A few weeks ago, while watching old episodes of Grey’s Anatomy on Netflix before going to sleep, I noticed my right eye felt drier than usual. I tried different tactics to adjust to this and fix my dry eye problem, but none really worked. Then, one morning, I woke up to find this same eye felt kind of sticky. It would improve after a few minutes of heavy blinking but, about a week later, I noticed it felt grittier when I blinked. A few days later, my left eye was starting to show some of the same symptoms, and also was bloodshot. How aggravating. I then discovered some kind of yellow-headed growth on the underside of my upper eyelid of my right eye. What was that? I found that thoughts and worries about my eyes started to interfere with my ability to be fully present in my daily life. I was distracted and less effective than usual.
My eyes are on the mend now. I went to my trusty eye doctor who prescribed a few eyedrops everyday, and the inflammation she discovered is going away. The yellow-headed growth? A benign calcification. So, everything is good, really, and my problem only illustrates a minor inconvenience. Nonetheless, this story illustrates how even one small stressor can negatively influence someone’s life.
Anything requiring a new response can be stressful. Stressors can involve loss, challenge, the anticipation of loss or challenge, or even something positive. In the classic social readjustment rating scale, stressors range in severity from minor (such as a speeding ticket or major holiday) to major (such as divorce or the death of a spouse). Traumatic life events can be even worse.
When we experience stress, our sympathetic nervous systems are activated. Our bodies direct stress hormones such as adrenaline to respond. Salivation decreases, perspiration increases, breathing quickens, heart rate accelerates, digestion slows, blood pressure increases, and immune system functioning lessens. Although this fight-or-flight response often protects us when we face an immediate, tangible danger, it causes problems when chronically activated, as typically is the case with modern stressors. This helps explain why many distressed individuals regularly experience symptoms such as dry mouth, sweaty palms, labored breathing, irregular heartbeat, nausea, high blood pressure, and vulnerability to sickness. Problems such as headaches, depression, and heart disease all become more likely as a result of chronic sympathetic nervous system activation.
In studying stress and coping for over 20 years, it has become clear to me that one common misconception we often believe is that external circumstances determine the amount of stress we experience. There is a kernel of truth in this misconception: when we experience stressful life events, we are more likely to experience negative outcomes. However, in the same stressful circumstance, it also is true that different people will respond differently. That is, whereas some of us who experience a layoff, illness, bad grade, financial setback, or relationship break-up will experience greater negative effects, others of us – under the same circumstances – will reveal resilience and continued thriving.
The famed psychiatrist, Victor Frankl, made the same observation in his classic book “Man’s Search for Meaning.” As an Austrian Jew, Frankl was deported to the Auschwitz death camp during World War II, witnessing and chronicling horrific abuses of fellow inmates that few of us can even imagine. Yet, he noticed how some prisoners responded more resiliently than others. He writes:
“There were enough examples, often of a heroic nature, which proved that apathy could be overcome, irritability suppressed. Man can preserve a vestige of spiritual freedom, of independence of mind, even in such terrible conditions of psychic and physical stress… They may be few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s own way.”
This, then, becomes a key insight: in order to respond effectively to life stressors, we must realize we have at least some control – if nothing else, over our attitudes. Those of us who believe life is determined by external circumstances (that is, those who psychologists would say have an “external locus of control”) often succumb to the worst of stress. However, those of us who believe there is some control to be found (those who psychologists would say have an “internal locus of control”) more often respond well.
I knew all of this when I was dealing with my eye problem. I knew there might be some ways I could respond that would help me deal with this situation more effectively. And, yet, I continued to struggle.
It can be really difficult to have clarity while stressed. In fact, research generally shows how our thinking tends to be constricted during episodes of negative emotion. What I needed was a clear plan of action.
What exactly do individuals do who respond more effectively to stressful circumstances?
A few weeks before, I was teaching my undergraduate students about stress and coping, and I made a classic distinction often made among stress scientists that has guided a good deal of research. There are two general ways of coping with stress. First, problem-focused coping involves addressing the underlying causes of a stressor. Second, emotion-focused coping involves directly addressing the difficult emotions that result.
Furthermore, there is a distinction to be made between avoidance-oriented coping and approach-oriented coping. When we engage in avoidance-oriented coping, we seek to avoid or distract ourselves from the underlying problems giving rise to our stress or the difficult emotions associated with stress. When we engage in approach-oriented coping, we actively seek to address our problems and work through the difficult emotion.
Usually, research finds, coping goes best when there is a blend of approach-oriented problem and emotion-focused coping. When we avoid or try to distract ourselves from the problem or the difficult emotion, we tend not to do as well.
Realizing this, I took out a piece of paper. “Physician, heal thyself,” I thought.
I asked myself: “what am I doing to avoid or distract from this stressor?” “Well,” I wrote, “I’m not really wanting to go to the eye doctor, for fear of what she’s going to find, particularly with this yellow-headed thing under my eyelid. And, to help myself feel better, I’m basically vegging out watching more Netflix, which probably also isn’t helping my dry eyes!” This needed to change.
So, the next question became: “what can I do to address the underlying causes of this stressor?” Realizing what I was doing to avoid the problem, I penned, “I’m going to make an appointment with my eye doctor and, after I meet with her, I’ll do whatever she tells me to do.” This ultimately ended up being a regimen of different kinds of eye drops, which I followed faithfully.
(As an aside, not every stressful event can be addressed effectively in this kind of problem-focused way. For instance, I have a friend who has incurable stage-IV cancer. There’s nothing she can do about the progression of her illness. This makes the next form of coping even more important.)
Finally, I asked: “what can I do to actively address and directly work through the difficult emotions I’m experiencing because of this stressor?” There are many options to consider here. I wrote, “I’m going to begin and end every day by writing down or speaking aloud what I am grateful for. I’m going to begin everyday in prayer, reading at least one Psalm that relates to my life. I’m going to talk with a few friends about what I’m experiencing and receive their support. I’m going to take this one day at a time and not get ahead of myself.” Finally, I noted, “I’m going to take care of myself, making sure to exercise, get adequate sleep, eat life-giving foods, and hydrate.”
And, then, I did one more thing.
I recognize that the placebo effect is a powerful phenomenon and that what ultimately helps us sometimes remains a mystery. However, this information can be intentionally applied as well, to our benefit.
So, every time I did something on my list – every time I took an eye drop or wrote down what I was grateful for or read a Psalm or went to the gym – I paused for a moment, and I acknowledged that this was part of my self-devised treatment plan. I trusted this would help, if not with my eye, then with my emotions.
I mentioned previously that the sympathetic nervous system is what gets activated during times of stress. There also is a counterbalancing system called the parasympathetic nervous system. When this gets activated, salivation increases, perspiration decreases, breathing slows, heart rate declines, digestion improves, blood pressure decreases, and immune system functioning increases. We become healthier physically, psychologically, and emotionally. We calm.
Anything that triggers more parasympathetic nervous system activity decreases the stress response, and what does this likely differs across people.
But, I wonder if faith, hope, and trust – broadly construed – aren’t most important.
This post first appeared at http://www.psychologytoday.com.