BTRIPP (btripp) wrote,

Good News For "Type-A" Types ...

As I've noted here from time to time, books coming out from the “Early Reviewer” program do have a tendency to just be “meh” … probably being due to being something of a “pig in a poke”, where one requests review copies on a couple of sentences of description in most cases. However, every now and again there's a “WOW!” book and Kelly McGonigal's The Upside of Stress: Why Stress Is Good for You, and How to Get Good at It is one of those. Now, I need to preface this all with a bit of a caveat: While Ms. McGonigal is a PhD (in Psychology from Stanford), I'm not sure how “grounded” her material is in a wider scope of research … while much of this is referenced to various studies, I don't get the sense of it being exactly massively vetted, and I kept wondering if this was like some of the “newagey” stuff out there (albeit, pointing in a rather different direction) which cherry-picks bits of research, often out of context, to support a “revolutionary” stance. And, frankly, the central thesis of the book is sufficiently removed from the realm of “common knowledge” that it could well have been featured in Woody Allen's “Sleeper” … where is character wakes up after 200 years in cryogenic suspension to a world where deep fat, steak, cream pies, and fudge are deemed health foods … so why not “stress is good for you” as well?

The author describes how she used to be “like everybody else” in believing stress is bad for you, and taught classes and workshops to get folks to “do whatever you can to reduce the stress in your life” , but then she ran across a study that changed her mind. I'm having a hard time effectively paraphrasing this, so forgive the long quote – but this is the “launching point” for the book:
… In 1998, thirty thousand adults in the United States were asked how much stress they had experienced in the past year. They were also asked, Do you believe stress is harmful to your health?
      Eight years later, the researchers scoured public records to find out who among the thirty thousand participants had died. Let me deliver the bad news first. High levels of stress increased the risk of dying by 43 percent. But – and this is what got my attention – that increased risk applied only to people who also believed that stress was harming their health. People who reported high levels of stress but who did not view their stress as harmful were not more likely to die. In fact, they had the lowest risk of death of anyone in the study, even lower than those who reported experiencing very little stress.
      The researchers concluded that it wasn't stress alone that was killing people. It was the combination of stress and the belief that stress is harmful. The researchers estimated that over the eight years they conducted their study, 182,000 Americans may have died prematurely because they believed that stress was harming their health.
      That number stopped my in my tracks. We're talking over twenty thousand deaths a year! According to statistics from the Centers for Disease Control and Prevention, that would make “believing that stress is bad for you” the fifteenth-leading cause of death in the United States, killing more people than skin cancer, HIV/AIDS, and homicide.
She obviously “connected the dots” and realized that her “anti-stress” work might well be killing people. She then looked at various health “crusades” that generally had backfired, from graphic anti-smoking materials to “shaming” strategies for weight loss, a lot of what passed for “common knowledge” in the medical community has turned out to be counter-productive when actually studied. And, just like smokers increasing their smoking in response to autopsy pics of cigarette-blackened lungs, or overweight subjects doubling their calorie intake in the wake of “eat healthy” campaigns, McGonigal realized that her audiences frequently were more depressed and distraught than before she “told them what to do” about stress. After digging into the subject she'd pretty much done a 180° turn:
… The latest science reveals that stress can make you smarter, stronger, and more successful. It helps you learn and grow. It can even inspire courage and compassion.
      The new science also shows that changing your mind about stress can make you healthier and happier. How you think about stress affects everything from your cardiovascular health to your ability to find meaning in life. The best way to manage stress isn't to reduce or avoid it, but rather to rethink and even embrace it.
Needless to say, this sounded like great news to somebody like me who's spent decades driving the body and mind to the limits of exhaustion – or in the Cowboy phrase “ridden hard and put away wet” – nice to think I wasn't killing myself all that time!

One criticism I've seen about the author's work here is that she doesn't have a sharply-defined concept of “stress” … she does offer up a definition, however: “Stress is what arises when something you care about is at stake.”, which one does have to admit is a bit wide-reaching and non-specific … and she does address the fact that covers a lot of ground. However, one person's major stressor might be another's minor irritation (she uses her personal fear of flying as an example which a lot of people would find laughable), and vice-versa, so having an “umbrella” that is big enough to cover “being out of cigarettes” and “death of a family member” is probably a good idea.

There's another key psychological field that plays into the main thrusts of the book, and that's “mindsets” … “Mindsets are beliefs that shape your reality, including objective physical reactions … and even long-term health, happiness, and success.” … and what's amazing about this work is that a single brief “intervention” addressed at changing one's mindset on something can seed seemingly permanent change. One study she cites was done with hotel housekeeping staffs, who were generally overweight with bad cardiovascular numbers … much as if they were sedentary (and they believed that they “weren't exercising regularly”) … the researcher, Alia Crum (another Psychology PhD at Stanford), developed an information program (posters and 15-minute presentations) describing how their work was exercise, burning as much as 300 calories an hour, and exposed a test group to this. The test group's mindset was changed from seeing their work as “hard on their bodies” to being “intensive exercise”, and, with just this shift, they began to lose weight, and improve their over-all health … results not seen in the “control groups” which did not have the material presented to them.

Crum also did research on how one's expectations effected hunger hormones … where what one had been told about a food, in this case a milkshake, determined the blood chemistry the subjects exhibited. She also developed a protocol for testing stress reactions, where subjects (including the author) went through a mock job interview, structured to be a horrible experience. One set of subjects first saw a 3-minute video about how stress can enhance performance, and the other set saw a video about how stress is worse for them than they thought … and both groups were tested for the presence of two “stress hormones”, DHEA and Cortisol, in their saliva during the experiment. Remarkably, the variable of which video was shown determined the ratio of these hormones, with the “stress is good” message providing a positive mix.

So, how did the “stress is bad” mindset get so established in the medical and psychological orthodoxies (let alone public opinion)? In 1936 Hungarian endocrinologist Hans Selye was doing a series of experiments involving injecting various substances into rats. He was noticing that the rats were having the same bad reactions no matter what he was injecting them with … and eventually generalized a theory that the structure of the experiment (injections, etc.) was what was making the rats sick (and eventually dead), and came up with “stress” as the word for the cause. His definition of stress was “the response of the body to any demand made on it”, not (in the author's description) “just a response to noxious injections, traumatic injuries, or brutal laboratory conditions, but anything that requires action or adaptation” – leading to pretty much anything being a potential lethal stress-inducer.

His work became a world-wide phenomenon (he was nominated for the Nobel Prize 10 times), and he published and lectured all over the globe … with the funding of the tobacco industry(!). Yes, back in those days, cigarettes were often marketed as a way to relax, and Selye even testified in Congress “that smoking was a good way to prevent the harmful effects of stress”. Also, most of his research (and those following) was based on investigations of lab rats, in hideous situations (the author describes it as “The Hunger Games for rodents”) that was then generalized to humans … even though humans (thankfully) rarely are subjected to the extreme degrees of “stress” that the poor rats in these studies were.

One of the things glossed over in these experiments is that sometimes the rats sailed through with no bad effects … which led other researchers to look at what might be “good”in stress. The author sums up these as: “The stress response helps you rise to the challenge, connect with others, and learn and grow.” … with specific examples of the various ways those happen. The stress response releases hormones that can be very beneficial, if “framed” properly, and this is where the “mindset” work comes in … even a very brief re-framing of what one expects out of stress can make a remarkable difference in how that stress is processed – not only mentally, but in terms of one's bio-chemistry.

There's quite a lot in here about how various researchers have implemented mindset-shifting programs in numerous settings, from “last chance” inner-urban schools to video game players … the subjects that got the messaging were able to re-frame threats into “challenges”, and overcome what previously seemed insurmountable.

The author shows that there are a lot more dimensions to stress-response than the familiar “fight or flight” dichotomy … she also proposes a “tend and befriend” aspect, which is typified by those who have been through horrific experiences frequently devoting their lives to help others. In this form, substances such as oxytocin, dopamine, and serotonin come into play, directly shifting how the brain is relating to situations around it.

A third modality she presents really hit home for me, the “defeat response” … which I feel is more prevalent than one would want to think:
The defeat response is a biologically hardwired response to repeated victimization that leads to loss of appetite, social isolation, depression, and even suicide. Its main effect is to make you withdraw. You lose motivation, hope, and the desire to connect with others. It becomes impossible to see meaning in your life, or to imagine any action you could take to improve the situation. Not every loss or trauma leads to a defeat response – it kicks in only when you feel that you have been beaten by your circumstances or rejected by your community. In other words, when you think there is nothing left that you can do and nobody who cares.
Yeah, it sounds like she's been reading my poetry!

The book is full of lots of stories from school systems, corporations, governmental programs, and psychological research which offer examples where the sort of mindset adjustment making stress appear as a beneficial factor in one's experience lead to vastly improved results versus “control” groups that got no messaging, or groups who were unfortunately exposed to “stress is bad” messages … results that not only were notable in their statistics, but also appear to have long-lasting effects.

Now, the copy I have is an “ARC” – advance reading copy – which often does not represent the final format of the book … I'm hoping that the published version (which came out last month) has set up the “exercises” in a more structured way, as they're easy to miss here, and they offer a lot of benefit … it would be great if those were in “boxes” or somehow otherwise set outside the general flow of the text, making them easier to find and refer back to. That was one of my few gripes with The Upside of Stress.

As the author somewhat intimates at points, even reading the book may have the sort of mindset-shifting effect to move the reader towards a more positive interface with stress … after all, if a 3-minute video on how stress can be a positive factor can change physical responses, how much more would reading a 300-page book with the same message help make those changes? While I'm not suggesting this is a “magic pill” for stress … stranger things (NLP, placebos performing better than actual drugs, various spiritual practices) have happened. In any account, it's an interesting read, and I can't think of anybody whose existence is sufficiently stress-free that they wouldn't get something out of this. As noted, it's only been out a month as of this writing, so your odds are pretty good of finding it in your local bookstore … and the on-line guys seem to have the hardcover for about a third off of cover price at the moment. I must admit, the caveats outlined at the top of this review still hang over this a bit … I hope that what McGonigal is outlining here is real and that the research will eventually come to solidify this version of stress, replacing the “tortured rats” model of Selye and his followers … but on some levels it has that “too good to be true” scent, making me hold off of a 100% endorsement of it.

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