Chapter 11 Stress Health and Human Flourishing Power

Chapter 11 Stress, Health, and Human Flourishing Power. Point® Presentation by Jim Foley

Stress and Health Topics that hopefully won’t become stressors § Stress: a Process of perceiving and responding to stressors § Stressors: § Catastrophes, § Life Changes, § Daily Hassles § The stress response system: General Adaptation Syndrome Psychoneuroimmunology: § Stress and Illness § Stress and AIDS, cancer, Heart Disease § Personality Factors and stress: Type A, pessimism § The role of hormones and inflammation

Health Psychology § Emotions, as well as personality, attitudes, behaviors, and responses to stress, can have an impact on our overall health. § Health psychology studies these impacts, as part of the broader field of behavioral medicine. § Topics of study in health psychology include: § the phases of stress response and adaptation § how stress and health are affected by • appraisal of stressors • severity of stressors • personality types • perceived control • emotion or problem focus • optimism • social support • exercise • relaxation • religious faith and participation

Stress: A Focus of Health Psychology § Many people report being affected by “stress. ” § Some terms psychologists use to talk about stress: § a stressor is an event or condition which we view as threatening, challenging, or overwhelming. § Examples include poverty, an explosion, a psychology test, feeling cold, being in a plane, and loud noises. § appraisal refers to deciding whether to view something as a stressor. § stress reaction refers to any emotional and physical responses to the stressor such as rapid heartbeat, elevated cortisol levels, and crying. Stress refers to the process of appraising and responding to events which we consider threatening or challenging.

Clarifying the Components of Stress § Stress isn’t something that happens to you; it’s a process in which you participate. § The process includes the stressor (event or condition), cognitive appraisal, body response, and coping strategies. § The advantage of breaking “stress” into these components is that we can see options for altering each of these different factors. What could this person do to reduce his level of suffering from stress?

Appraisal: Choosing How to View a Situation Questions to ask yourself when facing a possible stressor: Is this a challenge, and will I tackle it? Is it overwhelming, and will I give up? There are few conditions* that are inherently and universally stressful; we can often choose our appraisal and our responses. *extreme, chronic physical threats or challenges (such as noise or starvation)

Beneficial and Harmful Stress Effects A brief experience of stress can be beneficial: § improving immune system response § motivating action § focusing priorities § feeling engaged, energized, and satisfied § providing challenges that encourage growth, knowledge, and self-esteem Extreme or prolonged stress, causes problems: § mental and physical coping systems become overwhelmed and defeated rather than strengthened § immune functioning and other health factors decline because of damage The key factor is whethere is a chance for recovery and healing.

Stressors There may be a spectrum of levels of intensity and persistence of stressors. We can also see stressors as falling into one of four* categories: § catastrophes. § significant life changes. § chronic daily hassles. § low social status/power. *the text focuses on the first three. Stressors refer to the events and conditions that trigger our stress response, because they are perceived/ appraised as overwhelmingly challenging, threatening, and/or harmful.

Catastrophic Events/Conditions § Appraisal is not essential in a catastrophic event. Most people agree that the event is harmful and overwhelming. § Examples include earthquakes, floods, hurricanes, war/combat, and wildfires. § It can be one single event or chronic harmful conditions. § Short-term effects include increased heart attacks on the day of the event. § Long term effects include depression, nightmares, anxiety, and flashbacks. § Bonding: both the trauma and the recovery are shared with others.

Major Life Events/Changes § Even supposedly “happy” life changes, such as marriage, starting college or a new job, or the birth or adoption of a child, can bring increased challenge and stress. § Change is often challenging. § New roles, new priorities, and new tasks can put a strain on our coping resources. § The challenge, and the negative impact on health, increases when: § the changes are painful, such as a death in family, loss of job, or heart attack. § the changes are in a cluster, and there are too many at once.

Chronic Daily Difficulties Daily difficulties can be caused by facing too many tasks, too little time, and too little control. Daily difficulties can be caused by the lack of social power and freedom: § being bullied § living in poverty § living under oppressive political conditions

The Body’s Stress Response System When encountering a sudden trauma or other stressor, our body acts to increase our resistance to threat and harm. Phase 1: The “fight or flight” sympathetic nervous system responds, reducing pain and increasing the heart rate. The core of the adrenal glands produces norepinephrine and epinephrine (adrenaline). This system, identified by Walter Cannon (1871 -1945), gives us energy to act. Phase 2: The brain sends signals to the outer part of the adrenal glands to produce cortisol and other stress hormones. These focus us on planning adaptive coping strategies and resisting defeat by the stressor. Hans Selye (1907 -1982) indentified this extended “resistance” phase of the stress response, followed by: Phase 3: Exhaustion.

General Adaptation Syndrome [GAS] (Identified by Hans Selye): Our stress response system defends, then fatigues.

Effects of Prolonged Stress § The General Adaptation Syndrome [GAS] works well for single exposures to stress. § Repeated and prolonged stress, with too much Phase 3 time, leads to various signs of physical deterioration and premature aging: § the production of new neurons declines § neural circuits in the brain break down § DNA telomeres (chromosome tips) shorten, cells lose ability to divide, cells die, tissue stops regenerating, early aging and death

Female and Male Stress Response § In response to a stressor such § Men under stress are more as the death of a loved one, likely to socially withdraw and women may “tend and numb themselves with befriend”: nurture themselves alcohol. and others, and bond together. § Men are also more likely to § The bonding hormone oxytocin become aggressive under may play a role in this bonding. stress. § Women show behavioral and § In either case, men’s behavior neurological signs of becoming and brains show LESS more empathetic under stress. empathy and less tuning in to others under stress.

Studying the Stress-Illness Relationship § How does stress increase our risk of disease? § This is the subject of a new field of study: psychoneuroimmunology, the study of how interacting psychological, neural, and endocrine processes affect health. § Psychologists no longer use the term “psychosomatic” because it has come to mean an imagined illness. § We now refer to psychophysiological illness, a real illness caused in part by psychological factors such as the experience of stress.

How the immune system works, before stress plays a role:

Stress Increases The Risk of Illness Here we see psychoneuroimmunology in action: § psychological factors, such as appraisal, thoughts, and feelings. § neurological factors, such as brain signals engaging the stress response system. § immunology, such as stress hormone exposure which suppresses the immune system. Stress ors Apprai sal Thoug hts Feelin gs Brain signals Horm onal action Immu ne suppr ession Risk of illness

Psychoneuroimmunology Example: The Impact of Stress on Catching a Cold In a group exposed to germs, those experiencing stress were more likely to catch a cold. This tradeoff between stress response and immune response may help our bodies focus energy on managing stress.

Stress, AIDS, and Cancer AIDS = Acquired Immune Deficiency Syndrome Cancer: the stress link is not as clear § Because the stress response § Stress may weaken the suppresses the immune body’s defenses against response, exposure to the replication and spread stress obviously worsens of malignant cells. the development of AIDS in those exposed to HIV. § Reducing stress slows the progression of AIDS. This does NOT mean that stress causes cancer or AIDS.

Stress and Heart Disease In coronary heart/artery disease, the blood vessels that provide oxygen and nutrients to the heart muscle itself become clogged, narrowed, and closed. Clogging of the coronary artery Many factors contribute to heart disease. § Biological: genetic predisposition to high blood pressure and high cholesterol § Behavioral: smoking, inactivity, and high-fat diet § Psychological: chronic stress, and personality styles that worsen the experience of stress

Type A Personality Stress Heart Disease § People with a type A personality are impatient, verbally aggressive, and always pushing themselves and others to achieve. § People with a type B personality are more relaxed and go with the flow. § In one study, heart attacks ONLY struck people with Type A traits. § Accomplishing goals is healthy, but a compulsion to always be working, with little time spent “smelling the flowers, ” is not. Also a problem: ANGER. To reduce anger-related stress: defuse anger with exercise, talking, forgiveness, NOT “letting it out” (catharsis) by screaming, punching.

Pessimism and Heart Disease It can be helpful to realistically anticipate negative events that may happen, and to plan how to prevent or cope with them. Pessimism refers to the assumption that negative outcomes will happen, and often facing them by complaining and/or giving up. Men who are generally pessimistic are more likely to develop heart disease within ten years than optimists.

Depression and Heart Disease § Why does depression appear so often with heart disease? Does one cause the other? § One possible answer is that the two problems are both caused by chronic stress. § There may be an intervening variable: excessive inflammation.

Health Consequences of Chronic Stress: The Repeated Release of Stress Hormones § The stress hormone cortisol helps our bodies respond to brief stress. § Chronically high cortisol levels damage the body.

Coping with Stress and Promoting Health How to go from coping to thriving § Problem-focused and emotion-focused coping § Perceived control and learned helplessness § Benefits of Optimism, Social support § Reducing stress effects with Aerobic Exercise § The power of Faith communities § Complementary and Alternative Medicine

Promoting Health Some ways to reduce the health effects of stress include: § address the stressors. § soothe emotions. § increase one’s sense of control over stressors. § exchange optimism for pessimism. § get social support. Ways that help some people to reduce levels of stress, and to improve health: § aerobic exercise § relaxation and meditation § participation in communities of faith § alternative medicine

Coping with Stress Problem-focused coping means reducing the stressors, such as by working out a conflict, or tackling a difficult project. § Risk: magnifying emotional distress, especially if trying to change something that’s difficult to change (e. g. another person’s traits). Emotion-focused coping means reducing the emotional impact of stress by getting support, comfort, and perspective from others. § Risk: ignoring the problem. § We might focus on this style of coping when we perceive the stressor as something we cannot change.

Learned Helplessness vs. Personal Control Experiment by Martin Seligman: Give a dog no chance of escape from repeated shocks. Result: It will give up on trying to escape pain, even when it later has the option to do so. Normally, most creatures try to escape or end a painful situation. But experience can make us lose hope. Learned Helplessness: Declining to help oneself after repeated attempts to do so have failed. Personal Control: When people are given some choices (not too many), they thrive.

Stress factor: Perceived Level of Control Experiment: the left and middle rats below received shocks. The rat on the left was able to turn off the shocks for both rats. Which rat had the worst stress and health problems? § Only the middle, subordinate rat had increased ulcers. § It is not the level of shock, but the level of control over the shock, which created stress.

External vs. Internal Locus of Control Locus of control: Our perception of where the seat of power over our lives is located. Internal locus of control: we feel that we are in charge of ourselves and our circumstances. Too much internal locus of control: We blame ourselves for bad events, or have the illusion that we have the power to prevent bad events. External locus of control: we picture that a force outside of ourselves controls our fate. Too much external locus of control: We lose initiative, lose motivation to achieve, have more anxiety about what might happen to us, don’t bother developing willpower.

Self-Control: Resource, Skill, Trait § The ability to control impulses and delay gratification, sometimes called “willpower” § This is a finite resource, an expenditure of brain energy, which is replenished but can be depleted short-term: People asked to resist eating cookies later gave up sooner on a tedious task § With practice, we can improve our selfcontrol § There seem to be individual differences in this trait in childhood § The Marshmallow study: Kids who resisted the temptation to eat marshmallows later had more success in school and socially

Optimism vs. Pessimism We can be optimistic or pessimistic in various ways: § Prediction: We can expect the best or the worst. At the extremes, we can get ourselves overconfident or simply depressed or anxious about the future. § Focus of attention: We can focus on what we have (half full) or what we don’t have (empty). § Attribution of intent: We can assume that people meant to hurt us or that they were having a bad day. § Valuation: We can assume that we or others are useless, or that we are lovable, valuable. § Potential for change: We can assume that bad things can’t be changed, or have hope.

Excessive Pessimism I can’t do it, might as well forget it. vs. Realism It might be hard; I’d better plan. Excessive Optimism It will be easy, I won’t think about it. I’m trapped, can’t get out of this I want to make changes or get out. Someone will rescue me. That person hates me, he is against me. I should ask what he feels about me, what he wants. I’m sure he just wants what’s best for me, I’ll trust him. Excessive pessimism can leave us depressed, inactive. Excessive optimism can leave us unprepared, unsafe.

Promoting Health: Social Support § Having close relationships is associated with improved health, immune functioning, and longevity. § Social support, including from pets, provides a calming effect that reduces blood pressure and stress hormones. § Confiding in others helps manage painful feelings. § Laughter helps too. “Well, I think you’re wonderful. ”

Aerobic Exercise and Health § Aerobic exercise triggers certain Aerobic exercise refers genes to produce proteins which to sustained activity that guard against more than 20 raises heart rate and chronic diseases and conditions. oxygen consumption. § Aerobic exercise reduces the risk of heart disease, cognitive decline and dementia, and early death. Ultimate (Frisbee): you must run often to “get open” for a pass, then run more to cover the other team and block their passes.

Aerobic Exercise and Mental Health § Aerobic exercise reduces depression and anxiety, and improves management of stress. How do we know? § Aerobic exercise is correlated with high confidence, vitality, and energy, and good mood. § Is there causation? Perhaps depression simply reduces exercise. § One study establishing causation: mildly depressed young women randomly assigned to an exercise group showed reduced depression caused by exercise alone.

Lifestyle Modification § In one study, a control group was given diet, medication, and exercise advice. § An experimental group practiced lifestyle modification, a plan to slow down the pace of one’s life, accept imperfection, and renew faith. Result: modifying lifestyle led to reduced heart attack rates.

Relaxation and Meditation § Use of relaxation techniques can reduce headaches, high blood pressure, anxiety, and insomnia, and improve immune functioning. § People who meditate can learn to create a relaxation response: relaxed muscles, lower blood pressure, and slowed heart rate and breathing. § Meditation also increases brain activity associated with positive emotions. § Steps to get the relaxation response: focus attention on breathing, a focus word, and relaxing muscles from toes upward.

Faith Communities and Health While attendance at religious services may not directly save lives, it may make other healthy practices more likely. Religious attendance seems to have results, especially for men, comparable to the benefit of physically healthy lifestyle choices.

Faith Communities and Health: Intervening Factors The health impact of religious involvement may be indirect. Health may improve because of the lifestyle and emotional factors associated with religious involvement, and not [just] the faith.

Closer Look at a Particular Emotion: Happiness is: § a mood. § an attitude. § a social phenomenon. § a cognitive filter. § a way to stay hopeful, motivated, and connected to others. The feel-good, do-good phenomenon: when in a good mood, we do more for others. The reverse is also true: doing good feels good.

A More Positive Psychology § Martin Seligman, who earlier kept dogs from escaping his shocks until they developed learned helplessness. § Developed Positive Psychology, the “scientific study of optimal human functioning, ” finding ways to help people thrive. § Focus: building strengths, virtue, emotional well-being, resilience, optimism, sense of meaning. Three pillars of Positive Psychology: 1. Emotions, e. g. engagement 2. Character, e. g. courage 3. Groups, Culture, Institutions

Over the Course of a Week Happiness has its ups and downs. Levels of happiness, as well as other emotions, can vary over the course of a week (we like the weekend), and even over the course of a day (don’t stay awake too long!). Over the Course of a Day

Wealth and Well-Being: A Change in Goals § In the late 1960 s, students entering college had a primary goal of developing a meaningful life philosophy. § Since 1977, being very well-off financially has become more of a primary goal for first year students.

Can Money Buy Happiness? Money seems to buy happiness when it lifts people out of extreme poverty. Otherwise, money doesn’t seem to help our mood much. 1. The average level of income (adjusted for inflation) and purchasing power has increased in the United States. 2. The percentage of people feeling very happy, though, has not followed the same trend of improvement.

Adaptation-Level Phenomenon § When we step into the sunshine, it seems very bright at first. Then our senses adapt and we develop a “new normal. ” If a cloud covers the sun, it may seem “dark” in comparison. § The “very bright” sensation is temporary. § The adaptation-level phenomenon: when our wealth or other life conditions improve, we are happier compared to our past condition. § However, then we adapt, form a “new normal” level, and most people must get another boost to feel the same satisfaction.

Adapting Attitudes Instead of Circumstances § Because of the adaptation-level phenomenon, our level of contentment does not permanently stay higher when we gain income and wealth; we keep adjusting our expectations. § It is also true that misfortune, disability, and loss do not result in a permanent decrease in happiness. § In both cases, humans tend to adapt.

Relative Deprivation § If the average income has risen by 10 percent in your area, it might be hard to feel great about a 5 percent rise in your income because of § People who were satisfied with their own lives might become less satisfied if other people get more power, recognition, and income. § We can affect our happiness by choosing the people to whom we compare ourselves. § However, the tendency is to compare ourselves to people who are more successful. Relative deprivation: feeling worse off by comparing yourself to people who are doing better.

Correlates of Happiness There are behaviors that seem to go with happiness. Whether they are the cause or the effect of happiness is not clear, but it can’t hurt to try them. Researchers have found that happy people tend to: § § § Happiness seems not much related to other factors: Have high self-esteem (in individualistic § Age (example: the woman at countries) the laptop in the picture) Be optimistic, outgoing, and agreeable § Gender (women are more Have close friendships or a satisfying often depressed, but also marriage Have work and leisure that engage their more often joyful) skills § Parenthood (having children Have an active religious faith or not) Sleep well and exercise § Physical attractiveness There also may be a genetic basis for a predisposition to happiness. Whether because of genes, culture, or personal history, we each seem to develop a mood “set point, ” a level of happiness to which we keep returning.

Possible Ways to Increase Your Chances at Happiness § Look beyond wealth for satisfaction. § Bring your habits in line with your goals; take control of your time. § Smile and act happy. § Find work and leisure that engages your skills. § Exercise, or just move! § Focus on the needs and wishes of others. § Work, rest, …and SLEEP. § Notice what goes well, and express gratitude. § Nurture spirituality, meaning, and community. § Make your close relationships a priority.