1

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PART ONE
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The Nature of Stress

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Believe that life is worth living and

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your©NOT
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belief will
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OR DISTRIBUTION
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—William James
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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION CHAPTER 1

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The Nature of Stress

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I cannot and should not be cured of my stress,
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taught
FOR SALEtoORenjoy it.
DISTRIBUTION

—Hans Selye
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A
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUT
re you stressed? If the answer is “yes,” then Even before the pandemic, across the board, without
consider yourself to be in good company. exception, people admitted to having an increasing
Stress before the coronavirus pandemic of sense of anxiety, frustration, unease, and discontent
2020 was noted to be at the highest level in nearly every aspect of their lives. From the linger-
© Jones & Bartlett
in decades, Learning,
an all too common LLC trend. In fact,
behavioral © Jones
ing effects of the&coronavirus
Bartlett Learning,
pandemic and LLC its ensu-
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according to a 2019ORGallup
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poll, Americans r­ eported NOT FOR
ing economic SALE
effects to jobOR DISTRIBUTION
market challenges; college
the highest stress levels (anger and anxiety) in a decade, loan debt; ­environmental issues, such as allergies to
placing them as the most stressed people in the world genetically modified (GM) foods, overpopulation, and
(Ray 2019). The coronavirus (COVID-19) epidemic climate change–related weather incidents (e.g., dev-
that started in the spring of 2020 has only made mat- astating hurricanes and severe droughts); increases in
© Jones & Bartlett Learning, LLC
ters worse, with the United States surpassing China
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autism; concerns with global finance; gun violence and
NOT FOR SALEand OR DISTRIBUTION NOT
Italy in the number of those infected. Moreover, the FOR SALE OR DISTRIBUTION
terrorist attacks, the symptoms of stress can be found
fallout from the pandemic—those physically affected by everywhere. Ironically, in a country with a standard of
COVID-19 and the panic it produced—has sent trem- living that is considered to be one of the highest any-
ors of stress around the world. Mandated lockdowns, where in the world, the Centers for Disease Control and
self-isolation, © Jones
panic & Bartlett
buying, Learning,
massive layoffs and workLLC Prevention (CDC) estimates
© Jones & Bartlett
that nearly Learning,
one-­quarter of LL
furloughs, social
NOTdistancing,
FOR SALE forced
ORimmobilization,
DISTRIBUTIONthe American population NOTare FORon antidepressants
SALE OR DISTRIBUTand
canceled high school and college graduations, postponed that as many as one in three suffers from a chronic dis-
weddings, canceled professional sports, empty stadi- ease such as cancer, coronary heart disease, ­rheumatoid
ums, shuttered Broadway productions, closed movie
theaters, bare grocery store shelves, online funerals—
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nearly every aspect of society has been affected by this
© Jones & Bartlett Learning, LLC
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worldwide pandemic. Boredom, impatience, defiance, NOTTheFOR
Stress: SALE
experience of OR DISTRIBUTION
a perceived threat (real
or imagined) to one’s mental, physical, or spiritual
anger, and fear have all surfaced as people continue to
well-being, resulting from a series of physiological
just try to get by in the face of adversity. The world we responses and adaptations.
were raised in is NOT the world we are living in.
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 4 Part 1 The Nature of Stress

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arthritis,
NOT FOR SALE diabetes, or lupus, among many others.
OR DISTRIBUTION significant
NOT FOR roleSALE
in personal
ORupheaval, a new crop of social
DISTRIBUTION
Something is very wrong with this picture! stressors has added to the critical mass of an already vol-
Since the start of the Great Recession in 2008, a blanket atile existence, throwing things further out of balance.
of fear and anger has covered much of the country, if not Consider how these factors directly influence your life:
the world, keeping people©inJonesa perpetual state of frus- the rapid acceleration of technology (from software up-
& Bartlett Learning,
gradesLLC © of,
to Internet downloads); the use Jones
if not ­a& Bartlett Learning, LL
ddiction
tration and anxiety. The coronavirus
NOT FOR pandemic
SALEhas OR only
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added more stress to an already fragile global society. to, the World Wide Web (e.g., Instagram, TikTok, OR DISTRIBUT
NOT FOR SALE
Planetary problems only seem to intensify our personal WhatsApp, etc.); the proliferation of smartphones and
stressors. It doesn’t make a difference if you’re a col- Wi-Fi use; an accessible 24/7 society; global economic
lege student or a CEO of a multinational corporation, woes (e.g., unemployment, food prices); global terror-
where you©live,
Jones
or how &much
Bartlett
moneyLearning, LLC
is in your checking © Jones
ism; carbon footprints; & Bartlett
and public Learning,
health issues (e.g., the LLC
NOT FOR
account—stress SALE
is the equal OR DISTRIBUTION
opportunity destroyer! But latest epidemic of bedbugs or the coronavirus).
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it doesn’t have to be this way. Even as personal issues Times of change and uncertainty tend to magnify our
collide with social and planetary problems, creating a personal stress. Perhaps the biggest looming concern
perfect storm of stress, we all have choices—in both our facing people today is the issue of personal boundar-
attitude
© Jones and behaviors.
& Bartlett This textbook
Learning, LLC will help you con- ies, or the lack
© Jones & thereof.
Bartlett Advances
Learning,in smart
LLC technologies
nect the dots between mind, body, and spirit to create combined
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with a rapidly changing social structure
positive choices that empower you to navigate your life eroded personal boundaries and work–life balance.
through the turbulent waters of the human journey in These boundaries include, but are not limited to, home
the twenty-first century. and work, finances, nutritional habits, relationships,
and many, many more, all of which add to the critical
■■ Times of Change © Jones
and & Bartlett Learning, mass of LLC
one’s personal stress. Even© theJones
ongoing&war Bartlett
on Learning, LL
Uncertainty NOT FOR SALE OR DISTRIBUTION terrorism appears to have no boundaries! NOT FOR SALE
Ironically, the OR DISTRIBUT
lack of boundaries combined with factors that promote
Today, more than ever, the words stress and change a fractured society, where people feel a lack of commu-
have become synonymous, and the winds of change nity and belonging, leads to a greater sense of isolation
are in the air. Dramatic changes in the economy, and alienation, which also intensifies our personal stress LLC
© Jones & Bartlett Learning,
technology, communications, information retrieval,
LLC © Jones & Bartlett Learning,
NOT FOR SALE levels. Believe it or not, life wasn’t always like this.
health care, social media, andOR DISTRIBUTION
politics, as well as cat- NOT FOR SALE OR DISTRIBUTION
astrophic changes in the weather, are just some of the The stress phenomenon, as it is referred to today, is quite
gale forces blowing in our collective faces. By and new with regard to the history of humanity. Barely a
large, the average person doesn’t like change because household expression when your grandparents were
change
© Jones tends to disrupt
& Bartlett LLC zone. It appears your
one’s comfort
Learning, age, use&ofBartlett
© Jones the word stress is now asLLC
Learning, common as the
that the “known,” no matter how bad it may be, feels terms global warming and smartphone apps. However,
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like a safer bet than the unknown. Note that change—­ stress in terms of physical arousal can be traced back to
particularly change one cannot control—has always the Stone Age as a survival mechanism. But what was
been part of the human landscape. However, today the once ­designed as a means of physical survival is now
rate of change has become so fast and furious, with- ­associated with the development of disease and illness
© Jones & Bartlett
out an adequate reference point to anchor oneself, that Learning, LLC the lives of millions of©people
that claims Jones & Bartlett Learning, LL
worldwide.
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stress holds the potential to create a perpetual sense OR Recent statistics cited by the American Institute ofSALE
DISTRIBUTION NOT FOR Stress OR DISTRIBUT
of unease and uncertainty in the hearts and minds of (2017), the American Psychological Association, and
nearly everyone. Yet it doesn’t have to be this way. those gathered by the Gallup Poll Association (2019) sug-
Where there is change, there is opportunity. Where gesting that over half of Americans are affected by signif-
there is opportunity,
© Jones & there is comfort.
Bartlett Learning, LLC icant stress seem dated
© Jonesnow in&theBartlett ­coronavirus LLC
age of theLearning,
NOTgetting
FORmarried,
SALE OR DISTRIBUTION pandemic and subsequent socioeconomic
NOT FOR SALE OR DISTRIBUTIONripples.
At one time, changing jobs, buying a
house, raising children, going back to school, dealing The COVID-19 pandemic most likely has tipped the
with the death of a friend or close relative, and suffering scales for additional personal stress, compounding the
from a chronic illness were all considered to be major problems of alienation and isolation with “social isolation
life events that might shake
© Jones & Bartlett Learning, LLC the foundations of anyone’s mandates.”
© JonesAdded to this are
& Bartlett mounting LLC
Learning, economic hard-
life. Although these major life events can and do play a ships, the loss of personal milestones (high school and
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 Chapter 1 The Nature of Stress 5

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c
­ ollege graduations,
NOT FOR SALE OR DISTRIBUTION etc.), anxiety about health issues,
NOT andFORallSALE
peoplesOR
of every industrialized nation. The start of the
DISTRIBUTION
the loss of personal freedoms, all of which have ­become twenty-first century has seen the influence of smart tech-
the perfect storm for over-the-top stress levels with un- nologies dramatically alter our lifestyles. When first in-
certain long-lasting repercussions (Heid 2020). Is there troduced, many consumer products, such as the washing
more to come? Perhaps. Emmy Award winning doc- machine, clothes dryer, microwave oven, television, DVD
umentarian Ken © Jones & Bartlett
Burns compares Learning,pan-
the coronavirus LLC player, laptop computer,©and Jones
even the&cell
Bartlett Learning,
phone, were cited LL
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demic crisis to the Civil War and Great Depression, two NOT FOR SALE OR DISTRIBUT
as luxuries to add more leisure time to the workweek. But
topics he knows extremely well (Allen 2020). as mass production of smart technology items increased,
For decades stress has been linked to all the leading so, too, did the competitive drive to increase human effort
causes of death, including heart disease, cancer, lung and productivity, which had the consequence of actually
© Jones
ailments,&accidents,
Bartlett Learning,
cirrhosis, LLC
diabetes, and even suicide. © Jones
decreasing & Bartlett
leisure time, and thus Learning,
contributing toLLC
unhealthy
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A statistic quoted OR DISTRIBUTION
by countless health experts over the lifestyles
NOT andFOR
adverse health OR
SALE effects, most notably obesity.
DISTRIBUTION
past decade suggests that as much as 70 to 85 percent Currently, the leading causes of death are dominated by
of all diseases and illnesses are stress related (American what are referred to as “lifestyle diseases,” those diseases
Institute of Stress 2017). whose pathology develops over a period of several years,
© Jones & Bartlett Learning, LLC
Statistics compiled by the National Center for Health© Jones &andBartlett Learning,
perhaps even decades (LLC
FIG. 1.1). Whereas most in-
NOT FOR SALEStatistics
OR DISTRIBUTION fectious diseases
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in 2019 provide a host of indicators suggesting can be treated with medication, lifestyle
that stress is indeed a health factor to be reckoned with. diseases are, for the most part, preventable or correct-
Prior to 1955, the leading causes of death were the sudden able by altering the habits and behaviors that contrib-
onset of illness by infectious diseases (e.g., polio, rubella, ute to their etiology. Previously, it was suggested that an
tuberculosis, typhoid, and encephalitis) that, in most cases ­association exists between stress and disease, and in fact
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LL
(COVID-19 notwithstanding), have since been eradicated substantial research suggests that stress may be a causal
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or brought under control by vaccines and medications.
NOT FOR SALE
of diseases, OR DISTRIBUT
particularly auto-
The post–World War II era ushered in the age of high immune diseases (Segerstreom and Miller 2004). It is
­technology, considerably altering the lifestyles of nearly well-known that stress weakens the body’s physiological

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC

Vera, B., Division of Vital Statistics. “Deaths: Final Data for 2014,” National Vital Statistics Reports 65(4):1–121, 2016.
Data from (a) National Center for Health Statistics, Washington, D.C., 2010; (b) Kochanek, K. D., Murphy, S. L., Xu, J., and Tejada-
1900 2014
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
0 100 200 300 0 100 200 300 400 500 600 700 800

Diseases of
Influenza and pneumonia
the heart
© Jones & Bartlett Learning, LLC Tuberculosis, all forms© Jones & Bartlett Learning, LLC Malignant
neoplasms
NOT FOR SALE OR DISTRIBUTION Gastroenteritis NOT FOR SALEChronic
OR DISTRIBUTION
lower respiratory disease (cancer)

Diseases of the heart Accidents, fatal injuries

Vascular lesions of the Cerebrovascular
central nervous system diseases (stroke)
©Chronic
Jones & Bartlett Learning, LLC
nephritis Alzheimer’s disease © Jones & Bartlett Learning, LL
NOT FOR
All accidents
SALE OR DISTRIBUTION Diabetes
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Malignant neoplasms (cancer) Influenza and pneumonia

Certain diseases of early infancy Nephritis, nephrotic syndrome, and nephrosis

© Jones &Diphtheria
Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
Intentional self-harm (suicide)
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(A) (B)

FIGURE 1.1 Death rates for the 10 leading causes of death per 100,000 population in the United States in
© Jones & (a) Learning,
Bartlett 1900 and (b) LLC
2014. © Jones & Bartlett Learning, LLC
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 6 Part 1 The Nature of Stress

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
­systems,
NOT FOR thereby
SALE OR rapidly advancing the disease process.
DISTRIBUTION work
NOT(which
FOR isSALE not considered work time). Moreover,
OR DISTRIBUTION
The most notorious lifestyle disease, coronary heart dis- leisure time at home is often related to work activities,
ease (CHD), continues to be one of the leading causes of resulting in less time for rest and relaxation. For many,
death in the United States, far exceeding all other causes. work–life balance has become a myth. Downtime is
The Centers for Disease Control and Prevention Heart also compromised. Since 2001, Expedia has conducted
© Jones & Bartlett
Disease Facts (2019) states that one person dies from Learning, LLC survey on vacations called
an annual © Jones & Bartlett Learning, LL
the Vacation
NOT FOR SALE
heart disease every 37 seconds. Although the incidenceOR DISTRIBUTION NOT FOR
Deprivation survey. The 2018 results revealed that SALEone OR DISTRIBUT
of CHD has decreased over the past decade, cancer— out of every three Americans doesn’t use all of his or
in all its many types—­continues to climb the statistical her vacation time. One in five respondents cited work
charts as the second leading cause of death. According responsibilities/­pressure as the primary reason for can-
© Jones & Bartlett Learning, LLC
to the National Cancer Institute (2018), cancer is the celing a vacation.©A Jones
new word entered theLearning,
& Bartlett American LLC
second leading
NOT cause
FORofSALEdeath inORtheDISTRIBUTION
United States and lexicon in the summer of 2008 (and found
NOT FOR SALE OR DISTRIBUTION repeated use
one of the leading causes of death worldwide. Alarming during the COVID-19 pandemic)—the “staycation,” in
increases in suicide, child and intimate partner abuse, which people simply stayed home for vacation due to
self-injury, homicide, alcoholism, and opioid addic- financial or work constraints (Cloud 2008). Those who
tion are additional symptoms of a nation under stress. do head for the mountains or beaches for vacation often
© Jones & Bartlett Learning, LLC
Research ­repeatedly shows that many people maintain
© Jones
take & Bartlett
their work (in the formLearning,
of smartphonesLLC and laptops)
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poor coping skills in the face of the personal, social, and NOT FOR SALE OR DISTRIBUTION
with them—in essence, never really leaving their job.
even global changes occurring over the course of their It’s no surprise that staying plugged in doesn’t give the
lives (National Public Radio 2014). mind a chance to unwind or the body a chance to relax.
By comparison with other countries, Americans take less
Originally, the word stress was a term used in physics vacation time than other global citizens. (Germans, on
to describe the tension or © Jones
force placed&onBartlett
an objectLearning,
in LLC
average, take 4 to 6 weeks per
© Jones
year.) According
& Bartlett
to Tim
Learning, LL
NOT FOR
order to bend or break it. Relaxation, on SALE
the otherOR DISTRIBUTION
hand, NOT FOR SALE OR DISTRIBUT
MacDonald, general manager of Expedia, “The stress
was defined as any nonwork activity done during the associated with the current economy makes the need for
evenings or on Sunday afternoons when all the stores time away from work even more important than ever,
were closed. On rare occasions, if one could afford it, and it’s unfortunate that one-third of Americans won’t
relaxation©meant
Jones & Bartlett
a vacation Learning,
or holiday LLC
at some faraway © Jones
use all of their vacation & Bartlett
days this year.” TheLearning,
“dividend” LLC
place. Conceptually, relaxation was a value influenced
NOT FOR SALE OR DISTRIBUTION of high technologyNOT FORtoSALE
has proven OR DISTRIBUTION
be an illusion for many
by several religions and was meant to be viewed as a that has resulted in a stressed lifestyle, which, in turn,
day of rest. The word stress as applied to the human creates a significant health deficit (FIG. 1.2).
condition was first made popular by noted physiologist
Hans Selye in his book The Stress of Life (1978), in which

© Inspiration Unlimited. Used with permission.

© Jones & Bartlett
he described Learning,
his research LLC to understand the
as seeking © Jones & Bartlett Learning, LLC
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physiological responses to chronic stress and its rela- NOT FOR SALE OR DISTRIBUTION
tionship to disease (dis-ease). Today, the word stress is
frequently used to describe the level of tension people
feel is placed on their minds and souls by the demands
of their jobs, relationships, ©
andJones
personal&responsibilities.
Bartlett Learning, LLC © Jones & Bartlett Learning, LL
Oddly, for some, stress seems NOT be
to a status
FOR SALEsymbol
ORtied
DISTRIBUTION NOT FOR SALE OR DISTRIBUT
to self-esteem. Relaxation, meanwhile, has been trans-
formed from an American value into a luxury many
people find they just don’t have enough time for.
Despite various
© Joneseconomic changesLearning,
& Bartlett over the years,
LLCsome © Jones & Bartlett Learning, LLC
interesting insights have been observed
NOT FOR SALE OR DISTRIBUTION regarding work NOT FOR SALE OR DISTRIBUTION
FIGURE 1.2 With rapid economic, ecological, and
and leisure. The average workweek has expanded from
technological changes, the global village appears to
40 to 60 hours. The U.S. Department of Labor and have become a more stressful place, which is all the
Statistics reports that with more service-related jobs more reason to learn and practice effective stress
being created, more overtime is needed to meet cus- management techniques to maintain a sense of bal-
© Jones & demand.
tomer BartlettNotLearning, LLCpeople spend more
only do more ©ance
Jones & life
in one’s Bartlett
despite Learning,
these winds ofLLC
change.
NOT FOR SALE OR DISTRIBUTION
time at work, they spend more time driving to and from NOT FOR SALE OR DISTRIBUTION

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 Chapter 1 The Nature of Stress 7

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FOR SALE ■ OR■ Definitions of Stress
DISTRIBUTION NOT FOR­commented,
SALE OR“I’m an old man and I have known a great
DISTRIBUTION
many troubles, but most of them never happened.”
In contemporary times, the word stress has many conno- The holistic definition of stress points out that it is a
tations and definitions based on various perspectives of complex phenomenon affecting the whole person, not
the human condition. In Eastern philosophies, stress is just the physical body, and that it involves a host of
considered to© beJones
an absence& Bartlett Learning,
of inner peace. LLC factors, some of which
In Western © Jones
might not & yet
Bartlett
even beLearning,
recog- LL
NOT FOR SALE OR DISTRIBUTION
culture, stress can be described as a loss of emotional NOT FOR SALE OR
nized by scholars and researchers. As more research is DISTRIBUT
control. Noted healer Serge Kahili King (1989) has completed, it is becoming increasingly evident that the
defined stress as any change experienced by the individ- responses to stress add up to more than just physical
ual. This definition may be rather general, but it is quite arousal, yet it is ultimately the body that remains the
correct. Psychologically speaking,
© Jones & Bartlett Learning, LLC stress, as defined by battlefield
© Jonesfor the&war games of
Bartlett the mind. LLC
Learning,
noted researcher Richard
NOT FOR SALE OR DISTRIBUTION Lazarus (1984), is a state of NOT FOR SALE OR DISTRIBUTION
anxiety produced when events and responsibilities ■■ The Stress Response
exceed one’s coping abilities. Physiologically speaking, In 1914, Harvard physiologist Walter Cannon
stress is defined as the rate of wear and tear on the body. first coined the phrase fight-or-flight response to
Selye (1978) added to his definition that stress is the non- describe the Learning,
dynamics involved
© Jones & Bartlett Learning, LLC © Jones & Bartlett LLC in the body’s physi-
specific response of the body to any demand placed upon ological arousal to survive a threat. In a series of ani-
NOT FOR SALEitOR DISTRIBUTION
to adapt, whether that demand produces pleasure NOTorFOR SALE OR DISTRIBUTION
mal studies, Cannon noted that the body prepares
pain. Selye observed that regardless of whether a situ- itself for one of two modes of immediate action: (1) to
ation was perceived as good (e.g., a job promotion) or attack or fight and defend oneself from the pursuing
bad (e.g., the loss of a job), the physiological response threat or (2) to run and escape the ensuing danger.
or arousal was © Jones & Bartlett
very similar. Learning,
The body, according LLC
to What Cannon observed © Jones
was the & body’s
Bartlett Learning,
reaction to LL
Selye, doesn’tNOTknowFOR SALE OR
the difference DISTRIBUTION
between good and acute stress, what is now NOTcommonly
FOR SALE calledORthe DISTRIBUT
stress
bad stress. ­r eaction. Additional observations suggested that
However, with new psychoneuroimmunological data the fight response was triggered by anger or aggres-
available showing that there are indeed some physio- sion and was usually employed to defend territorial
© Jones & Bartlettbetween
logical differences Learning, LLCbad stress (e.g., boundaries
good and © Jones or to&attack aggressors
Bartlett equal toLLC
Learning, or smaller
NOTtheFOR
releaseSALE OR DISTRIBUTION
of different neuropeptides), specialists in in size. The fight response
NOT FOR SALE OR DISTRIBUTION required physiological
the field of holistic medicine have expanded Lazarus’s preparations that would recruit power and strength
and Selye’s definitions as follows: Stress is the inabil- for a short duration, or what is now described as
ity to cope with a perceived (real or imagined) threat short but intense anaerobic work. Conversely, the
to one’s mental, physical, emotional, and spiritual flight response, he thought, was induced by fear. It
© Jones & Bartlett Learning, LLC © Jones & was Bartlett
designedLearning,
to fuel the LLC
body to endure prolonged
well-being, which results in a series of physiologi-
NOT FOR SALEcalOR DISTRIBUTION
responses and adaptations (Chopra 2000; Dossey NOT FOR SALE
movement OR DISTRIBUTION
such as running away from lions and
bears. In many cases, however, it included not only
2004). The important word to emphasize here is per-
ceived (the interpretation), because what might seem
to be a threat to one person might not even merit a
second thought © Jones
in another& Bartlett
individual.Learning,
For example, LLC Holistic medicine: A©healing Jones & Bartlett
approach that Learning, LL
not long ago aNOTraffleFOR SALE
was held, withOR
the DISTRIBUTION
winning prize ­honors the integration, NOT balance,
FORand harmony
SALE ORofDISTRIBUT
being an all-expenses-paid 1-week trip for two to a mind, body, spirit, and emotions to promote inner
peace.
beach resort in Bermuda. Kelly, who won the prize,
was ecstatic and already had her bags packed. Her Walter Cannon: Twentieth-century Harvard physiolo-
gist who coined the phrase “fight or flight.”
husband,
© Jones &John, was mortified
Bartlett Learning, because
LLChe hated to fly © Jones & Bartlett Learning, LLC
andFORhe couldn’t Fight-or-flight response: A term coined by Walter
NOT SALEswim. In his mind, this would not be
OR DISTRIBUTION NOTthe
Cannon; FOR SALEphysiological
instinctive OR DISTRIBUTION
responses
a fun time. In fact, he really wished they hadn’t won.
preparing the body, when confronted with a threat,
Each perceived the same situation in two entirely dif-
to either fight or flee; an evolutionary survival
ferent ways. Moreover, with the wisdom of hindsight, dynamic.
our perceptions often change. Many episodes that at
© Jones & Bartlett Learning,
the time seemed LLC © Jones &Stress
catastrophic later appear insignifi-
reaction:
Bartlett The body’s
Learning, initial (central nervous
LLC
system) reaction to a perceived threat.
NOT FOR SALEcant,
ORasDISTRIBUTION
humorously stated by Mark Twain when NOTheFOR SALE OR DISTRIBUTION

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 8 Part 1 The Nature of Stress

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
fleeing,
NOT FOR but also
SALE ORhiding or withdrawal. (A variation on
DISTRIBUTION still
NOT exist
FOR in today’s
SALEculture, including domestic ter-
OR DISTRIBUTION
the flight response is the freeze response, often noted rorism, they are nowhere near as prevalent as those
with posttraumatic stress disorder, where a person threats perceived by the mind and, more specifically,
simply freezes, like a deer staring into a car’s head- the ego. A theory put forward by Simeons (1961), a
lights.) The human body, in all its metabolic splendor, disciple of Selye’s, and then reexamined by Sapolsky
© Jones & Bartlett
actually prepares itself to do both (fight and flight) at Learning,
(2009)LLC © Jones
is that, in effect, the fight-or-flight & Bartlett
response is Learning, LL
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an antiquated mechanism that has not kept evolution-SALE OR DISTRIBUT
this dynamic was so advantageous to survival that it ary pace with the development of the human mind.
developed in nearly all mammalian species, includ- Consequently, the stress response becomes activated
ing humans. (Some experts now suggest, however, by all types of threats—mental, emotional, and spir-
that our bodies have not adapted to
© Jones & Bartlett Learning, LLCthe stress-induced itual—not just physical
© Jones intimidations.
& BartlettThese physi- LLC
Learning,
lifestyles NOT
of the FOR
twenty-first century.)
SALE OR DISTRIBUTION ological repercussions can, and do, prove fatal.
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In simple terms, the fight-or-flight response consists of body enters a state of physical readiness when you are
four stages: about to receive your final exam grades or walk into
an important meeting late, just as it does when you
Stage 1: Stimuli from one or more of the five senses sense someone is following you late at night in an unlit
© Jonesare& sent
Bartlett Learning,
to the brain LLC the smell of fire,
(e.g., a scream, © Jones
parking lot. & Bartlettthis
Moreover, Learning,
same stressLLC
response kicks
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taste of OR DISTRIBUTION
poison, a passing truck in your lane). NOT FOR SALE OR DISTRIBUTION
in, to the same degree and intensity, even when the
Stage 2: The brain deciphers the stimulus as either a threat is wholly imaginary, such as monsters hiding
threat or a nonthreat. If the stimulus is not regarded under your bed when you were 4 or the unsubstanti-
as a threat, this is the end of the response (e.g., the ated idea that your boss doesn’t like you and is out to
scream came from the © Jones &
television). If,Bartlett get you
however, Learning,
the LLC(FIG. 1.3). © Jones & Bartlett Learning, LL
response is decoded as NOT a real FOR
threat,SALE
the brain then
OR DISTRIBUTION NOT FOR SALE OR DISTRIBUT
activates the nervous and endocrine systems to
quickly prepare for defense and/or escape. Freeze response: Part of the stress response, where
the individual neither fights nor flees, but freezes like
Stage 3: The body stays activated, aroused, or a deer caught in the headlights, paralyzed as if the
“keyed-up” until the
© Jones threat is over.
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person has forgotten to run. & Bartlett Learning, LLC
NOT
Stage 4: TheFORbody SALE
returns OR DISTRIBUTION
to homeostasis, a state Homeostasis: A NOT FOR state
physiological SALE OR DISTRIBUTION
of complete
of physiological calmness, once the threat is gone. calmness or rest; markers include resting heart rate,
blood pressure, and ventilation.
Scientists hypothesize that the fight-or-flight response
Stress response: The release of epinephrine and nor-
developed primarily against threats of a physical
epinephrine to prepare various organs and tissues for
nature;
© Jones that is, those
& Bartlett that jeopardized
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or flight.
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of theSALE Although clear physical threats
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FIGURE 1.3 Some of our worst stressors are fabricated in our minds.
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 Chapter 1 The Nature of Stress 9

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Cannon noted the
NOT FOR SALE OR DISTRIBUTION activation of several NOT FORTend
physiological andOR
SALE Befriend
DISTRIBUTION
mechanisms in this fight-or-flight response, affecting
Do women respond differently to stress than men? The
nearly every physiological system in the body, for the
answer may seem obvious. Generally speaking, men are
preparation of movement and energy production. The
prone to act with more hostility, whereas women have
following are just a few of these reactions:
© Jones & Bartlett Learning, LLC a proclivity to be more © nurturing.
Jones & Yet, until recently,
Bartlett Learning, LL
1. Increased heart rate to pump oxygenated
NOT FOR SALE OR DISTRIBUTION blood to every source on stress addressed the fight-or-flight
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working muscles response as if it were the only human default response.
2. Increased blood pressure to deliver blood to It was the work of Shelley Taylor and colleagues who
working muscles filled in the missing piece with regard to the female
response to stress. Curious about why only men were
3. Increased
© Jones & Bartlett Learning,
ventilation LLC
to supply working muscles studied © Jones & Bartlett
to formulate Learning,
the basis LLC
for the fight-or-flight
NOT FOR withSALE
oxygenOR for energy metabolism
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response, Taylor hypothesized that the stress response
4. Vasodilation of arteries to the body’s periphery needed to be reexamined, this time including astute
(arms and legs) with the greatest muscle mass observations of the female gender. In 2000, Taylor and
colleagues proposed a new theory for the female stress
5. Increased serum glucose for metabolic processes
© Jones & Bartlett Learning, LLC © Jones & response
Bartlett they termed tend
that Learning, LLCand befriend. Although
during muscle contractions
NOT FOR SALE OR DISTRIBUTION both men and
NOT FOR SALE OR DISTRIBUTION women have a built-in dynamic for the
6. Increased free fatty acid mobilization as an energy survival of physical danger, women also have an inher-
source for prolonged activity (e.g., running) ent nurturing response for their offspring as well as a
7. Increased blood coagulation and decreased clot- means to befriend others. This, in turn, creates a strong
ting time in the event of bleeding social support system, which is an invaluable coping
© Jones & Bartlett Learning, LLC technique. Taylor suggests © Jones & female
that the Bartlett Learning,
response to LL
8. Increased muscular strength
NOT FOR SALE OR DISTRIBUTIONstress is hardwired intoNOT FORand
the DNA SALE ORthrough
revealed DISTRIBUT
9. Decreased gastric movement and abdominal blood a combination of brain chemistry and hormones. The
flow to allow blood to go to working muscles biological basis for tend and befriend appears to be the
10. Increased perspiration to cool the core body hormone oxytocin, now regarded as both the “trust-
© Jones­temperature
& Bartlett Learning, LLC ing hormone”
© Jones and the “social
& Bartlett affiliation”LLC
Learning, hormone.
NOT FOR SALE Although
NOToxytocin is found in DISTRIBUTION
both women and (to a
Unfortunately, theOR DISTRIBUTION
metabolic and physiological changes FOR SALE OR
lesser degree) men, estrogen is known to enhance the
that are deemed essential for human movement in the effects of oxytocin in the brain. The tend-and-befriend
event of attack, pursuit, or challenge are quite ineffective behavior is built on connectedness—a caregiving pro-
when dealing with events or situations that threaten the cess, possibly triggered by a release of oxytocin in con-
ego, such
© Jones & Bartlett as receiving
Learning, LLCa parking ticket or standing © Jonesin & Bartlett
junction withLearning, LLC hormones, that may
female reproductive
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line at the grocery store, yet the body respondsNOT FORactually
SALEoverrideOR DISTRIBUTION
the flood of stress hormones so pro-
identically to all types of perceived threats. nounced in women’s male counterparts. Generational
Rest and Digest social factors may support the tend-and-befriend behav-
ior pattern as well (FIG. 1.4).
What is the opposite of fight or flight? The answer, a
© Jones
phrase that’s easy & Bartlett
to remember because itLearning, LLC Not only do men and ©
rhymes, is “rest Jones
women & differences
have Bartlett Learning,
in their LL
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and digest.” If living in a state of stress is considered liv- stress physiology, but there
NOT appears
FOR to be
SALE gender-specific
OR DISTRIBUT
ing in “survival mode,” then the opposite of this is living behaviors for discussing and solving problems as well.
with a sense of calm and inner balance. When the body Whereas men tend to think their way through by look-
is relaxed, it is allowed to rest, with various physiological ing for solutions to problems, women like to talk about
systems contributing problems. Women bond quickly by sharing confidences.
© Jones & Bartletttoward one’s health
Learning, LLCand well-being. © Jones & Bartlett Learning, LLC
NOTWhenFOR a person
SALE is under stress, gastrointestinal activities
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are suspended because all of the body’s energy is needed
Tend and befriend: A theory presented by Shelley
for survival. Under rest, the body can resume processes
­Taylor that states that women who experience stress
and tranquil functions, like digestion, to promote the
don’t necessarily run or fight, but rather turn to friends
highest degree of self-care. However, the body cannot
© Jones & Bartlett Learning,
do fight or flight and LLC © Jones &toBartlett
rest and digest at the same time.
cope with unpleasant events and circumstances.
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 10 Part 1 The Nature of Stress

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Three
NOT kinds
FOR of stressOR
haveDISTRIBUTION
been identified: eustress,

© LiquidLibrary
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neustress, and distress. Eustress is good stress; it arises in
any situation or circumstance that a person finds moti-
vating or inspiring. Falling in love might be an example
of eustress; meeting a movie star or professional athlete
© Jones & Bartlett Learning, LLC
may also © Jones
be a type of eustress. Usually, situations&that
Bartlett
are Learning, LL
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classified as eustress are enjoyable, and for this reason OR DISTRIBUT
are not considered to be a threat. Neustress describes
sensory stimuli that have no consequential effect; it is
considered neither good nor bad. News of an earth-
© Jones & Bartlett Learning, LLC quake in a remote©corner
Jones of &theBartlett
world might fall into LLC
Learning,
NOT FOR SALE OR DISTRIBUTION this category. The third type of stress, distress,
NOT FOR SALE OR DISTRIBUTION is consid-
ered bad and often is referred to simply as stress.
Distress can be acute or chronic. Acute stress surfaces,
FIGURE 1.4 Fight or flight isn’t the only response to is quite intense, and then disappears quickly. Chronic
stress. To cope with personal problems, women often stress may not
© Jones & Bartlett Learning, LLC
feel the need to socialize and bond together in what
© Jones &appear to beLearning,
Bartlett quite as intense,
LLC but it seems
to linger for prolonged periods of time (e.g., hours, days,
NOT FOR SALE
is now knownOR DISTRIBUTION
as the “tend-and-befriend” response. NOT FOR SALE OR DISTRIBUTION
weeks, or months). An example of acute stress is the
following. Say that you are casually driving down the
highway, the wind from the open sunroof is blowing
However, although talking may be beneficial, research- through your hair, and you feel pretty good about life.
ers note that merely talking © Jones & Bartlett
about stressors tendsLearning,
to With LLC © Jones
a quick glance in your rearview mirror&you Bartlett
see Learning, LL
perpetuate rather than solve NOT
one’sFOR SALE
stressors. Researchers flashing blue lights. Yikes! So you NOT
OR DISTRIBUTION FORand
slow down SALEpull OR DISTRIBUT
refer to stress-based conversations as co-rumination. over. The police car pulls up behind you. Your heart
Although talking may strengthen female friendships, it is racing, your voice becomes scratchy, and your palms
is also known to increase anxiety and depression if solu- are sweating as you try to retrieve license and registra-
tions aren’t introduced quickly. Experts
© Jones & Bartlett Learning, LLC warn against tion from your wallet while rolling
© Jones your window
& Bartlett down LLC
Learning,
“unhealthy rumination” and the emotional contagion at the same time. When the officer asks you why you
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that results from it (Stepp 2007). were speeding you can barely speak; your voice is three
It is fair to say that the concepts of survival are complex octaves higher than usual. After the officer runs a check
and perhaps not so neatly packaged by hormones or gen-
der. Women are known to backstab their “friends” and
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regrettably, Learning,
on occasion, LLCnewborn babies in
ditch their ©Co-rumination:
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Stress-based LLCbetween
conversations
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dumpsters and run away. Conversely, some men choose NOT FOR SALE OR DISTRIBUTION
women as a means of coping by finding support
peace over violence (Gandhi and Martin Luther King, among friends.
Jr. come to mind) and, when times get tough, some men Eustress: Good stress; any stressor that motivates an
are known to bond together over a beer or game of golf. individual toward an optimal level of performance or
health.
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■■ Types of StressNOT FOR SALE OR DISTRIBUTION Neustress: Any kind of information or sensory stimulus
NOT FOR SALE OR DISTRIBUT
that is perceived as unimportant or inconsequential.
It may come as a surprise that not all stress is bad. In fact,
Distress: The unfavorable or negative interpretation
many believe that humans need some degree of stress to of an event (real or imagined) to be threatening that
stay healthy. The human body craves homeostasis, or promotes continued feelings of fear or anger; more
physiological calm (rest
© Jones and digest),
& Bartlett yet it also requires
Learning, LLC commonly known©simplyJones & Bartlett Learning, LLC
as stress.
physiological
NOTarousal
FORtoSALE
ensure OR
the optimal functioning
DISTRIBUTION NOT FOR SALE
Acute stress: Stress that is intense OR DISTRIBUTION
in nature but
of several organs, including the heart and musculo- short in duration.
skeletal system. How can stress be good? When stress
Chronic stress: Stress that is not as intense as acute
serves as a positive motivation, it is considered benefi- stress but that lingers for a prolonged period of time
cial. Beyond this optimal point, stress of any kind does (e.g., financial problems).
© Jones
more&harm
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 Chapter 1 The Nature of Stress 11

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on your car and
NOT FOR SALE OR DISTRIBUTION license, he only gives you a warning
NOTforFORwhen
SALEstress
OR increases, moving from eustress to distress,
DISTRIBUTION
speeding. Whew! He gets back in his car and leaves. performance or health decreases, and there is greater
You give him time to get out of sight, start your engine, risk of disease and illness. The optimal stress level is
and signal to get back onto the highway. Within min- the midpoint, prior to where eustress turns into dis-
utes your heart is calm, your palms dry, and you start tress. Studies support the conventional wisdom, which
© Jones & Bartlett Learning,
singing to the song on the radio. The threat is over. The LLC © Jones
indicates that stress-related hormones& Bartlett Learning,
in optimal doses LL
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intensity of the acute stress may seem cataclysmic, but it NOT FOR SALE
actually improve physical performance and mental-­ OR DISTRIBUT
is very short-lived. processing skills like concentration, increasing alert-
Chronic stressors, on the other hand, are not as intense, ness (Fricchione et al. 2016). Beyond that optimal level,
but their duration may seem unbearably long. Examples though, all aspects of performance begin to decrease in
© Jones & Bartlett
might include Learning,
the following: beingLLC
stuck for a whole efficiency. Physiologically
© Jones & Bartlett speaking, the person’s
Learning, LLChealth
NOT FORwith
semester SALE“theOR DISTRIBUTION
roommate from hell”; a credit card is at serious risk. It would be simple
NOT FOR SALE OR DISTRIBUTION if this optimal level
bill that only seems to grow despite monthly payments; a was the same for all people, but it’s not. Hence, the focus
boss who makes your job seem worse than that of a gal- of any effective stress management program is twofold:
ley slave; living in a city you cannot tolerate; or maintain- (1) to find out where this optimal level of stress is for
ing aLearning,
relationship with you so that it can be used to your advantage rather than
© Jones & Bartlett LLCa girlfriend, boyfriend, husband,
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becoming Learning,
a detriment LLChealth status and (2) to
to your
or wife that seems bad to stay in but worse to leave. For
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physical arousal levels using both coping skills
this reason, chronic stressors are thought to be the real
villains. It is well understood and commonly cited that and relaxation techniques so that you can stay out of the
this type of stress is associated with disease because the danger zone created by too much stress.
body is perpetually aroused for danger (Rohleder 2016).
© Jones & Bartlett Learning, LLC ■■ Trauma: Stress on Steroids
© Jones & Bartlett Learning, LL
A concept called the Yerkes-Dodson principle that
NOT FOR SALE OR DISTRIBUTIONThere are times whenNOT
often is applied to athletic performance lends itself
FOR
you lose SALE
your OR DISTRIBUT
smartphone, and
quite nicely to explaining the relationship between eus- you get stressed. Crisis! But you find it in a few min-
tress, distress, and health. As can be seen in FIG. 1.5, utes and the stress goes away. Crisis resolved. There are
times when you have to tolerate the boss from hell or a
© Jones & Bartlett Learning, LLC bad job, and this,&too,
© Jones causes stress.
Bartlett However,
Learning, LLCsome epi-
NOTGood FOR SALE MaximumOR DISTRIBUTION
performance
sodes of stress can be defined as
NOT FOR SALE OR DISTRIBUTION traumatic, and this is per-
Low
haps best described as “stress on steroids.” Not only the
P I event, but also the lingering memories and emotional
e l
r l hemorrhaging, can last a very long time. A lost smart-
f n phone will turn up or be replaced. Changing jobs is an
e
© Jones & Bartlettor Learning, LLC © Jones
s & Bartlett
option. With Learning, LLC which often works its
emotional trauma,
Eustress Distress
NOT FOR SALE OR m DISTRIBUTION NOTs FORway SALE
deep OR DISTRIBUTION
into the body (repeated neural firings to deep
a
n muscle tissue), the resolution may take years of inner
c work and therapy. More and more research now links
e
a traumatic event, such as sexual abuse or physical vio-
Poor © Jones & Bartlett Learning, HighLLC lence, with attempted © suicide, chemical addictions, and
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Poor performance Poor performance other serious life-threatening behaviors. Living with a
NOT
Low
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Moderate
OR DISTRIBUTION
High
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traumatic episode can cause posttraumatic stress dis-
(underaroused – (optimally (overaroused –
bored) aroused) overwhelmed)
order (PTSD), where various situations trigger mem-
Stress (emotional arousal) ories of the trauma, bringing the past into the present
moment, causing a whirlpool of anxiety (Eckelkamp
© Jones
FIGURE&1.5Bartlett Learning,curve
The Yerkes-Dodson LLCillustrates 2019;©Gordon
Jones2019).
& Bartlett Learning, LLC
NOTthat,
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a point, stress or arousal can actually increase NOT FOR SALE OR DISTRIBUTION
performance. Stress to the left of the midpoint is Yerkes-Dodson principle: The theory that some
­considered to be eustress. Stress beyond the midpoint, stress (eustress) is necessary for health and perfor-
however, is believed to detract from performance mance but that beyond an optimal amount both will
and/or health status and is therefore labeled distress.
© Jones & Bartlett Learning, LLC © Jones &deteriorate
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 12 Part 1 The Nature of Stress

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■■ Types
NOT FOR SALE ORof Stressors
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A situation, circumstance, or any stimulus that is per-
ceived to be a threat or that causes or promotes stress
is referred to as a stressor. As you might imagine, the
list of stressors not only is© Jones
endless, but&also
Bartlett Learning, LLC
varies con- © Jones & Bartlett Learning, LL
siderably from person to NOT person.FOR
AcuteSALE
stress isOR DISTRIBUTION
often NOT FOR SALE OR DISTRIBUT
the result of rapid-onset stressors—those that pop up
unexpectedly—like a phone call in the middle of the
night or the discovery that you have lost your smart-
phone. Usually
© Jonesthe body begins toLearning,
& Bartlett react beforeLLCa full © Jones & Bartlett Learning, LLC
analysis of the situation is made, but a return to a state
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of calm is also imminent. Chronic stressors—those that FIGURE 1.6 Because of the tilt of Earth’s axis as
may give some advance warning yet manage to cause it moves in its orbit around the sun, areas closest
physical arousal anyway—often merit more attention to the poles vary the most in the amount of daily
because their prolonged influence on the body appears sunlight they receive. Studies have shown that an
© Jones
to be&more
Bartlett Learning,
significant. Much LLC
research has been con- ©inadequate
Jones & Bartlett
amount Learning,
of full-spectrum LLC
light is asso-
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ductedSALE OR DISTRIBUTION
to determine the nature of stressors, and they NOT
ciatedFOR SALE OR
with depression, DISTRIBUTION
a phenomenon now known
are currently divided into three categories: bioecologi- as seasonal affective disorder (SAD) or arctic winter
cal, psychointrapersonal, and social (Giradano, Everly, madness.
and Dusek 2012).
© Jones & Bartlett Learning, LLC modified organisms (GMOs),
Genetically © Jones & Bartlett Learning, LL
petrochemi-
Bioecological Influences
cals, synthetic chemicals, and someNOT
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of nanotech-
Several biological and ecological factors can trigger the nology are considered new bioecological threats. In
stress response to varying degrees, some of which are addition, some synthetic food additives may trigger
outside our awareness. These are external influences, the release of various stress hormones throughout the
including sunlight, gravitational pull, solar flares, body. Note that there is a growing awareness among LLC
© Jones &fields,
and electromagnetic Bartlett Learning,
that affect LLC
our biological © Jones & Bartlett Learning,
some health practitioners that increased stress levels
rhythms. NOT FOR
The field SALE OR DISTRIBUTION
of chronobiology has identified three NOT FOR SALE OR DISTRIBUTION
in the twenty-first century may be a direct result of
categories of biological rhythms: (1) circadian rhythms, our being out of touch with the natural elements that
fluctuations in physiological functions over the course so strongly influence our body’s physiological systems.
of a 24-hour period (e.g., body temperature); (2) ultra-
dian&rhythms,
© Jones Bartlett fluctuations
Learning, thatLLC
occur over less than a © Jones & Bartlett Learning, LLC
24-hour period (such as stomach contractions and cell Stressor: Any real or imagined situation, circum-
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divisions); and (3) infradian rhythms, changes that occur stance, or stimulus that is perceived to be a threat.
over periods longer than 24 hours (e.g., the menses). Circadian rhythms: Biological rhythms that occur
These biological changes are influenced by such natu- or cycle within a 24-hour period (e.g., body tem-
ral phenomena as Earth’s orbit and axis rotation, which perature) that create the body’s internal clock, also
give us periods of light and©darkness,
Jonesas&well Bartlett Learning,
as seasonal knownLLCas chronobiology. These can©beJones
affected&byBartlett Learning, LL
differences (FIG. 1.6). NOT FOR SALE OR stress,
DISTRIBUTION causing a disruption that is even
NOT more
FOR stress-
SALE OR DISTRIBUT
ful to the body.
A prime example of a bioecological influence is sea-
Ultradian rhythms: Biological rhythms that occur
sonal affective disorder (SAD), a condition affect- many times in a 24-hour period (e.g., hunger pangs).
ing many people who live at or near the Arctic Circle. These can be affected by stress.
Many of©these
Jones & Bartlett
people Learning,
become depressed whenLLC
they © Jones & Bartlett Learning, LLC
Infradian rhythms: Biological rhythms that occur
NOTofFOR
are deprived SALE
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prolonged periods of in periods longerNOT FOR
than 24 hoursSALE OR DISTRIBUTION
(e.g., women’s men-
time. Technological changes are also included in this strual period). These can be affected by stress.
category; for example, jet lag as a result of airplane
Seasonal affective disorder (SAD): The physiolog-
travel through several time zones. Electrical pollu- ical response to lack of sunlight that results in feel-
tion, environmental toxins, solar radiation, and noise
© Jones & Bartlett Learning, LLC ©ings
Jones & Bartlett Learning, LLC
of depression.
pollution are other potential bioecological influences.
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 Chapter 1 The Nature of Stress 13

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In any case, some
NOT FOR SALE OR DISTRIBUTION of these bioecological factors can beFOR SALE OR DISTRIBUTION
NOT
positively influenced by l­ifestyle changes, including■■ Social Stress: Yesterday, Today,
dietary habits, exercise, and the regular practice of and Tomorrow
relaxation techniques, which bring a sense of balance At the end of World War II, the biggest social stressor
back into our lives.
© Jones & Bartlett Learning, LLC that people lived with © was the fear
Jones of nuclear
& Bartlett anni-
Learning, LL
hilation, which was soon intertwined with suspicions
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of communist threats propagated by Senator Joseph
Our current understanding is that psychointraper- McCarthy in the 1950s. While African Americans
sonal influences make up the greatest percentage of lived under constant threat of Jim Crow laws and
stressors. These are the perceptions of stimuli that we discrimination, white Americans began to thrive for
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create through our own Learning, LLC (perceptions
mental processes © Jones
the next & Bartlett
several decades underLearning,
the promiseLLC
of a strong
NOTandFOR SALE OR DISTRIBUTION
interpretations). Psychointrapersonal stressors NOT FOR SALE OR DISTRIBUTION
economy.
involve those thoughts, values, beliefs, attitudes, opin- The social influences linked to stress have been studied
ions, and perceptions that we use to defend our iden- for decades, most notably by Holmes and Rahe (1967)
tity or ego. When any of these is challenged, violated, with the Social Readjustment Rating Scale (SRRS)
or even
© Jones & Bartlett changed, LLC
Learning, the ego is often threatened and the
© Jones &
andBartlett Learning,
the concept LLC units (LCUs). It was
of life-change
stress response is the outcome. Psychointrapersonal
NOT FOR SALE OR DISTRIBUTION NOT FORtheirSALE workORover
DISTRIBUTION
60 years ago that first highlighted
stressors reflect the unique constructs of our person- the list of top life stressors, including the death of a
ality, and in the words of stress researcher Kenneth spouse, the loss of a job, the death of a child, divorce,
Pelletier (2011), represent “the chasm between the per- and high mortgage payments (even then). Variations
ceived self and the ideal self-image.” These influences on the study of social influences included various
are the most © Jones
likely & Bartlett
to cause Learning,
stress. It is imperativeLLCto © Jones & Bartlett Learning, LL
demographic groups, including college students with
intercept the NOT FOR SALE
stress response in the OR
mindDISTRIBUTION
before it cas- predictable personal NOT FOR
concerns SALE grades,
regarding OR DISTRIBUT
job
cades down as a rush of stress hormones into the body, opportunities, and the stress associated with college
potentially causing damage. life. Although the types of stressors that Holmes and
Rahe observed persist today, the pace of society has
Social Influences
© Jones & Bartlett Learning, LLC moved © to
Jones & Bartlett
warp speed Learning,
to include LLC toxic-
issues of digital
Social
NOT FOR influences
SALEhave
ORlong been the subject of research
DISTRIBUTION ity, cyberbullying,
NOT FOR SALE OR DISTRIBUTIONand
identity theft, opioid addiction,
to explain the plight of individuals who are unable to climate change. With this rapid pace of change, addi-
cope with their given environment. Most notable is tional life issues have reconfigured the proverbial list
the issue of overcrowding and urban sprawl. Classic of “life stressors,” as well as confirmed the deleterious
studies conducted on several species have shown that impact of stress on one’s health.
© Jones & Bartlett
whenLearning,
their numbers LLC © Jones
exceed the territorial boundary of & Bartlett Learning, LLC
At the start of the twenty-first century, comprehen-
NOT FOR SALEeachORanimal,
DISTRIBUTION
despite an abundance of food andNOT water,FOR SALE OR DISTRIBUTION
sive studies conducted by the American Psychological
several seemingly healthy animals die off (Allen 1983).
Association (APA) (2015, 2016, 2019), and National
This need for personal space appears to be universal
Public Radio (NPR), the Robert Wood Foundation,
in the animal kingdom. This includes humans, who
and the Harvard School of Public Health (2014) iden-
likewise begin to show signs of frustration in crowded
© Jones & Bartlett Learning, LLC tified a host of stress indicators, © Jonesconfirming
& Bartlett Learning,
that stress LL
urban areas, traffic jams, long lines at checkout stands,
NOT FOR SALE OR DISTRIBUTION
or whenever their personal space is “invaded.” The
is indeed a health factorNOT FOR
to be SALE
reckoned OR
with. DISTRIBUT
For the
past two decades, the APA has conducted a yearly sur-
origin of this particular social influence may be instinc-
vey titled “Stress in America.” Based on interviews with
tual in nature. Additional social causes of stress include
more than 3,000 people in various demographic groups
financial insecurity, the effects of relocation, cultural
© Jones & Bartlett
assimilation Learning,
issues, some LLCadvances, vio- (e.g.,©gender,
technological Jones income level, generation,
& Bartlett Learning, race,LLC
sexual ori-
entation, etc.), the results have not been promising. The
NOT FOR
lation SALErights,
of human OR DISTRIBUTION
and low socioeconomic status, NOT FOR SALE OR DISTRIBUTION
following are key findings from the 2019 study:
to name but a few. New to the list of social influences
are screen addiction, social media, global warming ■ 71 percent of respondents fear becoming a victim
concerns, and water resource issues as the global pop- of a mass shooting. Nearly one in three cannot
ulation increases, taxing our very lifestyles with regard go anywhere without worrying about death or
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
to scarcity issues. injury from domestic terrorism.
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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 14 Part 1 The Nature of Stress

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FOR■ SALE
62 percent
ORofDISTRIBUTION
respondents are stressed about the been
NOTidentified
FOR SALE as a unifying factor. With 8 out of 10
OR DISTRIBUTION
state of politics in the country and the direction people citing stress as a significant part of their daily
the country is headed. Additionally, 54 percent lives, Gupta concludes that toxic stress is lethal, resulting
are stressed by the responsibility to stay informed. in what is now called “deaths of despair.” Alcoholism,
Listening to and deciphering the national news and subsequent liver disease; opioid addiction; and sui-
© Jones &
are a stressor for a great many people. Bartlett Learning, LLC
cide top © Jones
the list for stress-related deaths. Based& on
Bartlett
his Learning, LL
NOT FOR SALE OR DISTRIBUTION NOT FOR
research, Gupta concludes that chronic stress results SALE OR DISTRIBUT
■ 69 percent of respondents fear problems with
healthcare coverage, losing their healthcare cov- from (1) feelings of instability and a lack of control
erage, paying medical bills, or going into debt over one’s life and (2) the fear of downward mobility
paying medical bills. among the working class. Gupta further states that the
© Jones & Bartlett Learning, LLC American Dream© is illusive,
Jonesand that until social
& Bartlett condi- LLC
Learning,
■ 56 percent of respondents fear climate change and tions change, stress-related mortality rates will continue
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how its implications may impact their lifestyle.
NOT FOR SALE OR DISTRIBUTION
to increase.
■ 44 percent of respondents say that discrimination Chronic stress can be considered the Black Death of
and sexual harassment have interfered with their the twenty-first century. In 2019, the World Health
ability to achieve a full, productive life. Organization
© Jones & Bartlett Learning, LLC © Jones &(WHO) Bartlett cited worksite stress
Learning, LLC as an under-
■ SALE
64 percent lying factor leading to mental, emotional, and physical
NOT FOR ORofDISTRIBUTION
respondents cited economic issues, NOT FOR SALE OR DISTRIBUTION
job and career issues, and personal financial issues burnout, not just in the United States, but all over the
as continual sources of stress. world. The WHO cited three factors associated with
burnout: (1) fatigue and feelings of energy depletion,
■ Nearly 33 percent cited stress associated with
(2) displays of negativity and cynicism toward one’s
hunger (i.e., not having enough &
© Jones to eat).
Bartlett Learning, LLC © Jones & Bartlett Learning, LL
job, and (3) reduced professional efficacy (Chatterjee &
■ More than 9 in 10 of NOT FOR SALE
respondents youngerOR DISTRIBUTION
than Wroth 2019). NOT FOR SALE OR DISTRIBUT
22 years of age cited one or more physical or
Although major life events like getting married
emotional symptoms of stress, including feeling
(FIG. 1.7) or relocating for a new job may be chronic
depressed or sad.
stressors to some, renowned stress researcher Richard
The APA©concluded
Jones &theBartlett Learning,
2019 Stress in AmericaLLCstudy Lazarus hypothesized © Jones & Bartlett
in 1984 Learning, LLC
that the accumulation
by notingNOT that personal sources of stress and American
FOR SALE OR DISTRIBUTION of acute stressors NOT in the FOR
form ofSALE ORhassles,
daily life DISTRIBUTION
such
stress levels remain relatively consistent year to year. as locking one’s keys in the car, playing phone tag, or
Furthermore, they noted that those demographically a driving to work every day in traffic, are just as likely to
part of Generation Z (18 to 22 years), Millennials (23 to adversely affect an individual’s health as the death of a
40 years), or Generation X (41 to 54 years) cited the most spouse. These hassles are often based on unmet expec-
© Jones & compared
stress, Bartlett to Learning,
Baby BoomersLLC(53 to 73 years) and © Jones
tations & Bartlett
that trigger an angerLearning,
response ofLLCsome type, in
NOT FOR SALE OR DISTRIBUTION
older adults (74 years and older). NOT FOR SALE OR DISTRIBUTION
contrast with chronic stressors that more often have an
Although the 2019 study did not specifically enquire association with fear and anxiety. Lazarus defined hassles
about stress management skills, recent Stress in America as “daily interactions with the environment that were
studies have found that effective coping skills are in essentially negative.” He also hypothesized that a bal-
short supply. The conclusions © Jones
drawn from& Bartlett
the 2016 and ance of
Learning, emotional experiences—positive
LLC © Jones emotions and
& Bartlett Learning, LL
2017 surveys underscore the NOT FOR SALE
relationship betweenOR negative
DISTRIBUTION
stress ones—is necessary, and that people who have
NOT FOR SALE OR DISTRIBUT
and disease/illness and highlight the need for people to no exposure to life’s “highs” or emotional uplifts (eus-
harness better stress management skills. tress) are also susceptible to disease and illness. Further
research by Lazarus (1984; Lazarus and DeLongis 1983),
In 2019, CNN medical expert Sanjay Gupta, MD filmed
© Jones
a documentary & Bartlett
for HBO titled OneLearning,
Nation UnderLLC Stress. © Jones & Bartlett Learning, LLC
Richard Lazarus: Renowned stress researcher credited
Gupta used NOT the FOR SALEtoOR
documentary try DISTRIBUTION
to understand why NOT FOR SALE OR DISTRIBUTION
with the concept of “daily life hassles.”
life expectancy in America has fallen so dramatically
over the past several years. In 1997, the United States Daily life hassles: Occasional hassles, like locking
one’s keys in the car, that when combined with many
had one of the highest life expectancy rates in the devel-
other annoyances in the course of a day create a crit-
oped world. Times have changed. Mortality rates in the
© Jones & Bartlett Learning, LLC
United States are on the increase, and toxic stress has
©ical
Jones
mass of&stress.
Bartlett Learning, LLC
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 Chapter 1 The Nature of Stress 15

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FORnoSALE
doubt OR
we will see that a new chapter on this topic

© Inspiration Unlimited. Used with permission.

NOT FOR SALE OR DISTRIBUTION DISTRIBUTION
will be added to the disciplines that examine this power-
ful social dynamic, one that will certainly change many
aspects of work, social interactions, economics, health
practices, communication, and much more in the years
© Jones & Bartlett Learning, LLC to come. Already, mental
© Jones
health & Bartlett
experts Learning, LL
are forecast-
NOT FOR SALE OR DISTRIBUTIONing a dramatic need NOT FOR SALE OR DISTRIBUT
for mental health and self-care
programs to combat the long-term effects and trauma
from the COVID-19 pandemic (Heid 2020). Repeated
news accounts of COVID-19 deaths, social isolation,
© Jones & Bartlett Learning, LLC and other factors& have
© Jones experts
Bartlett warning ofLLC
Learning, a historic
NOT FOR SALE OR DISTRIBUTION mental health crisis with depression,
NOT FOR SALE OR DISTRIBUTION domestic violence,
substance abuse, PTSD, and suicide looming over the
country’s population (Wan 2020) (BOX 1.1).

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
■■ The General Adaptation
NOT FOR SALE OR DISTRIBUTION Syndrome
NOT FOR SALE OR DISTRIBUTION
Following Cannon’s lead early in the twentieth cen-
tury, Hans Selye, a young endocrinologist who cre-
ated a name for himself as a leading researcher in this
© Jones & Bartlett Learning, LLC field, studied the fight-or-flight
© Jones & response,
Bartlettspecifically
Learning, LL
the physiological effects of chronic stress, using rats
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUT
as subjects. In experiments designed to stress the rats,
Selye (1974) noted that several physiological adap-
tations occurred as a result of repeated exposures to
stress, adaptations that had pathological repercussions.
© Jones & Bartlett Learning, LLC © Jones
Examples & stress-induced
of these Bartlett Learning, LLC the
changes included
NOTFIGURE
FOR 1.7
SALE OR DISTRIBUTION
Weddings are supposed to be a joy- NOT FOR SALE OR DISTRIBUTION
following:
ous occasion. However, they can rank near the top
1. Enlargement of the adrenal cortex (a gland that
of one’s list of stressors when planning this event,
with the stress lasting well after the reception when produces stress hormones)
things don’t always go as expected. 2. Constant release of stress hormones (e.g., cortico-
© Jones & Bartlett Learning, LLC © Jones & Bartlett
steroidsLearning, LLC
released from the adrenal cortex)
NOT FOR SALE OR DISTRIBUTION NOT FOR 3.
SALE OR DISTRIBUTION
Atrophy or shrinkage of lymphatic glands (thy-
Ornstein and Sobel (1989), and others has proved that mus gland, spleen, and lymph nodes)
his hypothesis has significant merit regarding stress 4. Significant decrease in the white blood cell count
and disease. As might be expected, the issue of lifestyle
habits, changes,© Jones & Bartlett
and hassles as socialLearning, LLC 5. Bleeding ulcerations
influences has of the stomach
© Jones and colon
& Bartlett Learning, LL
NOT FOR SALE OR DISTRIBUTION
come under attack by those who argue that perception NOT
6. Death of the organism FOR SALE OR DISTRIBUT
or cognition plays an important role in the impact of Many of these changes were very subtle and often went
stressors. Suffice it to say that all stressors, regardless unnoticed until permanent damage had occurred. Selye
of classification, are connected to human well-being in referred to these collective changes as the general adap-
a very profound
© Jones & Bartlettway.Learning,
As observedLLCfrom various disci- © syndrome
tation Jones &(GAS),
Bartlett Learning,
a process LLC
in which the body
NOTplines
FOR (psychology,
SALE OR sociology, physiology, etc.) over the
DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
past decade, the impact of social stressors on personal
stress has grown in significance and continues to greatly General adaptation syndrome: A term coined by
undermine people’s health and well-being. Hans Selye; the three distinct physiological phases in
reaction to chronic stress: the alarm phase, the resis-
Although the data regarding the stressful effects of the
© Jones & Bartlett Learning, LLC © Jones &tance
Bartlett
phase,Learning, LLC phase.
and the exhaustion
COVID-19 pandemic have yet to be studied in earnest,
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 16 Part 1 The Nature of Stress

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
BOX 1.1 Post-traumatic Stress Disorder 101

There is stress, and then there is STRESS! Although Coast wildfires. Violent crime victims, airplane crash
most people claim (even brag) to live stressful lives, survivors, sexual/physical assault victims, and first
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LL
the truth of the matter is that few people encoun- responders (e.g., police officers, fire fighters, and emer-
NOT FOR SALE
ter truly horrific events of death and carnage. The OR gency medical technicians) are also NOT
DISTRIBUTION FOR
prone to this SALE
con- OR DISTRIBUT
repeated horrors of war, however, have notoriously dition. Given the nature of global warming and climate
ranked at the top of every list as the most unbearable change and terrorism, it is suggested that PTSD may
of all stressors that anyone can endure psychologi- become a common diagnosis among world citizens,
cally—and for good reason. To quote Civil War gen- with the ripple effect affecting legions of friends, col-
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
eral William T. Sherman, “War is hell.” These types of leagues, and family members alike. Secondary PTSD is a
NOT FOR SALE OR DISTRIBUTION
events typically include those that threaten one’s life, term given to familyNOT FORfriends,
members, SALEand ORcolleagues
DISTRIBUTION
result in serious physical injury, expose one to hor- who are negatively affected by the ripples of strife from
rific carnage, or create intense psychological shock, loved ones (even patients) who have had direct expo-
all of which are strongly influenced by the intensity sure to severe trauma.
and duration of the devastation
© Jones & Bartlett Learning, LLC either experienced or © Jones
Symptoms of & Bartlett
PTSD Learning,
include chronic anxiety,LLC
nightmares,
observed firsthand. The result is an emotional wound
NOT FOR SALE inOR flashbacks,
NOT FOR SALE OR DISTRIBUTION loss,
insomnia, loss of appetite, memory
embedded theDISTRIBUTION
unconscious mind that is very hard
hypervigilance, emotional detachment, clinical depres-
to heal.
sion, helplessness, restlessness, suicidal tendencies,
Every war seems to have its own name for this type and substance addictions (Mayo Clinic n.d.). Typically,
of anxiety disorder. Somber Civil War soldiers were a person suffering from PTSD has several of these symp-
© Jones
described as having “soldier’s heart.”& Bartlett
Affected Learning,
military toms atLLConce. Whereas symptoms for©some Jones & Bartlett Learning, LL
individuals
personnel returning from World War I were described
NOT FOR SALE OR DISTRIBUTION may last for months, for others PTSD becomes a lifelong
NOT FOR SALE OR DISTRIBUT
as being “shell-shocked,” whereas soldiers and vet- ordeal, particularly if treatment is avoided, neglected,
erans from World War II exhibiting neurotic anxiety or shunned. The key to working with PTSD patients
were described as having severe “battle fatigue” or is to access the power of the unconscious mind by
“combat fatigue.” The term posttraumatic stress dis- identifying deep-seated memories so that they may
© Jones
order, more commonly& Bartlett
shortenedLearning, LLCas be acknowledged ©
to PTSD, emerged andJones & in
released Bartlett
a healthy Learning,
manner LLC
a result of the treatment of returning
NOT FOR SALE OR DISTRIBUTION soldiers from rather than repressed and pushed deeper into
NOT FOR SALE OR DISTRIBUTION the uncon-
Vietnam who seemed to lack the industrial-strength scious mind.
coping skills needed to deal with the hellacious mem-
Specialists who treat patients with PTSD recommend
ories that haunted them both day and night. The
that treatment begin as soon as possible to prevent
disorder was first registered in the Diagnostic and
a worsening effect. Initial treatment (intervention)
© JonesStatistical
& Bartlett Learning,
Manual of Mental LLC
Disorders (DSM) in 1980
is©referred
Jonesto&asBartlett Learning,
critical incident stress LLC
management
NOT FORandSALE
has been
OR theDISTRIBUTION
topic of intense investigation ever NOT FOR SALE OR DISTRIBUTION
(CISM). The purpose of CISM is to (1) significantly
since. Sadly, the wars in Iraq and Afghanistan have
reduce the traumatic effects of the incident and
provided countless case studies for this anxiety dis-
(2) prevent further deep-seated PTSD occurrences.
order today.
Specific treatment modalities include eye movement
Although mortal combat ranks at the top of the list of desensitization and reprocessing (EMDR), counseling,
hellacious experiences, one © Jones & Bartlett
doesn’t have Learning,
to survive a LLCtherapy as a means to promote
and group © Jones & Bartlett Learning, LL
emotional
NOT FOR SALE OR
suicide bomber in the streets of Baghdad to suffer from catharsis. The Gil Institute for Trauma Recovery SALE
DISTRIBUTION NOT FOR and OR DISTRIBUT
PTSD. Survivors and rescue workers of the World Trade Education (gilinstitute.com) also cites art therapy,
Center and Pentagon catastrophes are known to still journal writing, and hypnosis as complementary cop-
be dealing with this trauma, as are several thousands ing skills for emotional catharsis. Many patients are
of people still displaced from the wrath of Hurricanes also prescribed medications. Although medications
Katrina©and
Jones
Harvey,&notBartlett Learning,
to mention LLCof may help reduce anxiety,
the devastation © Jones note&that
Bartlett
they doLearning,
not heal LLC
NOT FOR SALE OR DISTRIBUTION
towns in the paths of Category 5 tornadoes and West emotional wounds. NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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 Chapter 1 The Nature of Stress 17

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
tries to accommodate
NOT FOR SALE OR DISTRIBUTION stress by adapting to it. From
NOThisFORethic—work
SALE ORequals worth—so strong in the United
DISTRIBUTION
research, Selye identified three stages of the GAS: States, the greatest lion’s share of stress was associated
Stage 1: Alarm reaction: The alarm reaction describes with one’s job, career, and means to make a living, as
Cannon’s original fight-or-flight response. In this many people suffered massive student load debt and
stage, several body systems are activated, p­ rimarily lived in the basements of their parents’ homes. Stress
© Jones & Bartlett Learning,
the nervous system and the endocrine system, fol- LLC grabbed the national©headlines
Jones & BartlettsoLearning,
repeatedly, much LL
NOT FOR SALE OR DISTRIBUTION
lowed by the cardiovascular, pulmonary, and mus- NOT FOR SALE OR
so that it became nicknamed the “black death” of the DISTRIBUT
culoskeletal systems. Like a smoke detector alarm 21st century by many in the United States and abroad
going off at night, all senses are put on alert until the (Perman 2013). Cries for work-life balance could be
danger is over. heard from all corners of corporate America. Millennials
© Jones and Gen Zs have &notBartlett
fared wellLearning,
with job stress. A survey
Stage & Bartlett
2: Stage Learning,
of resistance: In theLLC
stage of resistance, © Jones LLC
NOT the FOR SALE OR DISTRIBUTION published
NOT FOR SALE OR DISTRIBUTIONthat
by Mindsharepartners.org (2019) found
body tries to revert to a state of physiological
half of Millennials and 75 percent of Gen Zs left a job
calmness, or homeostasis, by resisting the alarm.
partially for mental health reasons (Hibbs and Rostain
Because the perception of a threat still exists, how-
2018). And while people in these demographics are more
ever, complete homeostasis is never reached. Instead,
comfortable about admitting mental health issues, they
© Jones & BartletttheLearning,
body stays activated
LLC or aroused, usually at©a lesser Jones &areBartlett
also moreLearning,
susceptible toLLC
social media stress leading
intensity
NOT FOR SALE OR DISTRIBUTION than during the alarm stage but enough to
NOT FORtoSALE OR DISTRIBUTION
issues of isolation and alienation; the precursors for
cause a higher metabolic rate in some organ tissues.
depression (McMaster 2020).
One or more organs may in effect be working over-
time and, as a result, enter the third and final stage. The American Psychological Association’s 2019 annual
report, “Stress in America,” found that 91 percent of
Stage 3: Stage of exhaustion:
© Jones The stage
& Bartlett of exhaustion
Learning, LLC Generation Z noted physical
© Jones & Bartlett
and/or emotionalLearning,
symp- LL
occurs when one (or more) of the organs targeted
NOT FOR SALE OR DISTRIBUTIONtoms of stress including NOT FOR SALE
depression, anxiety,OR
andDISTRIBUT
frus-
by specific metabolic processes can no longer meet
tration. Gun violence, constant political bickering and
the demands placed upon it and fails to function
partisanship, economic uncertainty, ecological dystopia,
properly. This can result in death to the organ and,
and social media influences all played a role in this new
depending on which organ becomes dysfunctional
FIG. 1.8). It was learned through the
© Jones & Bartlett
(e.g., the Learning,
heart), possibly the death LLC
of the organism. Jones (&
stress©equation Bartlett Learning, LLC
2019 APA stress survey that members of Generation Z
NOT FOR
Selye’s GAS SALE ORthe
outlined DISTRIBUTION
parameters of the physiolog- NOT FOR SALE OR DISTRIBUTION
have high levels of loneliness, often substitute social
ical dangers of stress. His research opened the doors to media relationships for actual friendships and support
understanding the strong relationship between stress groups, are under constant bombardment of negative
and disease and the mind-body-spirit equation. In addi- self-comparisons, and carry an attitude that underlies
tion, his work
© Jones & Bartlett Learning, LLC laid the foundation for the utilization of
© Jones & Bartlettperfectionism
“destructive Learning, and LLC all-or-none thinking” all
NOT FOR SALErelaxation techniques that have the ability to intercept
OR DISTRIBUTION NOT FORofSALEwhich contributes to poor mental health and creates a
OR DISTRIBUTION
the stress response, thereby decreasing susceptibility to cloud of chronic stress (Hibbs and Rostain 2018).
illness and disease. Congruent with standard medical
With the lockdowns and self-quarantine imposed as a
practice of his day (and even today), initial stress man-
result of the COVID-19 pandemic, people had time to
agement programs were geared toward reducing or
eliminating the © symptoms
Jones &ofBartlett Learning,this
stress. Unfortunately, LLC © Jones & Bartlett Learning, LL
NOT FOR SALE
approach has not always proved successful. OR DISTRIBUTION NOT
Alarm reaction: The first FOR
stage SALE
of Selye’s OR DISTRIBUT
general
adaptation syndrome, in which a threat is perceived
■■ Stress in a Changing World and the nervous system is triggered for survival.
Stage of resistance: The second stage of Selye’s gen-
Before the coronavirus pandemic of 2020, it was easy eral©adaptation syndrome, in which the bodyLLC
tries to
© Jones & people
to see that Bartlett
livedLearning,
very stressedLLC
lives as they gazed Jones & Bartlett Learning,
recover.
NOT FOR SALE OR DISTRIBUTION
incessantly at their devices at all hours of the day. Gallup NOT FOR SALE OR DISTRIBUTION
Stage of exhaustion: The third and final stage of
Poll surveys, NPR reports, and American Psychological Selye’s general adaptation syndrome, in which one or
Association studies all pointed to a perfect storm of stress more target organs show signs of dysfunction.
with severe health implications. With the Puritan work
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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 18 Part 1 The Nature of Stress

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
would be right. Millennials are considered to be far

© Inspiration Unlimited. Used with permission.

NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
more stressed than the baby boomer generation or even
members of Generation X (40 to 54 years). The back-
story on this answer is a bit more complex than the daily
statistics of unemployment figures and unpaid college
© Jones & Bartlett Learning, LLCExperts often cite overprotective
loan debt. © Jonesparenting
& Bartlett Learning, LL
NOT FOR SALE OR DISTRIBUTION NOT FOR
styles (helicopter parents) of the Millennials and Gen SALEZ’s OR DISTRIBUT
as a primary reason. Unlike Baby Boomers, typically,
both parents of Millennials and Gen Z’s have jobs/
careers. The end result is less time with their children.
© Jones & Bartlett Learning, LLC Guilt kicks in, and © parents
Jonesovercompensate with poor LLC
& Bartlett Learning,
NOT FOR SALE OR DISTRIBUTION boundaries. Campus counseling centers across
NOT FOR SALE OR DISTRIBUTION the coun-
try see a theme among Millennials walking in the door.
“There is a generation of kids, now adults, who were
given everything on a silver platter as they were grow-
ing up. Everything has been given to them, fostering a
© Jones & Bartlett Learning, LLC
FIGURE 1.8 Although most Americans admit to
© Jones
false sense of&entitlement.
Bartlett Learning, LLCknow how
These kids don’t
NOT FOR beingSALE OR DISTRIBUTION
very stressed, in comparison to half the plane- NOT
to FOR SALE(Neu
fail successfully” OR 2013).
DISTRIBUTION
Millennials not only
tary citizens who earn less than $2 per day and strug- have poor coping skills when faced with adversity, but
gle to survive with substandard living conditions, we also feel that professional counseling provides no lasting
have it pretty darn good! help (Ferri 2013). In a cover story for Time magazine,
© Jones & Bartlett Learning, reporterLLC Joel Stein described the © rampant
Jonesimpatient,
& Bartlett Learning, LL
NOT FOR SALE narcissistic
OR DISTRIBUTION micro-celebrity status (i.e., 15 minutes
NOT FOR SALE of OR DISTRIBUT
examine lifestyle choices, and many people, as observed
fame) as the gateway to entitlement (Stein 2013).
with repeated memes on social media, began to ques-
tion if they really wanted to return to a fast-paced,
tech-heavy lifestyle. Some people enjoyed working ■■ Stress and Insomnia
from home © instead
Jonesof&spending
Bartlett oneLearning,
to two hoursLLCa day Muscle tension may be the number
© Jones & Bartlettone symptom
Learning, of LLC
commuting in traffic. As mentioned
NOT FOR SALE OR DISTRIBUTION previously, what stress, but in our ever-present, demanding
NOT FOR SALE OR DISTRIBUTION 24/7 society,
new changes await Americans and the rest of the world insomnia runs a close second. Insomnia is best defined
as we adapt to the “new normal” in a post pandemic as poor-quality sleep, abnormal wakefulness, or the
world are yet to be seen. It is fairly certain that with inability to sleep, and it can affect anyone. Americans
more change there will be more frustrations, anxieties, are not getting enough sleep, and many more are suffer-
© Jones
and & Bartlett
stress Learning,
as everyone LLC to new stress in an ing
learns to adapt © Jones
from poor &quality
Bartlett Learning,
sleep. LLCbut say that
Estimates vary,
NOT FOR SALE
uncertain and OR DISTRIBUTION
rapidly changing world. NOT
30% FORof SALE
to 60% OR
people are DISTRIBUTION
affected, depending on studies
Stress, it seems, knows no age, race, gender, religion, conducted and polls taken, but the general consensus is
nationality, or socioeconomic class. For this reason, it is that lack of sleep is a serious health issue for Americans,
called “the equal opportunity destroyer,” because when with quality sleep becoming another aspect of self-care
that needs attention. The National Sleep Foundation
© Jonesall
left unresolved, stress can undermine & aspects
Bartlett Learning,
of your LLC © Jones & Bartlett Learning, LL
life. Although it may seemNOT that stress becomes conducts a survey every year, with the most recent find-
FOR SALEa OR critical
DISTRIBUTION NOT FOR SALE OR DISTRIBUT
ings (2020) revealing that Americans feel sleepy during
mass in your life once you leave home and go to college,
the truth is that the episodes and behaviors associated the day (typically three days a week), impacting activ-
with stress start much earlier than the college years. ities, mood, mental acuity, and productivity (National
Pressures in high school, even grade school, as evidenced Sleep Foundation 2020).
© Jones & Bartlett Learning, LLC
by school shootings, cases of self-injury, cyberbullying,
© Jones & Bartlett Learning, LLC
Does your stress level affect your sleep quality? Even
NOT are
and insomnia, FOR SALE
well OR DISTRIBUTION
documented. Combined with if you sleep well, NOT FOR
it is hard SALE
these ORtoDISTRIBUTION
days not notice the
the stress of high technology, the effects are exponential.
Which demographic group carries the most stress in Insomnia: Poor-quality sleep, abnormal wakefulness,
the United States these days? If you said the Millennial or the inability to sleep.
© Jones & Bartlett
generation (peopleLearning,
between theLLC
ages of 22 and 38), you © Jones & Bartlett Learning, LLC
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 Chapter 1 The Nature of Stress 19

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proliferation of advertisements for sleep prescriptions,

© Randy Glasbergen. Used with permission from www.glasbergen.com.

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suggesting a serious public health concern.
Numerous studies have concluded that getting a good
night’s sleep on a regular basis is essential for optimal
health, whereas chronic &
© Jones insomnia
Bartlettis often associated
Learning, LLC © Jones & Bartlett Learning, LL
with several NOTkinds FOR
of psychiatric problems
SALE OR DISTRIBUTION (Walker NOT FOR SALE OR DISTRIBUT
2018). Emotional stress (i.e., preoccupation with daily
stressors) is thought to be a primary cause of insomnia.
The result of emotional stress is an anxious state of mind
where thoughts race around, ricocheting from brain cell
© Jones & Bartlett
to brain cell, Learning,
never allowing a pauseLLC
in the thought pro- © Jones & Bartlett Learning, LLC
NOT FOR
cesses, SALE
let alone OR DISTRIBUTION
allowing the person to nod off. NOT FOR SALE OR DISTRIBUTION
Many other factors (“sleep stealers”) detract from one’s
sleep hygiene, which can affect the quality of sleep,
including hormonal changes (e.g., premenstrual syn-
© Jones & Bartlett
drome,Learning,
menopause), LLC excessive caffeine intake, © Jones
little or & Bartlett Learning, LLC
NOT FOR SALEnoOR DISTRIBUTION
exercise, frequent urination, circadian rhythmNOT distur-FOR SALE OR DISTRIBUTION
bances (e.g., jet lag), shift work, medication side effects, slumber still baffles scientists. From all appearances,
and a host of lifestyle behaviors (e.g., social media, sleep promotes physical restoration. However, when
Internet use, binge-watching, video games, alcohol con- researchers observe sleep-deprived subjects, it’s the
sumption, constant smartphone use) that infringe on a mind—not the body—that is most affected, with symp-
© Jones & Bartlett Learning, LLC toms of poor concentration, © Jones poor&retention,
BartlettandLearning,
poor LL
good night’s sleep.
NOT FOR SALE OR DISTRIBUTIONproblem-solving skills.NOT FOR SALE OR DISTRIBUT
How much sleep is enough to feel recharged? Generally
speaking, 8 hours of sleep is the norm, although some Insomnia is categorized in three ways: transient (short
people can get as few as 6 hours of sleep and feel fully term, lasting 1 or 2 weeks), intermittent (occurs on and
rested. Others may need as much as 10 hours. New off over a prolonged period), and chronic (the ­inability
© Jones & Bartlett Learning, LLC
findings suggest that adolescents, including all people © Jones
to achieve & Bartlett
a restful night of Learning, LLC many
sleep over many,
NOTup FOR
to age SALE
22, needOR moreDISTRIBUTION
than 8 hours of sleep a night months).
NOTAlthough
FOR SALE each ofORtheseDISTRIBUTION
categories is problem-
(Dawson 2005). atic, chronic insomnia is considered the worst.

Not only can stress (mental, emotional, physical, or spiri- All-nighters, exam crams, late-night parties, and mid-
tual) affect quality and quantity of sleep, but the rebound night movies are common in the lives of college under-
© Jones & Bartlett
effectLearning,
of poor sleepLLC © mak-
can, in turn, affect stress levels, Jones &graduates,
BartlettbutLearning,
the cost of LLC
these behaviors is often too
NOT FOR SALEing OR theDISTRIBUTION NOT FOR SALE OR DISTRIBUTION of people who seem
poor sleeper become more irritable, apathetic, high. Unfortunately, the population
or cynical. Left unresolved, it can become an unbroken to need the most sleep but often get the least amount
cycle (negative feedback loop). Although many people are adolescents younger than age 20.
seek medical help for insomnia and are often given a Although sleep may be relaxing, it is important to
prescription, drugs should be considered a last resort. remember that sleeping is not a relaxation technique.
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LL
Many (if not all) techniques for stress management have Studies show that heart rate, blood pressure, and mus-
NOT FOR SALE OR DISTRIBUTION
proven to be effective in promoting a good night’s sleep,
NOT FOR SALE OR DISTRIBUT
cle tension can rise significantly during the dream state
ranging from cardiovascular exercise to meditation. of sleep. What we do know is that effective coping and
The field of sleep research began in earnest more than relaxation techniques greatly enhance one’s quality of
60 years ago. Yet, despite numerous studies, the reason sleep (Seaward 2016).
© Jones & Bartlett Learning, LLC
why we spend approximately one-third of our lives in
© Jones & Bartlett Learning, LLC
The following are a few suggestions for improving sleep
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
quality:
1.
Avoid drinking any beverages with caffeine after
Sleep hygiene: Factors that affect one’s quality
6:00 p.m., as the effects of caffeine on the nervous
of sleep, such as hormonal changes, shift work, or
excessive caffeineLLC
intake. system promote a stress response rather than a
© Jones & Bartlett Learning, © Jones & Bartlett Learning,
relaxation effect. LLC
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 20 Part 1 The Nature of Stress

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2. SALE
NOT FOR Daily physical exertion (e.g., cardiovascular exer-
OR DISTRIBUTION NOTand
FORsiblings
SALE are OR
yourDISTRIBUTION
roommates can become its
cise) is a great way to ensure a good night’s sleep. own form of stress.
3.
Keep a regular sleep cycle. Make a habit of going ■ P rofessional pursuits: What major should I choose?
to bed at the same time every night (within Perhaps one of the most common soul-­searching
15 minutes) and waking up about
© Jones the same time
& Bartlett questions to be asked in the
Learning, LLC college &
© Jones years is,
Bartlett Learning, LL
each morning (even NOTon weekends).
FOR SALE OR DISTRIBUTION “What do I want to do the rest of my life?”
NOT FOR SALE It is a OR DISTRIBUT
4. Enhance your sleep hygiene. Create a sleep- well-known fact that college students can change
friendly environment where bright light and majors several times in their college careers, and
noise are minimized or completely eliminated many do. The problem is compounded when
and sheets, pillows, and comforters easily lull you there is parental pressure to move toward a spe-
© Jones & Bartlett Learning, LLC cific career ©path
Jones(e.g., &lawBartlett Learning,
or medicine) or the LLC
to slumberland.
NOT FOR SALE OR DISTRIBUTION desire to pleaseNOTyour FOR SALE
parents OR DISTRIBUTION
by picking a major
5. Avoid screen time right before you go to bed. that they like but you don’t.
Instead, try reading, or better yet, meditating.
■ Academic deadlines (exams, papers, and projects):
6. Honor a media curfew by not using your screen Academics means taking midterms and finals,
© Jones &devices
Bartlett 8:00 p.m. to LLC
afterLearning, allow your pineal gland © Jones
writing&research
Bartlett Learning,
papers, LLC projects.
and completing
to make the sleep
NOT FOR SALE OR DISTRIBUTION hormone melatonin. NOTThisFOR SALE
is, after all, OR DISTRIBUTION
the hallmark of measuring what
7. Make your bedroom a tech-free zone. Avoid you have learned. With a typical semester load of
using your smartphone and/or tablet in the bed- 15 to 20 credits, many course deadlines can fall on
room, even as an alarm clock, and turn off your the same day, and there is the ever-present danger
Wi-Fi router before © youJones
crawl under the covers. that not meeting expectations can result in poor
& Bartlett Learning, LLC © Jones & Bartlett Learning, LL
grades or academic probation.
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUT
College Stress ■ F
 inancial aid and school loans: If you have ever
What makes the college experience a significant depar- stood in the financial aid office during the first
ture from the first 18 years of life is the realization that week of school, you could write a book on the
with the freedom of lifestyle choices comes the respon- topic of stress. The cost of a college education is
© Jones & Bartlett Learning, LLC © Jones
skyrocketing, & Bartlett
and the pressure Learning,
to pay off school LLC
sibility that goes with it. Unless you
NOT FOR SALE OR DISTRIBUTION live at home while NOT FORcan SALE
attending school, the college experience is one in which loans after graduation make OR DISTRIBUTION
you feel like an
you transition from a period of dependence (on your par- indentured servant. Assuming you qualify for
ents) to independence. As you move from the known into financial aid, you should know that receiving the
the unknown, the list of stressors a college student expe- money in time to pay your bills can be challeng-
© Jones & Bartlett
riences Learning,
is rather startling. Here isLLC
a sample of some of the ing. Problems
© Jones are compounded
& Bartlett Learning,when LLCyour course
NOT FOR SALE OR
more common DISTRIBUTION
stressors that college students encounter. NOT FOR SALE OR DISTRIBUTIONrecords
schedule gets expunged from computer
because your financial aid check was 2 weeks late.
■ Roommate dynamics: Finding someone who is These are just some of the problems associated
compatible is not always easy, especially if you with financial aid.
had your own room in your parents’ house. As we
■ 
Budgeting your money: It’s one thing to ask your
all know, or you may © quickly
Joneslearn,
& Bartlett Learning,
best friends LLC © Jones & Bartlett Learning, LL
do not make the bestNOT roommates, yet roommates parents to buy you some new clothes or have
FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUT
them pick up the check at a restaurant. It’s quite
can become good friends over time. Through
it all, roommate dynamics involve the skills of another when you start paying all your own bills.
compromise and diplomacy under the best and Learning to budget your money is a skill that
worst conditions. And should you find yourself takes practice. And learning not to overextend
© Jones & Bartlett Learning,
in an untenable situation, remember that cam-
LLC © Jones
yourself is not & Bartlett
only a skill, but also anLearning,
art. At some LLC
NOT FOR SALE OR DISTRIBUTION
pus housing does its best to accommodate stu- time or NOT
another, FOR
everyone SALE
bouncesOR a DISTRIBUTION
check. The
dents and resolve problems. However, their time trick to avoid doing it is not to spend money you
schedule and yours may not always be the same. do not have and to live within your means.
For those college students who don’t leave home, ■ 
Lifestyle behaviors: The freedom to stay up until
© Jones & Bartlett Learning, LLC
living as an adult in a home in which your parents © Jones
2 a.m. &
onBartlett
a weekday,Learning,
skip a class, LLC
eat nothing but
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 Chapter 1 The Nature of Stress 21

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NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Stress with a Human Face

© Inspiration Unlimited. Used with permission.

Joseph Ramos© Jones
has just&started
Bartlett his Learning,
first year at LLC
the He is well aware that©being Jones & Bartlett Learning, LL
NOT
University of FORBoulder.
Colorado SALELike ORnearly every other voted senior prom kingNOT
DISTRIBUTION proba-FOR SALE OR DISTRIBUT
freshman, a million thoughts filter through his mind daily bly won’t carry much weight in
regarding this stage of his life: the right college major, college. For better or worse, the college years are a time
new friends, finding a girlfriend, grades, a tendency to to prove, if not reinvent, yourself all over again. Joseph
procrastinate, roommate dynamics, budgeting his money, welcomes this challenge. Currently, Joseph’s strategy to
© Jones & Bartlett
volunteer Learning,
work, and time LLC
to do all the © Jones
things that he loves cope with & levels
his stress Bartlett Learning,
includes running andLLClifting
NOT whenFORnot SALE ORWith
studying. DISTRIBUTION
a physique and body composi- weights. NOT FOR
He also has SALE
a passionOR DISTRIBUTION
for the martial arts. These
tion that most college men would envy, Joseph is already activities have helped him get through high school and a
worried about packing on the “freshman 15” ­(undesired few family crises, but he realizes that he will need a few
weight gain), and he is determined not to let that hap- more stress management strategies to support his study
pen. In high school, Joseph played football, track, and habits in college if he is to achieve the desired grades
© Jones & Bartlettcross-country.
Learning,HeLLC also was involved in student©govern-
Jones to& get
Bartlett Learning,
into medical school soLLC
that he can achieve his
NOT FOR SALE OR mentDISTRIBUTION
and was a member of the National HonorNOT FORlifelong
Society. SALE ORofDISTRIBUTION
dream becoming a physician.

junk food, or take an impromptu road trip car- redefine your values, your friends, like you, will
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LL
ries with it the responsibilities of these actions. change, and so will the quality of each friendship.
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUT
Independence from parental control means bal- Cultivating a quality relationship takes time,
ancing freedom with responsibility. Stress enters meaning you cannot be good friends with every-
your life with a vengeance when freedom and one you like. In addition, tensions can quickly
responsibility are not balanced. mount as the dynamics between you and those in
© Jones
■ P
& Bartlett
 eer groups andLearning,
peer pressure LLC
(drugs and alcohol): ©your
Jones
close & Bartlett
circle Learning,
of friends LLC
come under pressure
NOT FOR SALE
There OR DISTRIBUTION
is a great need to feel accepted by new NOT
from FOR
all the SALE OR DISTRIBUTION
other college stressors.
acquaintances in college, and this need often ■ Intimate relationships: Spending time with one
leads to succumbing to peer pressure—and in special person with whom you can grow in love
new environments with new acquaintances, peer is special indeed. But the demands of an intimate
pressure can
© Jones & Bartlett Learning, LLC be very strong. Stress arises when the
© Jones & Bartlett Learning,
relationship LLC
are strong, and in the presence of a
NOT FOR SALE OR actions of the group are incongruent with
DISTRIBUTION NOTyourFOR SALE college
ORenvironment,
DISTRIBUTION intimate relationships are
own philosophies and values. The desire to con- under a lot of pressure. If and when the relation-
form to the group is often stronger than your will- ship ends, the aftershock can be traumatic for one
power to hold your own ground. or both parties, leaving little desire for one’s aca-
■ Exploring demic pursuits.
© sexuality:
Jones & While high school
Bartlett is the time
Learning, LLC © Jones & Bartlett Learning, LL
when some people explore their sexuality, this
NOT FOR SALE OR DISTRIBUTION ■ Starting a professional NOTcareer
FORpath:SALEIt’s aOR
myth that
DISTRIBUT
behavior occurs with greater frequency during the you can start a job making the same salary that
college years, when you are away from the confines your parents make, but many college students
of parental control and more assertive with your believe this to be true. With this myth comes the
self-expression. With the issue of sexual explora- pressure to equal the lifestyle of one’s parents the
© Jonestion & come
Bartlett Learning,
questions of values, LLC
contraception, preg- ©dayJones & Bartlett Learning, LLC
after graduation. (This may explain why so
NOT FOR SALE
nancy, sexualOR DISTRIBUTION
orientation, HIV and other sexually NOT
many collegeSALE
FOR ORreturn
graduates DISTRIBUTION
home to live after
transmitted infections (STIs), abortion, acceptance, graduation.) The perceived pressures of the real
and impotence, all of which can be very stressful. world can become so overwhelming that college
 
■ Friendships: The friendships made in college take seniors procrastinate on drafting a resume or ini-
© Jones & Bartlett Learning,
on a special LLC
quality. As you grow, mature, © Jones
and & Bartlett Learning,
tiating the job search LLC
until the week of graduation.
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 22 Part 1 The Nature of Stress

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For the
NOT FOR nontraditional
SALE college student, the problem can
OR DISTRIBUTION The
NOT field of medicine,
FOR SALE strongly influenced by Newtonian
OR DISTRIBUTION
be summarized in one word: balance! Trying to balance physics, applied the mechanistic model to the human
a job, family, and schoolwork becomes a juggling act organism, comparing the body to a clock as well. This
extraordinaire. In attempting to satisfy the needs of your applied paradigm, during what Dr. Larry Dossey often
supervisor, colleagues, friends, spouse, children, and par- calls “Era I medicine,” focused on symptoms of dysfunc-
© Jones & Bartlett
ents (and perhaps even pets), what usually is squeezed Learning, LLC
tion, and © Jones
like a watch repairman, physicians were&trained
Bartlett Learning, LL
NOT FOR SALE
out is time for yourself. In the end, everything seems OR to fix or repair any parts that were broken. Drugs and OR DISTRIBUT
DISTRIBUTION NOT FOR SALE
to suffer, particularly your health. Often schoolwork is surgery became the two primary tools forged in the dis-
given a lower priority when addressing survival needs, cipline of clinical medicine. Prime examples of the fix-
and typically this leads to feelings of frustration over the or-replace method include prescribing penicillin for an
inadequacy of time and effort available
© Jones & Bartlett Learning, LLC for assignments infection or transplanting
© Jones a damaged
& Bartlettorgan.Learning,
The appli- LLC
or exams.NOTOf course, there are other stressors
FOR SALE OR DISTRIBUTION that cross cation of this mechanistic model in medicine
NOT FOR SALE OR DISTRIBUTION essentially
the boundaries between work, home, and school, all of stripped the responsibility of healing from the patient,
which tend to throw things off balance as well. placing it completely into the hands of the attending
physician(s). There is no denying that many advances in
■■ A Holistic Approach to Stress
© Jones & Bartlett Learning, LLC
clinical medicine have been nothing less than astonish-
© Jones &example,
Bartlettheart
Learning,
ing. Take, for and liver LLC
transplants and
Management
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
total hip replacements. Yet along with these magnificent
When the stress response was first recognized, much achievements are significant limitations and hazardous
attention was given to the physical aspects of the side effects. Today, medicine is aptly referred to as an
dynamics involved with the fight-or-flight response, art as well as a science, but in the mechanistic model
specifically the symptoms of stress. As this field of
© Jones & Bartlett Learning,study of reality,
LLCanything that cannot be©measuredJones or & quan-
Bartlett Learning, LL
expanded to explore the relationship between stress and tified is still virtually ignored. Moreover, anything that OR DISTRIBUT
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE
disease, it began to overlap, and to some extent even cannot be scientifically explained by cause and effect
merge, with the fields of psychology, sociology, theol- is dismissed as superstition and regarded as invalid.
ogy, anthropology, physics, health, and clinical medi- What this medical paradigm failed to include was the
cine. What was once thought to be a physical response, dimension of the human spirit, an unmeasurable source
and then©referred
Jonesto&asBartlett
a mind-body Learning,
phenomenon, LLC is of energy with a © Joneshealing
potential & Bartlett
power Learning,
all its own. LLC
NOTto FOR
now thought SALE OR
be a complex, DISTRIBUTION
multifaceted, or holistic The human spiritNOT is nowFOR SALE so
considered OR DISTRIBUTION
important by
phenomenon involving the mental, physical, emotional, the WHO that it issued a statement that, “The existing
and spiritual components of well-being. Looking at ­definition of health should include the spiritual aspect,
stress from these four different perspectives may explain and that health care should be in the hands of those
why there are so many definitions of it. Ironically, these
© Jones
new&insights
BartletthaveLearning, LLCtension within the who
generated some
are fully aware of and sympathetic to the spiritual
© Jones & Bartlett Learning, LLC
dimension” (World Health Organization 1991).
NOT FOR SALE OR
healthcare community. DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
Medical science is slowly experiencing a paradigm shift.
A paradigm is a conceptual model used to understand a Paradigm shift: Moving from one perspective of real-
ity to another.
common reality. A shift is a change in the perception of
that reality. For the past 375©years
Jonesor so,&Western
Bartlett Learning,
culture RenéLLC © Jones
Descartes: Seventeenth-century scientist& Bartlett Learning, LL
and
NOT FOR SALE OR
has adopted a mechanistic model of reality, influenced in philosopher
DISTRIBUTION credited with the reductionist
NOT method
FOR SALE OR DISTRIBUT
of Western science (also known as the Cartesian prin-
large part by the philosophy of René Descartes that the
ciple). He is equally renowned for his influential phi-
mind and body are separate, and by the laws of physics losophy of the separation of mind and body as well as
outlined by Isaac Newton, some of which are believed the statement, “I think, therefore I am.”
to have been inspired
© Jones & by Descartes.
Bartlett The mechanistic
Learning, LLC © Jones & Bartlett
Isaac Newton: Eighteenth-century physicistLearning,
who LLC
paradigmNOT compares
FORtheSALE
universe
OR andDISTRIBUTION
all its components NOT FOR SALE OR DISTRIBUTION
advocated the mechanistic paradigm of the universe,
to a large mechanical clock, where everything operates which others then adapted to the human body.
in a sequential and predictable form. When it was first
Mechanistic model: A health model based on the
developed, the mechanistic model, also called the reduc- concept that the body is a machine with parts that
tionist model, seemed to logically explain nearly every
© Jones & Bartlett Learning, LLC
phenomenon. ©can be repaired or replaced.
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 Chapter 1 The Nature of Stress 23

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Congress, https://www.loc.gov/item/2004671908/.
© Courtesy of Turner, O. J., photographer. (ca. 1947) Albert Einstein, -1955. , ca. 1947. [Photograph] Retrieved from the Library of
www.metmuseum.org.
© Courtesy of The Jefferson R. Burdick Collection, Gift of Jefferson R. Burdick; The Metropolitan Museum of Art. Visit
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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LL

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LL

NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUT
FIGURE 1.9 Sir Isaac Newton (left), along with René Descartes, is credited with what is now referred to as the
mechanistic approach to scientific thinking, which is based on the idea that the universe operates like a large
mechanical clock. Albert Einstein (right) supported a different theory, called unified field theory, suggesting that
the universe is a living web, validating the ancient whole systems theory in which everything is connected together
© Jones
and the&whole
Bartlett Learning,
is greater LLC
than the sum of the parts. © Jones & Bartlett Learning, LLC
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The Newtonian paradigm was viewed as the ultimate Although current medical technology is incredibly
truth until the turn of the twentieth century, when a sophisticated, physicians, for the most part, still view the
young physicist
© Jones & Bartlett Learning, LLC named Albert Einstein introduced
© Jones & human body as
Bartlett a clock withLLC
Learning, fixable or replaceable parts.
NOT FOR SALEhis ORtheory of relativity in 1905 (FIG. 1.9). InNOT
DISTRIBUTION simpleFORInSALE
other words, the basic approach to modern medicine
OR DISTRIBUTION
terms, Einstein said that all matter is energy, and fur- in the Western world has not changed in more than
thermore, that all matter is connected at the subatomic 375 years. Furthermore, the mind and body, so com-
level. No single entity can be affected without all con- pletely separate in Descartes’s theory, are still treated
necting parts similarly being affected. From Einstein’s separately, not as one living system. The idea of a mind-
© Jones
view, the universe isn’t a & Bartlett
giant clock butLearning, LLC body connection (which
a living web. © inJones & Bartlett
rare cases Learning, LL
appears powerful
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New ideas are often laughed at, and old ideas die hard. NOT FOR SALE OR
enough to make cancers go into spontaneous remission) DISTRIBUT
But as new truths unfold, they gather curious follow- is still as foreign a concept to many physicians today
ers who test and elaborate on the original idea. Initially as the idea of a smartphone would have been to the
mocked, the complexities of Einstein’s theory have founders of the United States more than 240 years ago.
gained appreciation among
© Jones & Bartlett Learning, LLC physicists today, leading to © Jones & Bartlett Learning, LLC
NOTtheFOR
frontiers
SALEof the
ORnew field of quantum physics and
DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
a whole new understanding of our universe in what Albert Einstein: World-renowned theoretical phys-
icist who revolutionized perceptions of reality with
is now called the whole systems theory. In his attempt
the equation E = mc2, suggesting that everything is
to understand the big picture, one of Einstein’s more
energy. In his later years he focused on a spiritual
colorful quotes states, “Gravity is not responsible for
© Jones & Bartlett Learning,
people LLC
falling in love.” © Jones & philosophy, including pacifism.
Bartlett Learning, LLC
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 24 Part 1 The Nature of Stress

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But new
NOT FOR ­discoveries
SALE in the field of medicine have not
OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
Spiritual
fit so nicely into the concept of mechanical clock or intellec
Physical al (
reductionist theory. Instead, they mirror Einstein’s con- Spiritual Emotional nt t

ua
Me
cept of an intricate network of connecting systems. As well-being well-being

l)
a result, standard concepts regarding health and disease
are slowly beginning to give© Jones
way to & Bartlett
a more Learning,Mental
inclusive LLC Physical © Jones & Bartlett Learning, LL
(intellectual) well-being
NOT FOR SALE OR
reality or paradigm. As an example, medical research- DISTRIBUTION
well-being NOT FOR SALE OR DISTRIBUT
ers have substantiated that stressed-based emotions can, Emotional
indeed, suppress the immune system (Mehar 2018), an Model A Model B
idea thought to be inconceivable and ludicrous not long
ago. The body-as-machine
© Jones & Bartlettmentality no longer seems
Learning, LLCto FIGURE 1.10 Two © Jones & Bartlett
different approaches Learning,
to the well- LLC
answer allNOTthe questions posed about the
FOR SALE OR DISTRIBUTION human organ- ness paradigm. In Model A, expounded by
NOT FOR SALE OR DISTRIBUTIONElisabeth
ism, and thus some issues, like subtle energy systems Kübler-Ross, all components are present in the human
and the placebo effect, are being completely reexamined organism, but each holds specific dominance at differ-
as a part of the bigger health picture. ent phases of the individual’s growth cycle. The emo-
tional aspect is the first to develop; the spiritual aspect
But old
© Jones paradigmsLearning,
& Bartlett are not abandoned
LLC until new concep- ©is Jones & Model
the last. In Bartlett Learning,
B, each component isLLCsuperim-
tual models are created and established. Ironically, some posed on the others in a holographic form, yet it is the
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
new paradigms are actually old concepts that have been spiritual component in which they are all contained.
dusted off and resurrected. Such is the case with a very
old but newly rediscovered health paradigm strongly
paralleling Einstein’s theory and called the holistic fully acknowledge the link between stress and disease.
­wellness paradigm. This model © Jones & that
suggests Bartlett Learning,
total well- LLC
Nontraditional approaches (of which© Jones & Bartlett Learning, LL
stress manage-
NOT FOR
ness is the balance, integration, SALE OR
and harmony DISTRIBUTION
of the NOT FOR
ment is a part), specifically biofeedback, SALE OR DISTRIBUT
meditation,
physical, intellectual, emotional, and spiritual aspects of massage therapy, and mental imagery, are commonly
the human condition. These four components of total referred to as alternative medicine by the American
well-being are so closely connected and interwoven Medical Association. Because the word alternative has a
that it is virtually impossible to divide
© Jones & Bartlett Learning, LLC them. Although negative connotation to many&practitioners
© Jones in the field LLC
Bartlett Learning,
for the purposes of academic study these areas are best of holistic wellness, the words complementary and inte-
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
understood separately, in reality they all act as one inter- grative medicine also are used to refer to additional heal-
connected living system, just as Einstein hypothesized ing modalities. Every technique for stress management
about the universe. falls within the domain of complementary medicine.
The word health is derived from the Anglo word hal, Note that healing and curing are two different concepts.
© Jones & Bartlett
meaning “to heal,Learning,
to be madeLLC whole, or to be holy.” © Jones & Bartlett Learning, LLC
Typically, the word curing means that the symptoms of
NOT FOR SALE OR DISTRIBUTION
Throughout the ages, wholeness has been symbol- aNOT
diseaseFOR SALE
or illness areOR DISTRIBUTION
eradicated. Although in some
ized by a circle. The wellness paradigm states that the cases healing techniques may cure a person of disease or
whole is always greater than the sum of the parts, and illness, the concept of healing really means bringing a
all parts must be looked at as one system (FIG. 1.10). sense of inner peace to someone’s life, even in the face of
When applied to clinical medicine, the wellness para-
© Jones & Bartlett Learning, death.LLCFrom this vantage point you© canJones
see that & Bartlett Learning, LL
a person
digm encompasses the view that all
NOT FOR aspects
SALEof the
ORindi-
DISTRIBUTION NOT FOR SALE OR DISTRIBUT
vidual must be treated equally and each considered part
of the whole. Although advances have been made to Wellness paradigm: The integration, balance, and
integrate a host of mind-body-spirit healing modali- harmony of mental, physical, emotional, and spiritual
well-being through taking responsibility for one’s own
ties into Western health care, by and large, conventional
© Jones health; posits that the whole&is Bartlett
greater than the sum
medical practice still&treats
Bartlett Learning,
the physical LLC
component— © Jones Learning, LLC
NOT FOR SALE OR DISTRIBUTION of the parts. NOT FOR SALE OR DISTRIBUTION
the symptoms of stress—with drugs and surgery, often
Alternative medicine: Modalities of healing (homeo-
disregarding how the physical body connects with the
stasis) that include nearly all stress management tech-
mental, emotional, and spiritual aspects of well-being.
niques. Also known as complementary or integrative
Although the paradigm is slowly shifting, some physi- medicine.
cians&(because
© Jones Bartlett of Learning,
their medicalLLC training) still refuse to © Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION.
 Chapter 1 The Nature of Stress 25

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
can be healed
NOT FOR SALE OR DISTRIBUTIONand yet still be ill. In this age of high
NOTtech-FORability
SALE to gather, process, recall, and exchange (commu-
OR DISTRIBUTION
nology and instant gratification, expectations often are nicate) information. Exposure to stress tends to overload
placed on the curing aspects—eradicating the symptom- the cognitive “circuits,” decreasing the processing and
atic problems—rather than the essence of true healing. recall abilities needed to make sound decisions, as well
This in itself has caused tension in the allied health fields as the ability to communicate them. Physical well-­being
© Jones & Bartlett Learning,
because many healthcare professionals trained in the LLC © Jones
is described as the optimal & Bartlett
functioning of theLearning,
body’s LL
NOT FOR SALE OR DISTRIBUTION
mechanistic paradigm use both terms interchangeably. NOT FOR SALE OR DISTRIBUT
major physiological systems (e.g., cardiovascular, diges-
But the tension doesn’t stop there. In 1993, a landmark tive, reproductive). From the observations documented
study by David Eisenberg and colleagues published in Selye’s research, as explained in his book The Stress
in the New England Journal of Medicine announced of Life (1978), the inability to return to homeostasis can
that more than one-third
© Jones & Bartlett Learning, LLC of the American population prove©fatal to various
Jones organ tissues
& Bartlett and eventually
Learning, LLC to the
sought methods of healing
NOT FOR SALE OR DISTRIBUTION outside those accepted by host organism. Emotional well-being
NOT FOR SALE OR DISTRIBUTION is defined as the
traditional medicine because they were unsatisfied with ability to feel and express the full range of human emo-
the Western approach to health care. What makes this tions and to control them rather than be controlled by
matter even more astounding is that most healing meth- them. Anger and fear act as “umbrella” emotions that
ods are not covered by medical insurance, meaning that can collectively overload emotional circuits, resulting in
© Jones & Bartlett
peopleLearning,
are payingLLC for these services out of their© Jones
own & Bartlett
mental Learning,
paralysis and oftenLLC
leading to states of depres-
NOT FOR SALEpockets.
OR DISTRIBUTION NOT
In the highly acclaimed PBS television series FOR SALE OR DISTRIBUTION
sion. Spiritual well-being is described as the matura-
entitled Healing and the Mind (1993), producer and host tion of higher consciousness through strong nurturing
Bill Moyers distilled the trend in this way: “There is a relationships with both the self and others, the develop-
deep yearning for a human (whole) approach to medi- ment of a strong personal value system, and a meaning-
cine.” Stress management
© Jones &techniques,
Bartlettwhich attemptLLC
Learning, to ful purpose in life. Stress can create
© Jones & aBartlett
series of obstacles
Learning, LL
deal with theNOTcausesFOR
as wellSALE
as the OR
symptoms of stress,
DISTRIBUTION on the road to spiritual development, making
NOT FOR SALE OR DISTRIBUT the path
support and contribute to this holistic approach. to one’s higher self difficult, if not entirely inaccessible.
The use of complementary (alternative) medicine, Over the past few decades, scholars such as Bill Hettler
now commonly referred to as “integrative medicine,” (1976) and John Travis and Regina Ryan (2004), have
has grown significantly since first LLC
researched in 1993 included social well-being and environmental well-­
© Jones & Bartlett Learning, being ©asJones & Bartlett
additional components Learning, LLC para-
of the wellness
(Eisenberg) where one-third of Americans reported
NOT FOR SALE OR DISTRIBUTION digm.NOT FOR
Actually, SALE
what ORdone
they have DISTRIBUTION
is tease these aspects
using various forms of integrative medicine. According
to the most recent data collected in 2017, yoga, medita- out of the mental, emotional, physical, or spiritual fac-
tion, and visits to a chiropractor topped the list of uses tors involved. If you take a closer look at the original
of integrative medicine. Moreover, increases were seen four components, you will see that social well-being is
a large factor of spiritual well-being. And environmen-
© Jones & Bartlett
fromLearning,
2012 to 2017 LLC © Jones &
among U.S. adults in all modalities, Bartlett Learning, LLC
tal well-being demonstrates how interwoven these four
NOT FOR SALEwithORyoga and meditation seeing the biggest increases
DISTRIBUTION NOT FORcomponents
SALE ORreally DISTRIBUTION
are, integrating aspects of physical
(Clarke et al. 2018). Most people continue to pay out of
pocket for these services (totaling in the billions of dol- and spiritual well-being. Our ability to harmonize with
lars), because only a few holistic modalities, such as acu-
puncture and some forms of bodywork, are reimbursable Mental well-being: The ability to gather, process,
© Jones & Bartlett Learning,
by insurance companies. It should be noted that many LLC recall, and communicate© Jones & Bartlett Learning, LL
information.
NOT FOR SALE OR DISTRIBUTION
healthcare providers, including Duke Medical Center, NOT FOR SALE OR
Physical well-being: The optimal functioning DISTRIBUT
of the
now have centers for integrative medicine. Today, inte- body’s eight physiological systems (e.g., respiratory,
grative healing practices have gone mainstream, with skeletal).
massage, acupuncture, hatha yoga, T’ai chi ch’uan, aro- Emotional well-being: The ability to feel and express
© Jones & Bartlett Learning, LLC
matherapy, and many other modalities becoming com- the©full range of&human
Jones emotions
Bartlett and to control
Learning, LLCthese
mon healthcare feelings, not be controlled by them.
NOT FOR SALEpractices that are now recognized as
OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
essential components of self-care (Jonas 2017). Spiritual well-being: The state of mature higher
consciousness deriving from insightful relationships
Let us take a closer look at the components of the wellness with oneself and others, a strong value system, and a
paradigm and the effects that stress has on them. Mental meaningful purpose in life.
well-being,
© Jones & Bartlett or intellectual
Learning, LLC well-being, is regarded © asJones
the & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION.
 26 Part 1 The Nature of Stress

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
peopleSALE
NOT FOR within our
ORcollective environments is paramount
DISTRIBUTION Through
NOT FOR the efforts
SALEofOR advocates of the wellness par-
DISTRIBUTION
to total well-being. Thus, from a holistic perspective, adigm, attempts have been made to unite the practice
to effectively deal with stress, all areas of the wellness of both relaxation skills and coping skills for a unique
paradigm must be addressed and nurtured equally; the holistic approach to stress management. This implies
whole is always greater than the sum of the parts. viewing each person as more than just a physical body
© Jones & Bartlett Learning, LLC with the causes of stress©asJones
and dealing & physi-
well as the Bartlett Learning, LL
Not long ago (and in some cases
NOTtoday),
FORmany SALE stress
OR man-
DISTRIBUTION
agement programs were based on the mechanistic model cal symptoms. The primary focuses in the application of OR DISTRIBUT
NOT FOR SALE
and focused solely on physical well-being. Upon initial the wellness paradigm are on the prevention of disease
recognition of the association between stress and disease, and illness and the enhancement of health. Furthermore,
courses designed to intervene in this process emphasized the underlying current of this empowering philosophy
techniques ©toJones
decrease&the
Bartlett
physicalLearning,
symptoms ofLLC stress. is to place the responsibility
© Jonesof& healing back Learning,
Bartlett in the hands LLC
NOT
These classes FOR SALE
consisted primarilyOR DISTRIBUTION
of teaching one or two of the individual. Successful stress management
NOT FOR SALE OR DISTRIBUTION therapy
relaxation techniques to help decrease the most obvi- programs have now begun to adopt the wellness philos-
ous stress symptom: muscle tension. These techniques, ophy and holistic approach, supporting the concept that
addressing merely the symptoms (the physical com- the whole is indeed greater than the sum of the parts. A
ponent), did nothing to relieve LLC
the causes of stress (the sound stress management program does not attempt to
© Jones & Bartlett Learning, © Jones
merely & (fix
reduce Bartlett Learning,
or repair) stress, butLLC
rather to man-
mental, emotional, or spiritual components). As a result,
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
age it efficiently. This management process attempts to
people often experienced a rebound effect; their symp-
toms recurred. On a different front, coping skills (e.g., focus on all aspects of one’s well-being. This philosophy
cognitive restructuring, time management, and journal is implemented by attempting to both resolve the causes
writing) were taught by psychologists in private therapy and reduce or eliminate the symptoms of stress. It is
© Jones
sessions, and these coping strategies soon&made
Bartlett imperative
Learning,
their way LLCto remember that, as an© intervention
Jones &modal- Bartlett Learning, LL
into public awareness as wellNOT(FIG.FOR ity,
1.11).SALE OR DISTRIBUTION the wellness paradigm does not preclude
NOT FOR SALE the use of OR DISTRIBUT
medications or surgery. Rather, it strongly suggests that
there be a collaborative integration of several therapeutic
techniques to produce the most effective healing process
(e.g., chemotherapy and visualization). Equally import-
© Randy Glasbergen, used with permission from www.glasbergen.com.

© Jones & Bartlett Learning, LLC © Jonescoping

ant as preventive measures, & Bartlett Learning,
skills and relaxation LLC
NOT FOR SALE OR DISTRIBUTION techniques are alsoNOT FORtoSALE
advocated maintain OR DISTRIBUTION
inner peace.
Stated simply, effective holistic stress management
includes the following:
1. Sound knowledge of the body’s reaction to per-
© Jones & Bartlett Learning, LLC © Jones
ceived& Bartlett Learning, LLC
stress
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
2. Sound knowledge of mental, physical, emotional,
and spiritual factors associated with stress
3. Utilization of several effective coping techniques
to work toward a resolution of the causes of stress
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LL
NOT FOR SALE OR 4. Regular practice of relaxation
DISTRIBUTION NOTtechniques to OR DISTRIBUT
FOR SALE
FIGURE 1.11 Every year can be viewed as a difficult
maintain homeostatic balance of the body
year. No amount of drugs and self-medication will
permanently help. 5. Periodic evaluation of the effectiveness of coping
skills and relaxation techniques
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION.
 Chapter 1 The Nature of Stress 27

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

SUMMARY
■ 
The advancement of technology, which promised
© Jones & Bartlett Learning, LLC ■  Holmes and Rahe created the Social Readjustment
© Jones & Bartlett Learning, LL
more leisure time, has actually increased the pace of Rating Scale to identify major life stressors. They
NOT FOR SALE OR DISTRIBUTION
life so that many people feel stressed to keep up with
NOT FOR SALE OR DISTRIBUT
found that the incidence of stressors correlated with
this pace. health status.
■ 
Lifestyles
based on new technological conveniences ■ 
Selye coined the term general adaptation syndrome
are now thought to be associated with several dis- to explain the body’s ability to adapt negatively to
© Jones
eases,&including
Bartlettcoronary
Learning, LLC and cancer.
heart disease © Jones
chronic stress.& Bartlett Learning, LLC
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION
■ 
Stress is a term from the field of physics, meaning ■ 
Females are not only wired for fight or flight,
physical force or tension placed on an object. It was but also have a survival dynamic called tend and
adopted after World War II to signify psychological ­befriend, a specific nurturing aspect that promotes
tension. social support in stressful times.
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
■ 
Eastern and Western philosophies as well as sev- ■ 
Stress can appear at any time in our lives, but the col-
NOT FOR SALE OR DISTRIBUTION NOT FOR
eral academic disciplines, including psychology and
SALE OR DISTRIBUTION
lege years offer their own types of stressors ­because
physiology, provide many definitions of stress. The it is at this time that one assumes more (if not com-
mind-body separation is now giving way to a holis- plete) responsibility for one’s lifestyle behaviors.
tic philosophy involving the mental, physical, emo- ■ 
The
association between stress and insomnia is
tional, and©spiritual
Jonescomponents
& Bartlettof Learning,
well-being. LLC © Jones
­undeniable. The United States&isBartlett
said to be Learning,
a sleep-­ LL
■ 
NOT FOR
Cannon coined SALE
the term OR DISTRIBUTION
fight-or-flight response to deprived society, NOT FOR SALE
but techniques OR DISTRIBUT
for stress man-
­describe the immediate effects of physical stress. agement, including physical exercise, biofeedback,
This response is now considered by many to be inap- yoga, and diaphragmatic breathing, have been
propriate for nonphysical stressors. Rest and digest proven effective in promoting a good night’s sleep.
is the&expression
© Jones Bartlettfor the body when
Learning, LLCnot engaged in ■  E© Jones
arly & Bartlett
approaches to stress Learning,
management LLCwere based
fight or flight.
NOT FOR SALE OR DISTRIBUTION NOT
on FOR SALE
the mechanistic ORwhich
model, DISTRIBUTION
divided the mind
■ 
The
three types of stress are eustress (good), neus- and body into two separate entities. The paradigm
tress (neutral), and distress (bad). The two types of on which this model was based is now shifting
distress are acute (short-term) and chronic (long- ­toward a holistic paradigm, in which the whole is
term), the latter of which is thought to be the more greater than the sum of the parts, and the whole per-
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
detrimental because the body does not return to a son must be treated by working on the causes as well
NOT FOR SALE OR DISTRIBUTION
state of complete homeostasis. NOT FOR SALEas the OR DISTRIBUTION
symptoms of stress.
■ 
Stressors have been categorized into three groups: ■ 
Effective stress management programming must
(1) bioecological influences, (2) psychointrapersonal address issues related to mental (intellectual), physi-
influences, and (3) social influences. cal, emotional, and spiritual well-being.
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LL
STUDY GUIDE QUESTIONS
NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUT

1. How would you define stress? 6. What is trauma?

2. How does acute stress differ from chronic stress? 7. How does stress affect sleep? List as many ways
© Jones & Bartlett Learning, LLC ©asJones
possible.& Bartlett Learning, LLC
3. What is the general adaptation syndrome? List
NOT FOR SALE OR DISTRIBUTION
the stages. 8. WhatFOR
NOT SALE ORstress
is posttraumatic DISTRIBUTION
disorder (PTSD)?
4. Do men and women respond to stress in the same What is secondary posttraumatic stress disorder?
way? If not, how do their responses differ? 9. What is holistic stress management?
5. Learning,
© Jones & Bartlett What is rest LLC
and digest? How does it differ
© from
Jones & Bartlett Learning, LLC
fight or
NOT FOR SALE OR DISTRIBUTION flight? NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION.
 28 Part 1 The Nature of Stress

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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REFERENCES AND RESOURCES

Allen, M. 2020. “Ken Burns: Coronavirus Pandemic Is Carpi, J. 1996. “Stress . . . It’s Worse Than You Think.”
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a Crisis ‘On the Level’ of the Civil War and Great
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Psychology Today 29(1): 34–41, 74–76.
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Depression.” Axios.com, May 25. https://www.axios.com OR DISTRIBUTION NOT FOR
Centers for Disease Control and Prevention. 2019. SALE
“Heart OR DISTRIBUT
/ken-burns-coronavirus-transition-lab-podcast-4e247105 Disease Facts.” CDC.gov, December 2. https://www.cdc
-896e-4a2e-953f-7d4f6b9943c3.html. .gov/heartdisease/facts.htm.
Allen, R. 1983. Human Stress: Its Nature and Control. Chatterjee, R., and Wroth, C. 2019. “WHO Redefines Burnout
Minneapolis, MN: Burgess Press. as a ‘Syndrome’ Linked to Chronic Stress At Work.”
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Alter, A. 2018. Irresistible: The Rise of Addictive Technology and National Public Radio, May 28. https://www.npr.org
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the Business of Keeping Us Hooked (Reprint). New York: NOT FOR SALE OR DISTRIBUTION
/sections/health-shots/2019/05/28/727637944/who
Penguin Press. -redefines-burnout-as-a-syndrome-linked-to-chronic
American Institute of Stress. n.d. Homepage. https://www -stress-at-work.
.stress.org. Chokshi, N. 2019. “Americans Are Among the Most Stressed
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Learning, Times, April 25.
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Problem.” Stress.org, January 4. https://www.stress.org https://www.nytimes.com/2019/04/25/us/americans
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American Psychological Association. 2015. “Stress in Chopra, D. 2000. Personal communication, June 22.
America: Paying with Our Health.” February 4. http:// Clarke, T. et al. 2018. “Use of Yoga, Meditation, and
www.apa.org/news/press/releases/stress/2014/stress Chiropractors Among U.S. Adults Aged 18 and Over.”
-report.pdf. © Jones & Bartlett Learning, HCHS LLCData Brief, No. 325, November. © Jones https://www.cdc
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American Psychological Association. 2016. “Stress in America: .gov/nchs/data/databriefs/db325-h.pdf.
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The Impact of Discrimination.” March 10. http://www Cloud, J. 2008. “The Top 10 Everything of 2008.” Time.
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American Psychological Association. 2019. “Stress in America.” Comarow, A. 2008. “Embracing Alternative Care.” U.S.
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/stress-america-2019.pdf. Condon, G. 2003. “Futurists Say World Is atOR
Turning Point.”
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American Psychological Association. 2020. “Stress in America Chicago Tribune (Section 5), April 9. https://www.chicago
2020: Stress in the Time of COVID-19, Volume Two.” tribune.com/news/ct-xpm-2003-04-09-0304090089-story
Stress in America Press Room, June. https://www.apa.org .html.
/news/press/releases/stress/. Cryer, B., R. McCraty, and D. Childre. 2003. “Pull the Plug on
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Dawson, P. 2005. Sleep and Adolescents. https://teensneedsleep
Anxiety Disorders Association of America. 2007. Stress and .files.wordpress.com/2011/08/dawson-sleep-and-adolescents
Anxiety Disorders Study. https://www.adaa.org/stressOut .pdf.
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Journal of the American Medical Association 279: 1548–1553. Dossey, L. 2000. Reinventing Medicine. NOT
New York: Harper.
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Barrow, B. 2011. “Stress ‘Is Top Cause of Workplace Sickness’ Dossey, L. 2004. Personal communication, July 30.
and Is So Widespread It’s Dubbed the ‘Black Death of Eckelkamp, S. 2019. “Can Trauma Really Be ‘Stored’ in the
the 21st Century.’” Daily Mail, October 5. https://www Body?” mindbodygreen, October. https://www.mindbody
.dailymail.co.uk/health/article-2045309/Stress-Top-cause green.com/articles/can-trauma-be-stored-in-body.
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-workplace-sickness-dubbed-Black-Death-21st-century Eisenberg, D., R. B.©Davis,
Jones S. L.&Ettner,
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Becker, D. 2013. One Nation Under Stress. New York: Oxford 1990–1997: Results of a Follow-up National Survey.”
University Press. Journal of the American Medical Association 280:
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Thing of the Past.” Daily Telegraph, May 4. Eisenberg, D., R. C. Kessler, C. Foster, et al. 1993.
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Cannon, W. 1963.Learning,
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Medicine in the UnitedLLC States.” New
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W. Norton.OR DISTRIBUTION NOTEnglandFOR Journal
SALE of Medicine 328: 246–252.
OR DISTRIBUTION

© Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION.
 Chapter 1 The Nature of Stress 29

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC
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Expedia.com. 2018. “2018 International Vacation Deprivation Kanner, A., J. C. Coyne, C. Schaefer, and R. S. Lazarus. 1981.
Survey Results.” http://www.expedia.com/p/info-other “Comparison of Two Modes of Stress Management: Daily
/vacation_deprivation.htm. Hassles and Uplifts Versus Major Life Events.” Journal of
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