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Sunday, December 20, 2015

Stress: Is there a positive side to all this caring?

            Key Points

1. Stress is your mind’s interpretation of either an internal or external stimuli
2. Stress does not function as a simple external force causing harm
3. You have the ability to modulate your perceptions and approach to adversity, ultimately deciding if “stress” will cause DISTRESS or EMPOWERMENT
4. By learning to control your internal thoughts and your reactions to external stimuli, you can create an effective and downright feel good physiologic “stress response.”
5. Stress is simply CARING, A LOT
6. Stress can be way to create meaning in our lives, to connect with others and to reach higher states of functioning rather than succumbing to anxiety and fear.

            If you haven’t been living under a rock for the past few years, you are probably more than aware that stress management is often a pivotal part of any functional approach to improving health and avoiding disease. Along with this message, you may have also heard of the idea that chronic stress in the form a perpetually hyperactive  sympathetic nervous system, or ‘fight or flight” response, can create a relative imbalance in our overall autonomic nervous system, leading to significant dysfunction, morbidity and just plain poor health. Taking this into consideration, nothing seems more worrisome to me than an “automatic” machine that evolved to perform functions such as regulating blood pressure, orchestrating proper digestion and maintaining metabolic energy balance working in a less than optimal manner.  I cannot stress this enough (no pun intended)- automatic DOES NOT mean optimally functioning- it simply means autonomously and continuously performing a given task that may or may not actually be helpful to the system in question. Lastly and perhaps most intriguingly, automatic DOES NOT mean out of OUR control. While we are blessed with an autonomic nervous system that can function independently of any conscious thought, the beauty of this system lies in the fact that we CAN control the inputs to this system such that we can alter our physiology simply by our thoughts!  Ever heard of psyching yourself up for the big game? Well guess what, you may have just willfully increased blood flood to your skeletal muscles, mobilized glycogen stores to provide precious glucose for your mitochondria to make ATP- and increased your cardiac output in order to supply your cells with the oxygen required to maximize this energy production- did someone just say Electronic Transport Chain?

            In order to help answer the main questions at hand: what exactly is stress and how does it affect our overall health, I have turned to the wisdom of Kelly McGonigal, a prominent health psychologist, who has become the leading researcher wiithn this field of stress psychology. If you have not seen her TED Talk, I would like to say you are not alone, but the truth is, she has over 9 million views! Just perhaps she has something interesting to say.

TED Talk Link

 Additionally she recently did two wonderful podcasts with Brian Johnson, one of the most practical and productive mental health geniuses I know, which provide further fuel to this discussion.

Podcast Link:

One of Brian’s most important “Big Ideas” from his discussions with McGonigal is that “stress” can actually be a motivating and helpful component of our daily lives. As he point outs, rather than seeing stress as the all or nothing “fight or flight” response or stress as chronic, runaway anxiety with actually minimal amounts of “fighting or flighting,” we should simply see stress as the acknowledgment that we CARE, A LOT. Taking our positive approach to stress and applying it to a real world situation, let’s examine the scenario of an impending thunderstorm barreling down overtop some hikers completely exposed to the elements. If you feel like this would be a good time to begin some quiet mindful reflection, trying to avoid overt sympathetic arousal, maybe you should apply our new positive stress paradigm and think instead, "I do not have to necessarily fight or flee, but maybe I should start CARING, A LOT.”

            While we commonly associate enthusiasm and passion as “positive” traits and stress and anxiety as “negative”, McGonigal argues and I agree, why can’t stress be positive? Why can’t we channel this physiologic energy into passionate work? Ever been buzzing as you churned through a book, or hummed along writing a deadline paper- you may have been in what some people call a “Flow State.” With creativity seeming to ooze from your eyeballs, in this perceived “Flow State” there often times is very little thinking, just doing, feeling, and moving with the moment. Just as you can’t tickle or scare yourself by jumping around a corner, you cannot seek to obtain or reach a “Flow State” through purposeful action; it just simply happens. Now if I were to ask you how you were feeling during one of these moments of clear action, of precise expression, of being “in the zone” I can almost guarantee you would not describe it as the sympathetic response- running away from a saber tooth tiger, but you surely would also not describe it as a calm, collected and peaceful parasympathetic state; so what exactly then is this “Flow State?” To answer this last question, I turn to the work of Andrew Bernstein.

            Bernstein’s most recent book: “The Myth of Stress” seeks to completely shatter the idea that stress is some external force leading to the systematic activation of our sympathetic nervous system. Rather, Bernstein postulates that stress is pretty much all a mental construct, an interpretation, internally created through our thoughts regarding our present environmental circumstances. Bernstein discusses this idea and others further in a thought-provoking podcast with Robb Wolf.

Podcast Link

        Taking even what seems to be the most obvious rebuttal to his theory regarding stress: a massive grizzly bear standing 20 yards ahead of your path, he argues that  while we all just assume the presence of the bear will initiate our "fight or flight" response, we actually have to mentally decide “hmmm, interacting with this bear might not be the best idea, maybe I should start caring about staying alive.” So we see that the ensuing physiologic response involving fleeing or possibly fighting, depending on the person in question, stems not from some switch the bear triggered, but from our internal ruminations, a conscious decision that this situation requires a different level of attention. Going back to our previously described “Flow State,” I suggest to you that perhaps, the reason we do not perceive these moments of action as stressors or stressful or conversely, describe them as soothing or calming- operating at our normal homeostatic baseline, is because, just maybe, we aren’t thinking much at all. Thus we return to the question: Without thinking, without an internal dialogue, without conscious awareness of our thoughts, is stress even possible? Whether operating in a “Flow State” or choosing to mindfully direct our energy during situations of perceived stress, it seems that we truly have the power to control stress, and more importantly, use stress to live more productive, happy and fulfilled lives.

              The possibilities of a positive approach to stress are endless, but I want to end this discussion with one last key question and idea: what if we saw stress as a positive way to create meaning? McGonigal sites an amazing study that looked people personal interpretations of stress and meaning in there lives and sure enough, the people who said they were the most stressed also identified more meaningful pursuits and relationships in their lives. So if we approach stress as the opportunity to acknowledge our values and subsequently create meaning in our lives, instead of just another moment to let anxiety, worry and disappointment reign supreme, would we see stress differently? And lastly, I ask you curiously, do we really need stress management, when we can have stress empowerment instead? Just an idea or maybe some misdirected stressful thinking, who knows, it’s all just in our heads anyway.