Our findings show that social and psychological aspects of work situations are indeed significant risk factors for coronary heart disease, but not in the manner that might initially be supposed. While the psychological demands of work, along with time pressures and conflicts, are found to be significant sources of risk in many of our studies, work that is demanding (within limits) is not the major source of risk. The primary work-related risk factor appears to be lack of control over how one meets the job's demands and how one uses one's skills. In many cases, elevation of risk with a demanding job appears only when these demands occur in interaction with low control on the job. Other research has shown that regular physical exertion has positive effects on cardiovascular health in many situations (although physical hazards can of course pose major health threats beyond our stress perspective). Thus, in our research findings it is not the demands of work itself but the organizational structure of work that plays the most consistent role in the development of stress-related illness. (Theorell & Karasek, 1990, p. 9)
It has been known for many years that psychological stress can and does suppress the immune system, creating a situation in individuals where opportunistic infections, those that are around us every day but only rarely affect us, cause disease. Yet, historically such disease as this is often thought of as psychosomatic, regardless of the fact that it has been known for decades that stress on the mind can and does effect the body, making the body a host for illness, that may initially have been associated with an attempt by the body to force rest.
Psychological distress can suppress the body's defenses to the point of inducing physical illness. A college student suffers from a strep throat infection while studying for final exams. A corporate executive loses her voice prior to an important presentation to stockholders. A high school senior wakes up with a horrible headache on the morning of the prom. Both parents come down with the flu. after several sleepless nights with their sick child. Virtually everyone has experienced similar reactions. Who hasn't pondered why illness strikes precisely when it can be afforded least? Often, people wonder if these maladies are real or just "psychological." (Devito, 1994, p. 27)
The fundamental idea that stress can cause or at least make the body susceptible to disease has been so squelched in our society that individuals are often accused of faking sick to get out of whatever stressful situation they might find themselves in. Yet, there is a clear sense that this is a cultural construct that does not reflect what is actually happening, i.e. The individuals' body is weakened, from unresolved stress and is then reacting by allowing disease to surface.
The diagnosis is not always simple and straightforward. For centuries, physicians, philosophers, and psychologists have noted the apparent relationship among stress, illness, and health. Recently, medical scientists firmly have established causal relationships between them and have shown how our minds and emotions can influence the course of a disease. (Devito, 1994, p. 27)
Definitions of stress and stress related illness have been historically vague, resulting not ina universal defining character but an anomalous idea of what stress is and how it manifests in people. An historical overview of stress, and the research and theory surrounding it explains a great deal of the essential way in which stress affects the human mind and body. 20th-century physiological psychologist Walter Cannon and Canadian physician Hans Seyle are the seminal researchers of the modern ideology of stress, as it relates to humans. Cannon can be credited with observations, briefly touched on above, regarding the physical and mental reaction to stress;
Cannon defined the classic "fight-or-flight" reaction: When faced with stress, the body prepares for the emergency through the sympathetic portion of the autonomic nervous system. Adrenalin, a hormone, is released into the bloodstream through the adrenal glands and generates the energy to cope with the stressors, not unlike an army ready to defend its territory against an invader. Cannon maintained that this hormonal reaction was a remnant of humans' ancient past, when most stressors could be handled only through radical and robust...
In order to survive, our ancestors fought prey and fled from predators. Such intense reactions are not required in modem society; in fact, this kind of response potentially could be harmful to one's health and well-being. Consider how inefficient it would be to rely on "fight-or-flight" in order to pay bills, change a flat tire during rush hour, or ask a supervisor for a raise. Burnout may be the result of such overreactions to stress. (Devito, 1994, p. 27)
Cannon can then also be credited with the idea that historical physiological reactions to stress are not usually compatible with modern life. The individual actually spends a great deal of his or her developmental energy learning to suppress overreaction to external stressors and cannot in fact function appropriately without such skill. To mature in a modern sense has a great deal to do with moderating these physiological reactions to stress and not allowing them to dictate the outward actions. Anger is a particularly troubling aspect of the fight or flight response as manifest anger can seriously hamper social situations and dictate overreactions to stressful stimulus. Additionally on the flight side of the equation, fear can dictate flight, an create a situation where someone retreats from a situation, manifest in avoidance, which can simply make the situation worse, if one physically leaves or does what many report as "shut down" mentally and therefore become resistant to resolution. Either way the extremes of these responses are fundamentally hard wired and it takes years of maturation and social conditioning to challenge them. If this were not the case the world would be populated by very large two-year-olds, with little if any ability to mitigate behavioral responses associated with stress. Yet, when stress is prolonged, or as has been mentioned associated with ambiguity and lack of empowerment with regard to stress navigation, but stress reaction is expected to be socially acceptable individuals can experience pressure that manifests as stress-related illness. This can be associated with a whole list of disease processes, including but not limited to coronary disease. Seyle on the other hand is credited for studying stress from a situational or environmental view, taking into consideration the natural reaction to stress and then coupling it with abnormal suppression of stressful resolution:
Seyle studied stress by identifying those situations in which it occurs. A stressor is an event that places inordinate demands on the body and, in turn, sets off natural adaptive bodily defenses to cope with it. The process that he labeled the General Adaptation Syndrome includes three stages: the alarm reaction, resistance, and exhaustion. During the alarm reaction, there are increases in hormone levels, strong physical arousal, and severe emotional upheavals. When the alarm reaction is not sufficient to cope, the stressor maintains its attack. Enter resistance. During this stage, when successful, the stressor is tamed and normality returns. If coping is not successful, however, hormonal reserves become depleted, fatigue sets in, and the stage of exhaustion takes over, during which adaptation to the stressor breaks down completely. (Devito, 1994, p. 27)
It is during the exhaustion phase, but really more the whole process of navigating up and down an arc of physiological and psychological response that exhaust the individual, which then results in either a continual physiological state of stress or a moderated level of stress, suppressed by social norms and this leads almost directly to stress-related illness. Unresolved and recurring stress can lead to depression, anxiety, serious illness or even death.
Illnesses associated with stress once were known as psychosomatic disorders; today, the term psychophysiological more commonly is used. They have been referred to as diseases of adaptation since they are rooted in attempts to adapt physiologically to everyday tensions and problems. Psychophysiological disorders encompass common physical ailments such as asthma, chronic hyperventilation, peptic ulcers, colitis, hypertension, heart attacks, hives, and acne. Research by the psychologist Marianne Frankenhauser has corroborated Seyles' landmark work. Frankenhauser found that urban commuting, job dissatisfaction, personal conflict, loss of control over individual life decisions, taking exams, noise, anticipation of aversive events, and even boredom are profound stressors. (Devito, 1994, p. 27)
It is also important to note more modern connections between stress-induced illnesses and fundamental imbalances which can manifest into physical conditions that harbor disease, such as clinical obesity and even a simple state of overweight which is a result of adaptive physiology going wrong and effecting the body in negative ways. Though many like to attribute overweight and obesity to lifestyle choices and therefore behavioral problems, associate with over eating and a sedentary lifestyle the condition is often a symptom of stress that then exacerbates other stress…
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