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On Stress and Coping

Mechanisms

Jean Tache Hans Selye International Institute of Stress Montreal, Quebec, Canada

When internists and physiologists are asked to discuss the topic of stress with a group composed mainly of psychologists and psychiatrists, they have no other option than to analyze the problems from their own perspective, and then to try to bridge the differences between the two points of view. This is precisely the format used in this chapter, in the hope of presenting our position very clearly while, at the same time, remaining relevant to the goals of this NATO institute on coping with stress.

STRESS-FROM

OUR POINT OF VIEW

Because the word stress, as used in common language, has a number of different meanings, it may be necessary to explain how this term came to be applied to biology. In 1936, research on endocrinology at McGill University revealed that parenteral injec- tions of diverse, unrelated substances (e.g., ovarian extracts, formaldehyde, laboratory dust suspensions) consistently caused a number of stereotyped changes. There were also modifications that

This chapter was originally Chapter 1 in Volume 5 of this series, and the figures are nuinbered accordingly.

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School of Medicine, Levy Library] At: 07:11 31 March 2008 Fig. 1-1. The typical triad of

Fig. 1-1. The typical triad of the alarm reaction. (a) Adrenals. (b) Thymus. (c) A group of three lymph nodes. (d) Inner surface of the stomach. On the left are the organs of a normal rat, on the right, those of a rat exposed to the frustrating psychological

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were characteristic or typical of each agent: the dust suspensions elicited inflammation, concentrated formaldehyde produced local cell necrosis, and so on. Most impressive, however, were the common elements of the systemic response to these agents. The stress-induced modifications, especially the triad of thy- micolymphatic involution, adrenal enlargement, and gastric ulcers, were described at length in previous publications (Selye, 1976a, 1976b), and these observations finally led to the current definition of stress as the “nonspecific response of the body to any demand.” The typical effects of stress on the adrenals, the thymus, the lymph nodes, and the inner surface of the stomach are shown in

Fig. 1-1.

A Common Response that Is Not Specific of the Agent

The often complex total response of an individual to a stimulus can frequently be subdivided into reactions that are more or less closely associated with the agent. For instance, one can usually conclude that people’s body temperatures are too high if they sweat profusely or too low if they shiver. Similarly, physical exercise causes such characteristic changes as increased cardio- vascular activity and a rise in muscle metabolism. We refer to these reactions that are elicited by particular agents as “specific,” in contrast to “nonspecific” changes that are common to a number of agents. It is this not-specific-of-the-agent part of the adaptation process that is stress as defined in modern medical dictionaries and encyclopedias. Nonspecific adaptation is a wide-ranging concept, and many of the mechanisms involved in it still remain to be elucidated. One known physiological mechanism, the hypothalamus-hypophysis-

stress of being forcibly immobilized. Note the marked enlargement and dark discoloration of the

adrenals (due to congestion and discharge of fatty secretion granules), the intense shrinkage of the

as the

thymus and the lymph nodes, as well

numerous blood-covered stomach ulcers in the alarmed rat. (From The Stress of Life, 2nd ed., by H. Selye. Copyright 1976 by McGraw-Hill. Re-

printed by permission.)

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adrenal axis, has received much attention and can be discussed at some length. Some pathways that mediate the response to a stressor agent are shown in Fig. 1-2. Even while the importance of a demand is being appraised and

possible specific responses are being tested, certain cells in the area

.This

signal, which could be mediated via nervous pathways and/or chemical substances in the blood, is of a very general nature- alarm or call for action that induces the secretion of corti- cotrophin-releasing factor (CRF) by cells located in the median eminence. CRF travels down the portal-venous system into the adenohypophysis, where it triggers the release of adrenocorti- cotrophic hormone (ACTH). Carried through the vascular system, ACTH acts directly on the adrenal cortex and regulates the secretion of various hormones, known collectively as corticoids, among which cortisol and corticosterone are the most well known. These hormones are transported to all cells of the body, inducing numerous effects: gluconeogenesis is facilitated at the expense of fat and carbohydrate reserves and even, if necessary, structure proteins; thymicolymphatic involution and eosinopenia develop; and immune-inflammatory reactions decrease. Simultaneously, gastric or duodenal ulcers are formed through stimulation of the sympathetic nervous system. The end result of these hormonal modifications seems to be an increase in the body’s capacity for many kinds of activities. Because these activities help the body to meet challenges more efficiently, the stress reaction is deemed to be natural, adaptive, and useful.

A Nonspecific and Stereotyped Response

At this point, confusion may arise over the nonspecific character of the stress response and its stereotyped manifestations. We should not lose sight of the fact that although the stress response is not characteristic of any one agent, it is by no means vague: it can be well defined and quantified biochemically. Stress hormones can be accurately measured and variations in their concentration can be studied. The response is stereotyped inasmuch as common reactions take place and the same hormones are secreted; the pattern, however, can be modified, depending upon the specific effects of each stressor agent. Although we constantly refer to the hypothalamus-hypophysis-

of the hypothalamus are alerted to a state of

emergency.

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Fig. 1-2.Principal pathways mediating the response to a stressor agent. When an agent acts upon the body (thick outer frame of the diagram), the effect will depend upon three factors. All agents possess both nonspecific stressor effects and specific properties; the latter are inseparably attached to the stressor effect and invariably modify it. Exogenous and endogenous conditioning factors largely determine the reactivity of the body. Because all stressors have some specific effects, they cannot elicit exactly the same response in all organs; furthermore, even the same agent will act differently on different individuals, depending upon the internal and external conditioning factors that determine their reactivity. (From Stress in Healfh and Disease by H. Selye. Copyright 1976 by Butterworths. Reprinted by permis- sion.)

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adrenal axis as a parameter by which the stress response is measured, stress cannot be equated with this reaction. The hypophysis or adrenals are sometimes dysfunctional or may be removed and, as a consequence, ACTH, corticoids, or both may be secreted excessively, insufficiently, or not at all. Yet, the absence of these structures does not eliminate the capacity for nonspecific adaptation. Other mechanisms are then put into action, even though what seems to be the main pathway of adaptation is absent and the potential for defense decreased.

The Stimulus or Stressor

The organism’s response during stress has been the central point of investigation in our laboratories during the past 30 years. At one time, however, the word stress may have been used to identify both the stimulus and the response. As the concept evolved, new terms had to be coined to distinguish between its different elements. The word stressor was consequently introduced to denote the stimulus or eliciting factor. Our studies were always oriented toward the response, inasmuch as, by definition, no one stressor agent could be considered equal to all others.

In the early days of stress research, there probably was a feeling

that only physical or chemical agents could produce the morpho- logical modifications in the body that came to be known as the stress triad. Subsequent work proved that psychological com- ponents also play a decisive role in eliciting a typical stress response (Selye, 1976a). Some researchers even insist that it is not the physical or chemical elements of the stressor that produce the triad, but only the psychological component of the agent, namely, emotional arousal (Lazarus, 1974; Mason, 1971). However, through an ingenious surgical intervention involving a specially shaped knife, neural deafferentation of the hypothalamic region can be accomplished (HalLz & Pupp, 1965), following which most stressors such as formaldehyde, tourniquet shock, ether, restraint, and even unilateral adrenalectomy still cause an increase of ACTH secretion.

Animal Experimentation

A wide variety of stimuli have been tested in our laboratories

over the years. The agents most frequently employed are chosen for practical reasons: (1) their specific effects are not such that

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they overshadow the nonspecific ones; (2) variations in individual sensitivity of the animals to the agents are not so great that the results cannot be submitted to statistical analysis; (3) the stressors are easy to apply and are neither dangerous to technicians nor time consuming; (4) they are simple and do not involve sophisticated or expensive apparatus. The agents that we have routinely used to study stress manifestations in laboratory animals such as rats are prolonged exposure to cold or heat, physical exercise (in a treadmill), chemical treatment (parenteral injection of drugs), and restraint in a spread-eagle position (by fastening the animal’s legs with adhesive tape to a board or metal plate). Only those modifications that are common to all five agents are considered to be stress parameters. The specific effects are deemed to be relevant only if they interact with the nonspecific influence of the stressors. Some investigators object to the use of these five agents because they represent more intense forms of trauma than what man experiences in daily life and, hence, the manifestations they elicit would seem to be characteristic only of severe stress. In short, these researchers claim that the whole concept would be repre- sentative of human suffering only in such stressful situations as severe infection, burns, war, famine, or some other catastrophe, but not of everyday life experiences. Initially, because of the nature of the parameters that were monitored as indicators of stress (i.e., modifications in the size of the adrenals and thymus, and the incidence of gastric ulcers), the stressors chosen had to be quite intense and prolonged. Short- lasting or mild stress could not be easily studied. Now, however, biochemical measurement of hormones makes it possible to appraise the nonspecific modifications induced by mild or even enjoyable stressors (Collu & Jequier, 1976; Elvidge, Challis, Robinson, Roper, & Thorbum, 1976). Parallel modifications can also be monitored. A shift in hormones secreted by the ACTH-producing adenohypophysis has been demonstrated after exposure to stress. Chronic immobilization of rats causes an increase of plasma corticosterone (which is indicative of plasma ACTH levels) well above normal values, but the secretion of other adenohypophyseal hormones controlling growth (GH) and sexual functions (FSH, LH, prolactin) is dramati- cally decreased (Tache, Du Ruisseau, Tache, Selye, & Collu, 1976).

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individual Differences

J. TACHE AND H. SELYE

Although the word stressor usually refers to a stimulus, such as an external insult, we must not forget that an effective stressor is an agent perceived, psychologically or physiologically. What would normally be an alarming situation, if unnoticed, would cause no stress. We often wonder why close friends show very different stress manifestations when they experience a common stressful episode. Why does one develop duodenal ulcers and another a cardiac infarct, while a third is unaffected by the same difficulties that overpowered the other people? We must recognize that each person is unique and that, first, the very same stressor does not have the same impact on all individuals and, second, even when it seems to be felt with the same intensity, each person develops a unique set of manifestations. Individual differences in reactions to stressors are created by a combination of endogenous and exogenous factors. The endogenous factors are generally inherited or acquired traits: familial characteristics or diseases, proneness to certain types of maladies, or weaknesses of certain organs. The exogenous factors are usually various environmental conditions, including social, intellectual, and psychological elements as well as climate, physical surroundings, and nutrition. Because every person is different, it is unlikely that a given stimulus will be perceived in the same way by everybody. This is obviously true when certain physical or chemical agents are involved. For example, due to exogenous and/or endogenous factors, some individuals cannot cope with pollen, ragweed, dust, and so on.

Stress Tests

The literature on stress has assumed awesome proportions as stress research has increased by leaps and bounds. The development of numerous stress tests has further emphasized the importance of this subject. These tests vary from the subjective evaluation of an experience to the behavioral manifestations or physiological and biochemical modifications that can be precisely quantified. A rapid survey of the literature would show that various stress tests appraise different things. It might be concluded, therefore, that

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some of them do not measure stress and are of no use as stress indicators. The hope for the perfect stress test arises from the expectancy that there should be, in the body, an absolutely nonspecific (i.e., a specifically nonspecific) modification that could always be relied upon to measure the level of stress. Inasmuch as this unique parameter has not been demonstrated, it has been said by some that the body does not adapt nonspecifically . In determining what parameters could be used to indicate stress, two facts should be taken into consideration. First, there are degrees of specificity (e.g., an effect may be characteristic of a group of stressors), and, second, the specific effects of a stressor necessarily modify the nonspecific effects to some extent.

Galvanic Skin Resistance: lndicative of Stress or Anxiety?

Galvanic skin resistance (GSR) is widely employed as a stress test, and we have selected it, for didactic purposes, from among such other measures as questionnaires, interviews, ECG, and electromyograms (EMG). By measuring resistance to a weak electrical current through the skin, it is possible to monitor palmar secretion resulting from mobilization of the autonomic nervous system. It is generally assumed that palmar secretions result from certain states of emotional arousal, especially anxiety. Whereas GSR appears to be an adequate indicator of psychogenic stress, it seems unreliable in measuring stress induced by other agents. Because GSR reflects the level of anxiety in a person, it might just quantify specific effects and not necessarily the nonspecific response. As a matter of fact, some use GSR as a specific test for anxiety. On the other hand, in stress studies, it is employed to measure one of the many nonspecific responses to stimuli (namely, autonomic nervous system involvement), and this is no different from evaluating corticoid secretion. GSR should not be discarded as a stress test; its significance and limitations must be realized, however, as should those of other tests, such as those that measlire catecholamine or corticoid levels. The observation that some agents cause a much greater increase in catecholamine, corticoid, or ACTH secretions than others merely indicates that none of these parameters are totally nonspecific.

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Using a Battery of Tests to Achieve Some Precision

J. TACHE AND H. SELYE

Because no one parameter can reliably reflect stress either qualitatively or quantitatively, it is necessary to fall back on a battery of tests to measure different indexes in an individual under stress. This approach has been utilized by J. W. Mason (1974, 1975) whose work in psychosomatic medicine is known interna- tionally. After studying the effects of several stressors on certain parameters, he noted that the resulting modifications were not always the same. Not only were there differences in the degree of response, but these differences were sometimes quite the opposite of each other (e.g., increased or decreased). Mason contends that there does not seem to be any agent- nonspecific response in the body. It is our view that, in the interpretation of Mason's results, insufficient attention was given to the specific actions of the stressors, which could have interfered or interacted with their nonspecific effects (Selye, 1975). Contrary to expectations, a typical parameter may not be modified during a stressful experience if the specific effect of the eliciting agent can inhibit the nonspecific response. Stress in laboratory animals is almost always associated with a loss of body weight (or decreased growth); this physiological change is as characteristic of stress as is the triad. Certain stressors (forced gavages, for instance) do not diminish body weight, however, which again illustrates that there is no purely nonspecific response of the body. Temperature regulation is also affected during acute stress. Unlike people, rats react to most acute stressors (e.g., restraint) by significantly lowering their body temperature (hypothermia), and both species, when they are exposed to acute stress situations, share the common denominators of gastric ulcers, adrenal enlarge- ment, and involution of the thymicolymphatic system. These parametersas we noted earlier-form the classical triad of the stress response. However, hypothermia is minimal (36°C) and no gastric ulcers develop when restrained rats are maintained at an elevated room temperature of 32" f 2°C. In contrast, the body temperature of similarly stressed rats falls to 25OC if the ambient temperature is kept at 24" t 2"C, and these animals show all the typical manifestations of stress (Salas, Tuchweber, Kourounakis, & Selye, 1977).

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This experiment indicates that gastric ulcers are an agent- nonspecific response mediated through hypothermia. It also under- scores the importance of using a battery of parameters instead of only one or two measures to evaluate the level of stress induced by a stimulus. The stress-elicited modifications reported by Mason (1974) impressed him in terms of their differences, but they were impressive to us because of their similarities. The following essential points can be extrapolated from the model of stress:

1. All

life

psychological

events

cause

agents,

some

stress.

Physical,

chemical,

and

the emo-

directly or indirectly

(through

tions

they

provoke,

for

instance), can

elicit

the

stress

reac-

tion.

2. Stress

should be avoided whenever possible. The body's capacity for nonspecific adaptation has developed over millions of years and has been preserved during the course of recent evolution, but adaptation is always acquired at a cost that has to be evaluated against the long-term survival value of adaptation. 3. The stressor is the stimulus eliciting the need for adaptation; stress is the response to the stimulus but it is not the total response of the body. 4. The nonspecific aspects of the body's reaction to an agent may

not be as obuious as the specific effects. The same pathways of nonspecific adaptation can be mobilized dozens of times a day, however, without the individuals being aware of this as they

experience diverse situations. Sometimes, only disease or dys- function will make individuals realize they are under stress. 5. Stress should be monitored through a battery of parameters. The secretion of ACTH and corticoids (namely cortisol, corti- costerone, and their metabolites) as well as catecholamines are, however, fairly reliable indicators of stress.

6. Stress cannot be equated with ACTH, corticoid, or catechola-

mine secretion. These are but a few elements of a very complex scheme of modifications although they seem to be the main pathways of nonspecific adaptation. 7. Removal of the stressor eliminates stress. Because stress is part of the response to an agent, it can be dealt with most easily by avoiding the stimulus or resolving the conflict that it gene- rates.

is

not

bad per se, but excessive or unnecessary stress

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APPLICATION OF THE STRESS CONCEPT TO DAILY LIFE

Adaptation to the environment is vital for the survival of all living beings. Throughout history, people have lived in close relationship to nature in developing the special skills and traits necessary for their survival. We easily lose sight of this relationship between human beings’ environment and their physiology. In the course of millenia, homo supiens adapted to living in small groups, earning their survival through labor (hunting, agriculture) in an environment that was not greatly modified from generation to generation. Their options in response to quite diverse situations were limited; in most cases, they involved physical activity, and thus, stereotyped psychological and physiological processes devel- oped. As the human brain evolved and people became less primitive, many other ways of coping were devised that depended less on strength or force. In the last few hundred years, human dependence on nature for survival has become more indirect and, in this sense, one might say that people have lost contact with nature. Thus, modem people’s daily activities bear little resem- blance to those of their not-too-distant ancestors, but their biological reactions to environmental stressors continue to be mediated via the same nonspecific coping mechanisms that they have acquired through evolution, and they still respond to challenges and to survival-directed emotions in the same age-old way. It is clear that, in an ever-increasing segment of the population, these responses have lost some of their original timeliness because they involve coping mechanisms that are often obsolete in a well-organized, well-policed, left-hemisphere kind of society.

Stress-From Other Points of View

Stress is obviously a twentieth-century word and it seems to be gaining in popularity. Its connotation varies considerably according to the ways in which people use it. A survey of formal and working definitions leads to the conclusion that the term is employed to characterize an area of special interest to the indi- vidual with important and potentially harmful repercussions on human life. Not surprisingly, this area often lies in the realm of the

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user’s professional activity. In this context, there are various definitions of stress that cannot be faulted on theoretical grounds as long as they remain consistent and logmil and add something new to what other words already say. It is not our intention to review all the different meanings of the term stress. However, at least two definitions have been brought to our attention by speakers at this NATO institute and it seems useful to reach beyond the word itself and try to reconcile diverse points of view.Charles D. Spielberger (1971) defines stress as the external forces that act on an individual, i.e., the objective properties of environmental or stimulus conditions that are characterized by some degree of objective danger (see Chapter 9, this volume). This is an extension of the definition of stress that is used in mechanics and engineering in which the effect on material subjected to physical stress is known as strain. Such a definition of biologcal stress has the advantage of an analogy to the physical sciences. Aside from the need to have a definition close to that of physics, using the word stress to characterize the external agents or stimuli indicates a concern that could be phrased approximately in these terms: given many individuals, it is of interest that certain events or situations will affect most in a special way that presumably will influence their interpretation of reality and their behavior. The importance of stimuli has led some researchers to study stressful life events (Dohrenwend & Dohrenwend, 1974) and draw up life-event scales (Holmes & Rahe, 1967). This approach may prove to be useful since, ideally, it would identify some of the causes of massive copping out, of many psychosomatic illnesses, of social unrest, and of general dissatisfaction. It may also lead to the development of “tools” (administrative, professional, or personal, such as counseling or help provided through government agencies) to enable individuals to cope with specific situations. Irwin G. Sarason defines stress as a person’s assessment of what he or she finds is asked from the environment (see Chapter 10, this volume). It contains strong subjective elements and is clearly dfferent from the objective stimulus. The essence of this usage of the word stress could be expressed as follows: Given a stimulus,

Readers are advised to consult Chapters 9 and 10 in this volume, in which these two definitions are presented in greater detail.

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what really is of importance is not so much its objective meaning as its subjective impact. Events that are pleasant to most people can cause distress in some individuals who tend to become quite depressed and anxious upon observing a beautiful sunset; certain

energy-drained executives may go to pieces at the mere thought of

a holiday. This approach is relevant, not only to entire popula-

tions, but also to each individual without exception because the objective stimuli are evaluated through sociocultural background, personal experience, and idiosyncrasies. Of course, we cannot agree with the use of the word stress to express what we, and many other authors, have been calling for some years the objective stressor and its subjective counterpart, but we think that under any name these two areas should be clearly differentiated and investi-

gated. If we were to phrase our views in the same language, we would have to say that, given an objective stimulus that is assessed by the body, there are many responses, strategies, and coping mech- anisms-other than the agent-specific ones-that are put into action to ensure survival of the individual. These reactions pertain basically to the two well-known systems of behavior: fight (physical, metabolic, what we recently have called “catatoxic activity”) and flight (physical withdrawal from a situation and the psychological variants such as daydreaming, mental suppression of unpleasant ideas or events, etc.). In discussing stress, our expression shows strong overtones of a physiologist’s preoccupations, but, although the problems of perception and interpretation were not developed because they were somewhat outside the expertise of physiologists, provisions were made for them nevertheless, and cognitive and deliberative processes can be integrated into this model. We feel that none of the points of view presented up to now are irreconcilable. To the contrary, each underlines one important element of human encounter with the environment. We have tried to integrate them all in a simple diagram in Fig. 1-3,which is based on the elements

of stress that have been discussed so far.

Homeostatic Imbalance

Ever since Claude Bernard developed the concept of the milieu interieur and Walter Cannon (1939) coined the term homeostasis

to refer to the fluid stability of the milieu interieur, scientists have

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Fig. 1-3. Dealing with stressors usually entails finding the right specific response to the demand. Because endogenous and exogenous factors preside over the stimulus-to-response process, assessment may be modified by bringing a new outlook or by analyzing the situation from a different viewpoint. The nonspecifically secreted hormones are also meant to play a role in preparing for the specific response phase. With the human being’s evolved neocortex and with the variety of specific responses now available, however, these hormones may not be helpful in coping well with certain aspects of the environment. Dotted arrows indicate possible feedback.

used the notions-knowingly or not-to explain many phenomena that extend well beyond the limits of traditional physiology. We like to express people’s daily encounter with the environment in terms of homeostasis. Because harmony with the internal and external environment conditions survival, the individual fights to preserve or restore it. An event in the environment becomes a stimulus--or a stressor-whenever an individual’s homeostatic equi- librium is disrupted by it. Homeostasis can be endangered and restored at many different levels, for instance, vasoconstriction helps maintain adequate arterial tension after an important loss of blood. Psychological stimuli differ from physiological ones in that they are much more subject to interpretation. Human needs being more complex than those of an amoeba, the human network of communication with the environment is correspondingly much more elaborate. Most often, the brain is seen as an organ of thought that enables people

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to philosophize or enter into other highly thought of intellectual activities. To a biologist, the prime function of the nervous system is to allow individuals to deal with their environment, that is, to bring about perception and evaluation of events that may affect their well-being or survival, and also to elicit certain kinds of activity to reestablish harmony. When the body has to adapt to the demands of an external event (see Fig. 1-3),perception and interpretation of the stimulus lead to an assessment of the phenomenon and its implications; this may be considered the input. Then, specific potentially adaptive responses are tested, and one or many will be chosen and utilized; this is the output. If the response is adequate to the challenge, adaptation will follow as the stimulus is dealt with or a new level of homeostasis is reached. Evaluation of the demand is based partly on an individual’s background (e.g., genetic makeup, natural capacities, basic educa- tion, and recent experiences), which an individual draws upon for points of reference in assessing the significance of the stimulus. These factors are, in a way, the cast that will mold certain events, or the diffracting crystal that will give special colors to our experiences. These aspects of stress have been expertly discussed by the authors of other chapters of this book; our intention is only to underline the importance of the endogenous and exoge- nous factors that are referred to in Fig. 1-2. Specific responses may be intellectual, emotional, or metabolic, and they are not necessarily elicited late in the stimulus-to-response process. Specific physiological modifications may arise all along the process, starting with perception and carrying over into the specific reaction phase. The emotional arousal may begin with a growing awareness of the magnitude of the demand and subside once a specific countermeasure has been chosen. The intellectual responses depend upon individual predisposition, experience, and expertise, and these can be abetted through learning. This diagram is very simple and does not comprise the various phases leading to assessment or specific responses; in reality, many feedback loops are necessary to adequately reflect the process. This process may involve requests for additional information on the nature of the stimulus and the circumstances surrounding it, or a decision on a specific response may be arrived at after much internal dialogue and testing of possibilities. For the sake of

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simplicity, these details are not included here, for they are not essential for our discussion. Stress (the nonspecific response of the body) is initiated at a very early stage. In fact, nonspecific physiological adaptation starts as soon as the body becomes aware of a demand, which could be physiological as well as psychological, and this nonspecific response grows with the magnitude of the demand. If for some reason (internal conflict or lack of experience) the specific response is not easy to elicit, the stimulus-to-response process will be slowed down or stopped as evaluation of the situation is prolonged and as tentative, inadequate reactions are probed, thereby increasing stress. Nonspecific behavioral coping mechanisms may also be put into action, such as distracting one’s attention from the problem or orienting one’s attention to a secondary problem that suddenly seems to become most important. In rats, mild tail pinching several times a day leads to immediate hyperphagia, and other behavior patterns are also modified, for example, male infighting, sexual intercourse, and maternal attention to young pups are all increased by this stress procedure (Rowland & Antelman, 1976). Normal behavioral activity for this species becomes abnormal in that it occurs more frequently. These responses are not agent specific although they are goal oriented (and the goal is determined by the environment ).

STRESS AND COPING MECHANISMS

Stress develops in people whenever survival is at stake. We have previously noted that this response increases people’s resistance and therefore improves their chances of survival. Obviously, people do not like these stressful events, for so many of their efforts have been directed to doing away with them. In the modern world, well-organized, well-policed, welfare-oriented states have made our physiological stress response less relevant by removing many of the stressors that our ancestors knew. Stress nowadays is not so much associated with physical survival as with a certain idea of survival. Society has identified new values that have been tagged as “necessary for survival,” and part of the nonspecific response is needlessly elicited. Sitting for an exam, applying for a job, the climate of competition in which money

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and power are the criteria of success-these are some of today’s stressors that elicit the old physiological response preparing the human organism for physical activity.

We have already discussed some of the principles that could be used as guidelines for adapting to stress situations. Of course, a serious neurosis or severe anxiety will affect an individual’s capacity to deal with stress. This problem, however, should be left for specialists to discuss, and we would like to confine our remarks as much as possible to the “normal and healthy” public. Broadly speaking, coping with stress in our society can be

(1) by removing stressors from our

lives, (2) by not allowing certain neutral events to become stressors, (3) by developing a proficiency in dealing with conditions we do not want to avoid, and (4) by seeking relaxation or diversion from the demand. 1. Changing the environment-In some cases at least, it would be easier to alter social conditions to human needs than to force people to waste their energy trying to adapt to changes in the environment that are of their own making and that they could easily modify. Think of the uselessness, for example, of daily traffic jams, overpopulated housing projects, and the irrelevance of much of our schooling. When society has a choice in determining certain parameters of the environment, it should not disregard the needs of people to relate, to communicate, and to exercise physically, etc., which have been forgotten in recent times. 2. Handling the potential stressors-Modifying one’s perspective of things is an effective individual way of coping with stress. Very often, severe stress is induced unnecessarily when there is little or no correspondence between the objective and subjective stressors (e.g., the boss’s remarks and the secretary’s interpretation). It is not so much to what we react, but how we react that is at the root of the problem. There is a parallel in the field of pathology, namely, allergy. Although most people do not react to common allergens, certain individuals will mobilize important immunological defense mechan- isms against them. In this case, it is not the allergens (what they react to) but the response (how they react) that is the cause of disease. The allergen per se is not injurious to their health, but by mobilizing unnecessary defense reactions, people make themselves sick.

accomplished at four levels:

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Taking an exam does not have the same survival significance as living through a drought or facing a pack of wolves, yet we have not learned to respond in a different way to these stressors. The prevalent value system needs constant rethinking by individuals. For example, at times, during a workshop or seminar, one of the authors (Tache) has asked executives to fill in the Holmes and Rahe (1967) Social Readjustment Rating questionnaire in which various life events are graded, with marriage as the point of reference. Contrary to the norms for this instrument, “being fired from work” was rated by senior government managers above “divorce” and “death of a close family member.” When made aware of these ratings, however, many wished to modify their evaluation. Competition is not made by our society; it is a law of nature, a condition of survival. People have always competed against animals and other people for food, possession of territory, or shelter. These

necessities are basic inasmuch as, without their acquisition, survival is impossible. They are replaced by the “luxury” necessities that are now proposed to us as being basic. From the two-family house of some years ago, we have evolved to the two-house family, which in itself would not be bad were it not for the fact that it has now become an “essential,” a criterion of success. Obviously a new set of values needs to be proposed so that the inborn tendency to compete will be more usefully oriented toward goals that will not be shrouded by an aura of the “need for survival.” 3. Finding adequate specific responses-In all cases in which an event has become a stressor, an adequate specific response elicited as rapidly as possible will relieve stress. Barring quantitative

an expert,

the trade, and learns how to use them. In

other words, when the capacity to elicit the specific response has been developed, the demand of a stressor will be assessed differently. A manager once told us that she spent three days (and nearly as many nights) writing her first letter as special assistant to

a deputy minister; at the time of relating her case, she claimed that she could now write important letters without becoming personally involved. 4. Seeking relaxation or diversion from the demand-After a hard day’s work, even highly trained people may find that tension has accumulated and they feel tired. Although the objective

overload,

stress levels will

of

decrease,

as

one

becomes

develops the tools

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22

J. TACHE AND H. SELYE

stimulus is no longer present, the body keeps responding to it. The brain still seems to be working and imposing on us a tension that we want to relieve. It is often said that if you can relax your muscles, the psychological cause of your tension will disappear. Whether this is true or not, we cannot but be impressed by the number of people claiming that such exercises are beneficial and do help them to get away from the demands. Numerous techniques are now being proposed, from Transcendental Meditation (Bloomfield & Kory, 1976; see also Chapter 13, this volume), the Relaxation Response (Benson, Beary, & Carol, 1974), and autogenic training (Luthe, 1969), to transactional analysis and yoga. Physical exercise would be similar in its effects. For some, these are replacing the five o’clock martini in pleasant surroundings. Although such techniques do not seem to work equally well for all, it may still be worth the time and effort to take a close look at them.

Priorities in Choosing Coping Techniques

The most popular stress-reducing techniques may not be the most effective or the most useful for a particular person. Reducing stress sometimes entails refusing to be placed under stress and, up to a point, refusing to meet challenges. While this may make you a healthier animal, it would hardly facilitate your becoming an executive vice-president. Regular hours, good eating habits, physical exercise, and physical withdrawal from stressful situations are reported to be associated with less stress symptoms than other more result-oriented techniques such as a change to a different work activity, a new strategy of attack on work, etc. (Howard, Rechnitzer, & Cunningham, 1975). Stress is the price that individuals have had to pay to survive as animals; humans now pay the same price to accomplish what they consider great things. There should be a proportion between what people want to do and what they can do, between the significance of challenges they rise to meet and the prices they will have to pay as a consequence. Their goals and priorities should be established accordingly.

In

this chapter,

our

competence, but we have done so in an effort to bridge

we have extended

ourselves well beyond

field of

the gap between the different disciplines. We hope that psycholo-

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ON STRESS AND COPING MECHANISMS

23

gists and sociologists working on problems of stress will also give their attention to correlating their observations with those made in different fields.

REFERENCES

Benson, H., Beary, J. F., & Carol, M. P. The relaxation response. Psychiatry,

1974, 37, 37-46.

Bloomfield, H. H., & Kory, R. B. Happiness: The TM program, psychiatry, and enlightenment. New York: Simon & Schuster, Dawn Press, 1976. Cannon, W. B. The wisdom of the body. New York: Norton, 1939. Collu, R., & JCquier, J. C. Pituitary response to auditory stress: Effect of treatment with a-methyl-p-tyrosine. Usefulness of a factorial mixed design for statistical analysis. Canadian Journal of Physiology and Pharmacology,

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Dohrenwend, B. S., & Dohrenwend, B. P. (Eds.). Stressful life events: Their nature and effects. New York: Wiley, 1974. Elvidge, H., Challis, J. R. G., Robinson, J. S., Roper, C., & Thorburn, G. D. Influence of handling and sedation on plasma cortisol in Rhesus monkeys (Macaca mulatta). Journal of Endocrinology, 1976, 70, 325-326. Halkz, B., & Pupp, L. Hormone secretion of the anterior pituitary gland after physical interruption of all nervous pathways to the hypophysiotrophic area. Endocrinology, 1965, 77, 553-562. Holmes, T. H., & Rahe, R. H. The social readjustment rating scale. Journal of Psychosomatic Research, 1967, 11, 213-218. Howard, J. H., Rechnitzer, P. A., & Cunningham, D. A. Coping with job tension: Effective and ineffective methods. Public Personnel Management,

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Lazarus, R. S. Psychological stress and coping in adaptation and illness. International Journal of Psychiatry and Medicine, 1974, 5, 321-333. Luthe, W. Autogenic therapy. New York: Grune & Stratton, 1969. Mason, J. W. A re-evaluation of the concept of “non-specificity” in stress theory. Journal of Psychiatry Research, 1971, 8, 323-333. Mason, J. W. Specificity in the organization of neuroendocrine response profiles. In P. Seeman & G. M. Brown (Eds.), Frontiers in neurology and neuroscience research. Toronto: University of Toronto, 1974, 68-80. Mason, J. W. A historical view of the stress field. Journal of Humon Stress,

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Rowland, N. E., & Antelman, S. M. Stress-induced hyperphagia and obesity in

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Salas,

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Selye, H. The stress of life (2nd ed.). New York: McGraw-Hill, 1976. (a) Selye, H. Stress in health and disease. Reading, Mass.: Butterworth, 1976. (b) Spielberger, C. D. Trait-state anxiety and motor behavior. Journal of Motor Behavior, 1971, 3, 265-279. Tach6, Y., Du Ruisseau, P., TachC, J., Selye, H., & Collu, R. Shift in adenohypophyseal activity during chronic intermittent immobilization of rats. Neuroendocrinology, 1976, 22, 325-336.