It has been described as an epidemic, the culprit for myriad crimes against human health. But stress is a natural phenomenon, the stuff of excitement, says Matthew Gwyther. And a little stress in the office is good for you. Without it nothing would ever get done.
Stress appears to have become Public Health Enemy Number One - the West's last 20th-century epidemic. We all seem to complain of its effects at work, at home, even on holiday if things do not go right. We are continually wound up by the environment that we have created ourselves.
The stress business used just to be the concern of the psychologists and their luckless lab rats, but in recent years it has been adopted by a far wider circle and has been elevated into a major national issue.
The western world has become almost obsessed by it. Stressed-up or stressed-out, off with stress, we're awash in a sea of unwanted adrenaline. Type the word into the box on an internet search engine and, in a trice, it can come up with 402,574 references. There's everything from executive stress specialists, through the Calm Centre - 'a group of artists and musicians who strive to spread calm', to the pills 'A1 General Vitamin Anti-oxidants' and how to get hold of a bottle. You could even get quite stressed-out trying to find the right solution for you.
Stress is now viewed by some as the culprit for a myriad of complaints: from irritable bowel syndrome to low birth-weight babies; from heart attack to asthma; and from migraine, even to making women go bald. (And you shouldn't forget those clinical conditions road-and supermarket-trolley-rage.) One report from the California Institute of Technology suggested that roughly 80% of individuals who attend doctor's surgeries do so because of stress-related diseases.
Throughout the late '90s the stress surveys and reports have stacked up: an Institute of Management survey reported that every day in the UK 270,000 individuals take time off work due to job-related stress at an annual cost of £7 billion; Barclays contributed a look at 400 small-business owners which painted a picture of a beleaguered group fuelling themselves on caffeine and cigarettes, getting little sleep and generally feeling under the cosh; and the Industrial Society confirmed that, after colds and flu, stress was now the third most common cause of absenteeism among staff.
One of the more surprising surveys by EBN, a business TV channel, discovered that men suffered stress more than women, while the young were more severely afflicted than the old. It was your job not the relative size of your salary that gave rise to high tension levels. So students, it claimed, were more stressed than medical professionals. Thus, it deduced, the ultimate stressed person, in danger of fusing all his synapses, is aged between 18-24 and lives in Northern Ireland in a flat sharing with six or more people which, when you think about it, doesn't sound like that rosy an existence. Clearly a life slumped in front of Teletubbies, wolfing down 'Ulster Fries' and consuming Carling Black Label could really get to you after a while.
But hold on for just one second here. Let us stand back and attempt to get things into some sort of perspective. Are young people's lives really more tense than they've ever been? Or are we simply lumping all life's age-old problems under the term. One should remember that the stress 'epidemic' is now regularly used, not always entirely convincingly, as a marketing tool to sell everything from exercise machines to vitamin tablets.
Any analysis of what is going on needs to be clear from the outset what stress really is and why a word which actually refers to a very specific physiological phenomenon has some how become a catch-all for life's day-to-day vicissitudes. Why it's become both cause and effect.
Our adrenal glands - a pair of five gramme, tricorn-hat-shaped objects which sit one on top of each kidney - have got a lot to answer for. When trouble appears over the horizon they prepare the body for the 'fight or flight' reaction by pumping out the hormone cocktail of adrenaline, noradrenaline and cortisol. Off go the alarms which increase the heart rate, raise the blood pressure and release sugar into the blood from liver stores. Our pupils dilate and then we are primed for action. This is what psychologists call 'stress arousal'. It is not an illness but a perfectly natural and, indeed, necessary part of the way we are made.
This sequence seems to have worked all right for our primitive ancestors who tensed-up accordingly and either slugged it out with their cudgels or ran for their lives. These days, however, fighting or heading for the hills is not an option open to the average individual suffering behind a desk, the wheel of a car or during family ructions at home. Most of the time we remain stuck to the spot and the cause of the stress remains. But that does not mean you should be let yourself be defeated by it.
And why is all this happening now? What's so stressful about the 1990s? Why are we apparently so much tenser about life than we were 20, 120 or 200,000 years ago? Those cudgel-bearing primitive ancestors can't have just fought or flown every time before returning to relaxed equilibrium. What about when they had a row in the family cave and it was too cold to escape outside? Darwin never said evolution was a bowl of cherries. But he did imply that those who don't just roll over win.
In the middle of all this stress-fest some dissenting voices have now begun to make themselves heard. Angela Patmore an erstwhile research Fellow at the University of East Anglia's Centre for Environmental and Risk Management cautions that stress can be allowed to get out of perspective. She has written a paper entitled, 'Killing the Messenger: the Pathologising of Stress Response'. She writes, 'The fear of stress has become like the fear of witchcraft or voodoo. Stress is not a disease. "Stress arousal" is a natural response to a challenge.'
She reminds us of the need to discriminate when it comes to making use of the burgeoning 'stress-management business' which she describes as a 'lucrative, under-qualified and largely unregulated industry ... whose techniques have been questioned by a number of scientific investigators as to their effectiveness and purpose.'
Other psychologists have questioned the existence of 'stress' as a condition. They say that if you break it down you would find that people are not suffering from stress at all but from problems caused by bullying, sleeplessness and bereavement. Dr Stephen Palmer, a chartered psychologist, is part of the stress industry. He runs the Centre for Stress Management in South London and is a senior visiting clinical and research Fellow at City University.
He is not keen on Patmore's ideas but agrees that things have got a bit out of hand. He questions how many individuals who call themselves 'stress counsellors' actually have the required skills to be effective, admitting there are 'a lot of cowboys out there and the potential for doing harm is considerable'. It takes a properly qualified individual, for example, to be able to diagnose the potentially serious conditions of clinical anxiety, clinical depression or even obsessive-compulsive disorder.
More generally, he agrees that the term needs more careful definition and is bandied about far too readily. He agrees with other researchers in the area that the 'central principle in the philosophy of preventative stress management is: stress is inevitable, distress is not'. 'It's a fact', he remarks, 'that if you put 10 people into a high-pressure situation or job then five will be unpleasantly stressed but the other five will enjoy it.'
Dr Palmer's approach is cognitive behavioural and 'multi-modal'. He believes 'emotional self-management is a vital key to stress management' and together with his clients is likely to examine in detail why they behave in the way they do in the face of stress and deconstruct the elements. 'In the end I just want people to think realistically,' he says. 'All they can do is their best.' Stress may be over-diagnosed these days but it cannot be ignored. 'Stress is now part of health and safety law', reminds Dr Palmer, 'and employers can be sued for it.' In an historic decision a year ago John Walker, a social worker from Northumberland, settled out of court for £175,000 compensation with his former employers having suffered two nervous breakdowns after which he took early retirement. He had argued that his job had involved an impossible amount of work. This was the first successful 'stress' civil action of its kind.
Dr Palmer is also interesting on stoicism and the difference between younger and older generations. 'I see an increasing low frustration tolerance among younger people,' he says. 'We just don't put up with things in the way of our parents and grandparents did. Our expectations are far higher and we assert ourselves much more strongly.' The health union Unison expresses no surprise that its members are off with stress-related conditions a lot because, it claims, 40% of health staff have suffered violence at work. Few people took swings at doctors and nurses 50 years ago.
Anyone who cowered at the bottom of the garden in an Anderson shelter during the Blitz in London in the second world war - living off powdered egg and never seeing a banana - will never tire of telling you what an experience that was, although they might not use the word 'stress'. Of course, some perversely will tell you they're actually the better for it. They are likely, with the benefit of hindsight, to talk up the benefits of stoicism - pulling together and getting on with it. It did not apply to every member of that generation - on the other side of the channel Hitler got so stressed-out he was a regular popper of herbal valerian tranquillisers.
Among older people, Prince Philip seems sceptical, for example, about the increasingly common diagnosis of Post Traumatic Stress Disorder. He suspects that we've lost the ability to stiffen our upper lips. 'We didn't have counsellors running around every time somebody let off a gun asking, "Are you all right - are you sure you don't have a ghastly problem?" ' he said referring to his war years, 'We just got on with it.' (In response, a spokesman for Combat Stress, a mental welfare charity for ex-servicemen confirmed that indeed 70% of its 4,500 people cared for were 1939-45 veterans. How many ex-servicemen spent the 20s and 30s debilitated by 'shell shock' is simply not known.)
There is no doubt, though, that western society has changed. Consumerism, the growth of the service sector and the new-found 'culture of complaint' are all cited as stress-causing culprits. The Americans have taught us no longer to be stoical about poor service, and nor should we be, so higher expectations and therefore shorter fuses are now the norm when we are out and about spending our money.
The popular answer to the stress question is that our speed of life has accelerated and we are racing to keep up. More to do, less time to do it. At work, even the Industrial Society admits that after nearly two decades of downsizing, 'the evidence suggests that many organisations are now suffering from being too "lean and mean".' In Britain we've also grown addicted to a long-hours culture. Between 1983 and 1991 the average working week for full-time service sector employees went up from 41.9 hours to 43.1, while falling from 40.3 to 40 hours in the rest of Europe.
In addition to having more to cope with there is a corresponding reduction in job security. Jobs for life are now a rarity and watching your back all the time is a tiring business. With the chilly draft of recession, or at least a 'correction', coming down the alley, this anxiety is raised still further.
So, the fact that stress is at the forefront of our minds cannot be argued with. It was telling that when the National Trust chose to ban stag hunting on its land recently it wasn't because the activity in itself was deemed cruel or degrading, the clinching factor was a vet's report that suggested the animals became 'stressed' when chased.
The claim that stress will make you ill requires close scrutiny. For 40 years the people in white lab coats have been trying to prove that stress gives you heart disease but the true nature of the relationship between the two is as obscure as ever. The famous research done in the States in the '60s by Drs Friedman and Rosenman on 'Type A personalities' and their propensity to drop down dead with heart attacks remains highly contentious.
Type As typically display a chronic sense of time urgency, impatience, explosive speech patterns, aggressiveness, free-floating hostility, an extremely competitive nature and a need for high achievement. We all know the type.
Friedman and Rosenman argued that Type As had higher blood cholesterol and were therefore more likely to keel over as a result of coronary heart disease. This is hugely simplistic and the psychological components of heart disease are merely one thread in a complex fabric of genetic factors, other environmental conditions and other learned behaviours. (Bizarrely, a few studies have actually found an increase in cholesterol levels following psychotherapy or stress management treatment.) Either way, there are many possible reasons why nasty, bullying, aggressive personalities wind up in an early grave but no definitive proof that stress arousal is among them.
The truth is we can't live without stress and shouldn't want to. It's the stuff of excitement - positive or negative, falling in love and being kicked out of it - and it's what stops us being lotus-eating cabbages that just lay there doing nothing. A measure of stress is natural. And a degree of it at work is no unhealthy thing, either. It's very odd that in a period where we are fuller than ever with admiration for athletes who harness stress in their bodies to good effect in their performances we try and shy away from stressing the brain. Sir John Harvey-Jones is right when he says that, 'The creative use of conflict and stress is the key to change.' Without stress nothing would ever get done. Life would be one long eventless equilibrium. There would always be manana to do everything.
For confirmation that there are big bucks in the stress game one need go no further than Paul Wilson, author of the celebrated 'Little Book of Calm' which at the last count had sold 2 million copies worldwide and was still going like a steam train. (Channel 7 even went so far as to call him, 'the coolest man in Australia' which rather makes you wonder who the other contenders were.)
Wilson is an ad man at the agency Henlon Wilson Weekes in Sydney. Becoming a creative director before the age of 30 he fell victim to the stress-related problems of 'having sleepless nights, drinking too much and having temper outbursts in the office'. Then he discovered meditation and entered the world of stress relief which led to his invention of the 'calm technique'.
Rarely can such a series of simple, gnomic utterances - one for each little page, with a small cloud floating above the text - have gone so far. Here are four random samples. 'Wear white: the clothes you wear have a distinct influence on the way you feel. Loose garments, natural fabrics and light colours all lead to calm.' 'Pretend it is Saturday.' 'Sip warm water: a glass of chilled water will calm you more than most other liquids. A cup of warm water will calm you even more.' 'Dance till you drop: one of the most pleasurable exercises around, uninhibited dancing distracts even the most committed worrier.'
So there you have it. Next time you feel under pressure in the office with a deadline approaching just get up and jive furiously around the desks, sipping warm water and pretending it's Saturday. And wait for the men in the white coats to arrive.
Meanwhile, Wilson's counterpart in the United States is Richard Carlson, author of 'Don't Sweat the Small Stuff ... and It's all Small Stuff'. This little gem - one of 13 self-help books the Californian has churned out - has sold more than five million copies and was the US's best-selling book in 1997. (He's been on 'Oprah' three times and she keeps a copy permanently by her bedside.)
For mind-numbing banality Carlson trumps Wilson and is often down at sub-Forrest Gump levels. 'Do one thing at a time' and 'Smile at strangers, look into their eyes and say hello' are favourites, but 'Once a week, write a heartfelt letter' is especially meaningful. Apparently Bill Clinton has admitted he finds the 'Accept that life is unfair' epigram especially comforting in his own times of stress of which, last year, there were quite a number.