Stress is a ubiquitous term nowadays. In Sweden,
people’s daily conversation concerns how stressed they feel, or how much stress
they have in their life, or how one particular daily event has "stressed
them out." Balancing work, family and leisure time is a challenge for
working men and women in a number of countries, although the workload €“ and the
potential for "stress" €“ is greater for women (Krantz &
Östergren, 2001). Recently, I was on a city bus in Stockholm going home,
reading the end of Cooper & Dewe’s interesting book on the history of
stress, when my concentration was interrupted by a neighboring traveler’s loud
telephone conversation. I couldn’t avoid hearing the details of a problem that
had "stressed out" my bus-neighbor. My bus-neighbor described every detail
of his attempts to solve the problem with the help of people who had no idea
how to solve it and didn’t seem to be taking responsibility for finding a
solution. The conversation continued with various other descriptions of minor
work events, punctuated with the somewhat disconcerting comment that "we
actually don’t have that much to do." I left the bus with the impression
that this man worked in some kind of security-related, logistics-oriented
setting, and that he had a relatively high level of decision latitude in his
work.

This account illustrates a number
of aspects of what stress is about. Cary L Cooper and Philip Dewe, both British
professors of organizational psychology with excellent academic reputations,
have written a brief history of how the concept of stress developed within
scientific research circles into the expansive field it is today. Cooper and
Dewe point out in their preface that the book is "a" history, not
"the" history. They also define themselves as "lay historians,"
admitting that they are not experts in the field of stress. The authors do not
specify any group of readers for their book. Significantly, Lennart Levi,
almost an icon of stress research, certainly in Sweden as well as elsewhere, is
quoted on the back of the book praising it as "a fascinating and highly
readable account of the long and difficult journey" to the insight that
"stress-related disorders are often the cause of early death."
Lennart Levi, as a stress researcher, could easily navigate the contents of the
book. The less well-prepared reader might find some parts of it rather heavy
going. As a history, it is a fascinating summary of the movements of ideas and
how research in a specific field takes different directions depending on the
persons and currents of thought involved. However, the many direct quotations
and quite a few typographic errors suggest that the authors have not had the
time to digest their material well enough to describe it fully in their own
words, and those involved in the production of the book have not taken the time
to proofread it properly. Although the many quotes and the lack of diagrammatic
figures to help visualize the movement of ideas make the book an uphill read,
undergraduate or even graduate research students doing a course on basic stress
research €“ or in the history of scientific ideas €“ might find the book quite
valuable in conjunction with relevant scientific articles. The main
contribution of the book lies in its review of streams of thought that helps
clarify which paths of research have been rich lodes of inspiration and which
ones have turned into dead ends.

The authors begin by tracing stress
research from the seventeenth century, when stress according to Robert Hooke
was a term basically applied in industrial contexts to the load that an
engineered structure like a bridge could tolerate, to the beginning of the
twentieth century, when the schools of functionalism and applied psychology
opened up possibilities for the relatively new discipline of psychology to be
involved in social engineering projects. Fatigue and mental hygiene were two
areas studied in relation to work performance. Another seminal area was
psychosomatic medicine, where Walter Cannon’s conceptualizations of the
mechanism of homeostasis, and the "fight or flight" response to
environmental stimuli gave impetus to much later research. Hans Selye was the
first to formulate an original theory of stress based on a non-specific
physical response to environmental changes. His concept of the "general
adaptation syndrome," first outlined in 1936, eventually led to his
definition, in the 1970s, of four types of stress €“ eustress (good stress),
distress (bad stress), hyperstress (overstress), and hypostress (understress).
Cooper & Dewe also bring up less well-known figures such as Harold Wolff,
who connected stress to the development of disease and launched the concept of
the "protective reaction response" which could arise in an often
maladaptive attempt to protect the organism from an increase in the stress
load.

In chapters 3 and 4, the authors
cover the 1950s and 1960s, focusing primarily on the influential work of
Richard Lazarus at Berkeley. One main impetus to Lazarus’ work was the
expansion of psychosomatic medicine to two causal relationships: that between
life events and illness, and that between individual and personality variables
and illness. An interesting figure in this work was Adolf Meyer, who developed
a "common-sense psychiatry" that included a life chart relating life
events to physical illnesses or disorders. Later work focused either on the
effects of single events or types of events or on aggregated effects of a
number of life events. Meyer’s work eventually led to the development
instruments to measure life events and stress. An instrument that Cooper & Dewe
describe at length is Holmes and Rahe’s Social Readjustment Rating Scale
(1967), listing 43 key life events that either reflected a person’s life style
or occurrences that affected him or her. A Life Change Unit (LCU) could then be
calculated to measure whether a cluster of events constituted a crisis. The
introduction of such instruments elicited fierce debate centering around the
question of whether it was the event itself that was the problem, or the
person’s perception of the event. The Hassles Scale, including 117
hassles and 135 uplifts, was meant to measure everyday difficulties in life
that would better reflect stress- and illness-related processes rather
than single events with great impact. The measurement of daily events versus
life events elicited another area of debate that concerned confounding of
these two types of stressors.

Richard Lazarus is described as the
major stress scholar, and the whole of chapter 4 is devoted to his work.
His contribution was in the area between the stimulus (the stressor) and the
response (the individual’s way of coping with the stressor). Lazarus emphasized
the need to take into account individual motivational and cognitive
differences in responding to events, whether daily or unique. Lazarus’ work
on appraisal of events eventually led to the conceptualization of emotions
as the underlying template influencing appraisal and thereby coping. An
important instrument €“ the Ways of Coping Questionnaire €“ provided an empirical
means of measuring cognitive and behavioral strategies in coping with
stressors.

Cooper and Dewe conclude their
history with a chapter on work stress and occupational health psychology. The
discussion of work stress includes concepts like role conflict, role ambiguity
and overload. In the area of intervention the authors discuss coping, self-help
and stress management as methods to enhance individual coping strategies. Their
background in organizational psychology partly explains the richness of detail
in this chapter. Cooper’s development of the Occupational Stress Indicator for
monitoring organizational health and encouraging engagement in preventive
stress management strategies is a convincing example of a state-of the-art
instrument in applied psychology. Cooper and Dewe point out that the now relatively
mature area of work stress research has provided a framework for the evolution
of "creative and ecologically sensitive methods" for measuring and
intervening in the area of stress in order to enhance occupational health. In
the final chapter, the authors attempt to define what we mean by stress, and
what the future of this research can hold. Their final note to the reader
concerns the importance of maintaining high ethical standards in research and
practice.

In sum, this book provides an
interesting overview of the area of stress research, good for the student or
scholar interested in the history of scientific ideas. If we return to my
bus-neighbor, he clearly suffered from role ambiguity and some sort of
inability to cope with this stress. His individual idiosyncrasy in broadcasting
his problems to the bus-riders might reflect a coping deficiency. He seemed
comfortable with his earphones and warm winter jacket, in a way that would lead
me to conjecture that he was not suffering the stress brought on by a life
event, but rather an inadequate way of dealing with his daily hassles. Perhaps
he did not have enough uplifts, or the fact that he stated a low level of
intensity at work left him feeling inadequate. Or else, there was an underlying
emotion (depression following his girlfriend having left him recently?).

Cooper & Dewe’s book could
certainly be used as one of the books in a course on stress research; from a
psychological point of view I missed practical information on the body-mind
relationship, specifically the effects of psychological factors on physical
health, such as that provided in a recent book by a prominent Swedish
researcher does (Lundberg & Wentz, 2004). But the authors’ ambition has
been to provide a history of stress, and that they have done, more than
adequately. If the book should be published in a second edition, I would
appreciate the enlisting of an expert proofreader, the development of diagrams
to make the streams of thought described easier to envision, and the
elimination of the numerous quotes that interfere with the smoothness of the
reader’s experience. I would recommend the authors to try writing in their own
words!

References

Krantz, G. & Östergren, P.-O. (2001) Double exposure:
the combined impact of domestic responsibilities and job strain on common
symptoms in employed Swedish women. European Journal of Public Health,
11, 413-419.

Lundberg, U. & Wentz, G. (2004). Stressad hjärna,
stressed kropp: Om sambanden mellan psykisk stress och kroppslig ohälsa. [Stressed
brain, stressed body: On the relationship between mental stress and bodily
ill-health]. Stockholm: Wahlström & Widstrand.

©
2004 Anne H. Berman

Anne H. Berman, Ph.D., Division of Forensic
Psychiatry, Neurotec Department, Karolinska Institutet, Sweden

Categories: Anxiety