright-Hatton, 2004). That is, such rumination can elicit re-cyclical thinking patterns that can be detrimental to our health and wellbeing.

Nevertheless, learning to change our reaction to stress as the participants in the Harvard study did is a self-regulatory process that positively normalises the stress response and can prevent meta-cognitive rumination. The more we do this over time, the more automatic a positive reaction to stress becomes. Thus positive reframing and the assertion of our executive function can benefit our short- and long-term health. It also allows us to better harness our emotional response and free up valuable cognitive capacity, making self-regulation and the normalisation of stress beneficial not just for health but performance too. Because of the benefits it can offer performance and leadership capability, it is important that people in all kinds of organisations – be they schools or corporations – enhance their ability to regulate the stress response.

A recent Positive survey found that out of a group of 215 students who were asked how often they felt nervous, anxious, on edge, or unable to stop worry in the last two weeks, over 76% answered “several days,” “more than half the days,” or “nearly all the days.” To avoid protracted anxiety, which threatens the performance and wellbeing of students, it is crucial that teachers and those in pastoral roles are trained and can train others to alter their thoughts and perceptions in ways that normalise the stress response. This is also true for leaders and managers, with regard to their teams, in organisations. This can be achieved by acknowledging the power our thinking style has vis-à-vis our physiology and by practicing tools and techniques designed to strengthen our cognitive processes.

Moreover, to facilitate an environment in which we can enhance individual normalisation of the stress response, we also need to create cultures in which stress is perceived more positively, cultures in which we are willing to admit to being stressed and are able to discuss stress freely, without judgment. It is dangerous to enforce the idea that stress is a sign of weakness or incompetence. Doing this will deter people from openly discussing stress, thereby further stigmatising it and increasing the risk of repression and ruminative cycles perpetuated by a “fear of stress” – a fear that, in turn, only becomes further entrenched in the group’s mindset.

Thus, on an individual and group level, we should heed McGonigal’s advice and, as the Harvard study’s participants did, rethink stress as a positive, performance-enhancing reaction. Because it will improve not just individual wellbeing and physical health but also performance, a more positive attitude can be nothing but beneficial for all.