The Truth about Stress, by Angela Patmore

Stressed out? Go take a running jump
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"Stress" is everywhere, a term invoked by both schoolchildren and scientists, understood in hundreds of ways by millions of people. A great therapeutic industry has grown up, promising to manage it without defining it. We are urged to talk, to cope with a range of experiences from being at the scene of a tragedy to watching it on TV. It doesn't seem a bad idea to stop and ask what we are talking about.

This book, however, is not an inquiry. It is a crusade; an implacable, agitated assault on everything that goes with the idea of stress. Angela Patmore believes not only that stress is poorly defined, and that the marketing of services to manage it is often dubious, but that there's nothing there to manage. According to her, the millions of miserable workers recorded as suffering from stress are actually suffering from "stress phobia": a fear of a non-existent force. They have, she proposes, been pushed into this deluded condition by the "stress industry".

Patmore is drawn to the definition question, listing hundreds of associated terms and rewriting statements made by health bodies. She also offers a disparaging sketch of the endocrinologist who appropriated "stress" from engineering. But she pays little attention to current research, and the contrast between the standards she applies to her targets and those she permits her opinions is breathtaking. Her beliefs are rooted in a reactionary common sense that seems almost to take pride in cliché: "Asian shops are open all hours, and their workers are tirelessly polite and cheerful."

Another people who impress her are the stoical ancient Romans, whose embrace of bloodbaths as family entertainment she offers as an example of character-building. Patmore believes in the old ways: gritting teeth, getting on with it, being made strong by whatever doesn't kill us. But she is far beyond mere stoicism. For her, stress is the essence of life, and relaxation living death. She rhapsodises over the "cerebral climaxes" achieved by skydivers and extreme sportspeople, as the goal all should pursue. By this stage she has left science far behind, and is on to a Russian psychic who supposedly moved objects by the power of her mind alone.

Patmore's paean to an utterly individual sensation reflects on what is missing from the book. She is fundamentally uninterested not just in science, but also in society. There is no recognition that the problems covered by the word "stress" may arise not from failure to rise to challenges, but from the structures in which individuals live their lives. Like other primates, we are profoundly affected by experiences of our position in social hierarchies, of being subordinate or in control. As in other primates, these experiences are determined by our actual positions, not what we decide to feel about them.

Fear and challenges put the body into emergency mode, reallocating resources away from essential maintenance and towards fight or flight. If we're constantly in fear and frustrated, the subordinate's condition, our bodies and minds will suffer. This "psychosocial" model of stress isn't discussed in Patmore's book. To her, other people are "the flock" that the stress industry lures, and there is no such thing as society.

Marek Kohn's 'A Reason for Everything' is published by Faber & Faber

Angela Patmore responds to this review