What to do about all that stress…

“I feel stressed.” How many times did you hear it last week? Better yet, how many times did you say it last week?

We attribute our stress to all sorts of things: a looming work deadline or performance review; an unexpected financial obligation; a family illness, death, or caring for a loved one; parenting; seeing a close colleague laid off and wondering if you’re next; inadequate or nonexistent paid sick leave or maternity leave; a volatile stock market; stories of violence on the news; and the list could go on.

The most “toxic” forms of stress, as they’re known, are things much larger, more systemic, and more pervasive than any one person. These are the things that result in significant, stunted growth over time. Yes, we can talk about a child’s stunted growth from the stress of chronic malnutrition. But I don’t just mean “stunted” in a physical sense. As past research has shown, disparities in income, stemming from disparities in academic achievement, can be traced to experiencing the chronic stress of poverty during childhood. The stress of childhood poverty, as we’re now learning, has the power to elicit epigenetic changes at biology’s most fundamental level. Telomere length, for example, which is a marker of healthy aging and general health within our DNA, are shortened in children from impoverished families.

Poverty’s role in mental health cannot be overlooked. According to recent data from the Centers for Disease Control and Prevention, adolescents and adults (specifically, ages 12 years and older) living below the poverty level are more than twice as likely to have depression compared to those living at or above the poverty level.

Here’s the big question, though. How do we, in turn, go about addressing stress?

In many respects, our individual experience of stress can be traced back to broader societal, cultural, and institutional issues that fall outside our control. For example, if I was a newborn baby, I have no control over whether I grow up in an impoverished household. It’s this perception and feeling of control that might be the lynchpin for mental health and well-being.

Our understanding about the importance of perceived control in psychology isn’t new. Martin Seligman’s experiments on learned helplessness date back to the mid 1960’s, when he first tested the hypothesis with dogs. These “triadic” experiments, as they were called, included an escapable shock group (i.e. the group with control), an inescapable shock group (i.e. the group without control), and a third group, which received no shocks.

For the first escapable shock group, dogs could turn off the shock by pressing a panel with it’s nose. They were subjected to a stress – the shock – but removing the source of their stress was within their control.

The second group wasn’t able to do this. These dogs received the same shock as the first group, but the panel that turned off the shocked wasn’t operational. Like the first group, the second group experienced the same stress, but in this case, could not control its removal.

Following this adaptation period, all three groups of dogs were taken to a shuttlebox, which is a two-compartment apparatus where one side produces a shock, and the other doesn’t. A small partition divides the two sides, but is low enough for the experiment’s subject to jump over it.

Once in the shuttlebox, dogs from the first and third groups behaved similarly. After they experienced a shock the dogs quickly jumped over the small divider to escape the shock.

Dogs from the second group acted differently, however. Having learned they could not control the shock during the initial conditioning phase, these dogs made no effort to try and escape the shock in the shuttlebox. Though the divider was the exact same height, and all other conditions were the same, the dogs that felt helpless, unable to control the source of their stress, reacted apathetically to the shocks in the shuttlebox.

It is this real or perceived lack of control over a situation’s outcome that Seligman theorizes leads to clinical depression and other mental illness. As the theory goes, adversity is beyond my control, I’m helpless to change whether this adversity happens or not, so I give up trying.

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In some cases, we do have the capacity to change our individual circumstance, to overcome adversity, or reduce a particular kind of stress. When we have some degree of control over stress, there may even be some benefit to experiencing it. Take the example of child development. As Paul Tough argues in his book How Children Succeed, some kids are shielded from failure. Well-intentioned parents want their child to succeed so badly that they remove all the obstacles in their way. But this can backfire when a child is stressed to try and accomplish something new or challenging. Having rarely failed, a child is ill-equipped with the skills needed to persevere through adversity. So instead they give up.

Another big example that comes to mind relates to exercise and athletic performance. Whether running, cycling, swimming, weightlifting, or whatever, all types of exercise is a physiological stress on the body. Then, in the time after the activity, our body repairs and rebuilds. Overtime, through controlled dosages of stress, our bodies become stronger, faster, and more aerobically capable.

But I think a lot more about those uncontrollable stressors in people’s lives. The new mother without paid maternity leave who has to choose between a paycheck and spending time with her newborn. The worsening income inequality in the United States. The growing uncertainty about affording a college education, or the burden of student debt accumulated by recent graduates. These circumstances create huge amounts of stress in millions of people’s lives. However, the remedies for these challenges are largely outside our control. Yes, we can fulfill our civic duty and elect a Representative, Senator, or President, who claims to support our values, and promises to advance them through the arduous policy-making process. But regardless of how much we lobby or voice our concerns, it’s still out of our hands how they vote or what they do while in office.

Are we spending enough time talking about these sources of stress?

In her book, One Nation Under Stress, professor Dana Becker argues absolutely not. “What today’s stress concept obscures, however, are the social underpinnings of the ‘stresses’ we bemoan.” In essence, we spend a lot of time talking about how individuals need to cope or deal we stress. There are all kind of programs, websites, apps, you name it, all in the spirit of helping us de-stress. Yet, however important this component, they still only focus on our personal reaction to stressful events.

What about the other side of the equation? What about the underlying social, economic, and political conditions that breed stress in the first place?

And the most important question, are we creating/have we created conditions similar to those experienced by the second group of dogs? Despite the overwhelming presence of significant stress, say from growing up in poverty, we never see/feel improvements, and grow pessimistic that we ever will.

Is it this pessimistic perception, feeling of helplessness, and a lack of control that’s helping drive our biggest mental health challenges today?

Maybe.

There’s another perspective to consider, though.

I’ve written before about the extraordinary experience of Viktor Frankel, a psychiatrist from Vienna who was imprisoned in four different Nazi concentration camps between 1942 and 1945. He experienced a kind of adversity many of us will thankfully never encounter. On more than one occasion, he stared his impending death in the face, and on a daily basis, witnessed the worst that human being’s are capable of.

Yet, through some combination of luck and personal grit, he somehow survived to see liberation. In his seminal work, Man’s Search for Meaning, Frankel describes being totally stripped of almost everything: his possessions, contact with his family, his dignity. In these circumstances, it’s easy to conclude Frankel was totally deprived of any choices. Many who read or hear his story will instinctively say he lacked any control over his sub-human condition.

That’s not how Frankel saw it. “They may be few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of the human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s own way.”

He goes on to say,

“And there are always choices to make. Every day, every hour, offered the opportunity to make a decision, a decision which determined whether you would or would not submit to those power which threatened to rob you of your very self, your inner freedom; which determined whether or not you would become the plaything of circumstance, renouncing freedom and dignity to become molded into the form of the typical inmate.”

In Frankel’s view, it would be easy to fixate on the uncontrollable, because there were plenty instances of them. But by doing this, he would overlook, and indeed relinquish, his last remaining power: his control over how he reacts to any situation, good or bad.

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At the heart of the dichotomy I just outlined is “locus of control.” Those with an internal locus of control believe they are able to influence events and their outcomes. As such, their success or failure rests hinges on internal factors. Those with an external locus of control have the opposite view, believing their success or failure is the result of external factors or outside influences.

When it comes to health, those with an internal locus of control tend to adhere to certain health behaviors more so than those with an external locus of control, whether smoking, weight loss, or medical treatment adherence. Further, locus of control may be a critical factor when it comes to overall mental health, including among adolescents, as this study found. It can potentially act as a buffer, and even reduce the physiological response to stress if an individual perceives they have control over the stressor.

So we come back to control, whether real or perceived. And, however inconclusive it sounds, the solution to improving mental health and well-being is probably a “both-and” strategy. Yes, there is plenty of opportunity for psychological adaptations among individuals, like identifying the variables in any situation that you can control and focus the majority of your attention in that direction.

But we still can’t forget about these larger societal-level forces that create the worst forms of persistent stress in people’s lives. These are the forces the shape how we view the world and our circumstance. Perceptions matters. Even if a challenge can be overcome, we still need to believe its possible. As Henry David Thoreau posited, “The question is not what you look at, but what you see.”

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