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Health: Stress? That went out with the Eighties: It was the scapegoat for all sorts of ills, but two psychologists now insist it doesn't exist, writes Jerome Burne

Jerome Burne
Tuesday 02 February 1993 00:02 GMT
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ANOTHER Eighties emperor, along with junk bonds and nouvelle cuisine, has been exposed as having a serious clothes deficit. Stress, it seems, has not just been badly overworked - it is an impostor.

Not so long ago, stress was one of those badges of life in the fast lane. A job was not worth having unless it was loaded with the stuff, and stress management consultants appeared with promises to keep the workers happy, cut absenteeism and increase productivity for the, usually exorbitant, price of a stress-reducing package.

But according to two psychologists, there is no evidence that stress exists at all. At a recent psychology conference Shirley Reynolds and Dr Rob Briner criticised stress consultants who had, they said, 'ignored, avoided or denied the confusion and inconsistencies in occupational stress literature'.

'The problem,' says Ms Reynolds, who works at the Medical Research Council Psychology Unit at Sheffield University, 'is that the word 'stress' is used both to describe what someone does - works late, takes many telephone calls, is responsible for lots of money - and how they feel - anxious, depressed, panic-stricken.

'Talking about stress does not help to deal with any of those problems. People make claims about hundreds of thousands of days lost every year to stress, but it is rubbish.'

Highly lucrative rubbish, however. Stress reduction - ranging from a soothing pounds 10 tape telling you to concentrate on the orange liquid filling your veins, to expensive courses for employees - is big business. There is a private hospital for stressed executives and only last month Virginia Bottomley, the Secretary of State for Health, launched a drive to reduce mental problems at work. This was widely regarded as a campaign against stress.

The trouble, Ms Reynolds says, is that the links between stress and health are not clear, and the optimistic claims for stress-reduction courses have never been tested.

'We are not saying that people at work don't experience distress, nor that this may affect how people feel, but you don't need the idea of stress to sort it out,' she says. If someone is overworked, for example, they should learn to organise time better, or take on an assistant. If someone is often ill, the answer is to look at diet or drinking habits, but not to confuse the two and call it stress.

Dr Briner, a lecturer in occupational psychology at Birkbeck College, London, says: 'You could say that someone with a lot of work which had become a worry was suffering from anxiety. Equally, somebody who had a lot of work and wasn't feeling valued could be suffering from depression.'

But what about all that research that links stress with heart disease? What about the Whitehall study - a key text of the stress gurus - which found that lower ranking civil servants were more likely to have heart attacks than the high-fliers who had more control over their lives?

'That is just the sort of simplification that goes on,' Ms Reynolds says. 'There are dozens of differences between upper and lower grade civil servants: low grade ones are poorer for a start, they probably have worse housing, they are likely to drink more - and so on. It's ridiculous to pick on stress as being the factor that makes the difference instead of the really important influences such as diet and poverty.'

Dr Briner agrees. 'The evidence for a link between being stressed and heart disease is conflicting and tenuous. Twenty years ago there was a similar belief in the health problems caused by 'life events' - moving house or getting married - but no serious researcher believes in that now, as the evidence just isn't there. I believe stress will go the same way.'

What about that other apparently cast-iron link between stress and disease - its effect on the immune system, weakening it and making flu and a host of other infections more likely?

Again, Ms Reynolds is not impressed. 'There are problems with the way that all these studies are organised. They all ask people if they are overworked and then ask them how they feel - are they anxious or tense, for example. But how do you know if you are overworked? If you feel anxious then you say - I must be overworked. It is not surprising that the studies keep finding connections with problems at work and feeling bad.'

The stress studies, she says, tend to present people as punchbags, passive things buffeted by life. 'But we know that people construct their own lives; and we know there are people who will always say that their life is awful and others who look on the bright side.'

Dr Briner agrees that emotions can influence health but says the picture is very complex. 'People have massively oversold the link between stress and health. But if you exclude the definite connection between ill-health and being involved in tragedies such as Hillsborough, you are left with pretty unconvincing evidence.'

Cary Cooper, professor of organisational psychology at Manchester University's Institute of Science and Technology, denies that the links between stress and ill health are shaky. 'Some of the early studies were poor, but we now have firm evidence for the physical effects of stress.'

Professor Carey has been measuring traces of hormones and other chemicals in blood which would indicate stress.

'I've been running blood tests on several thousand teachers at the beginning and end of term and finding large differences,' he says. 'I think American studies such as the long-running investigation into heart disease in Framingham, Massachusetts, show the connection very clearly. Stress is definitely a triggering factor for heart and immune-system problems.'

He does accept that a lot of unqualified people have jumped on the bandwagon. 'It is certainly true that if you have a problem with a bullying boss, it is not going to be solved by sitting and practising relaxation.' However, overworked as the term stress may be, he feels that it does have value. 'When the pace of work began hotting up in the early Eighties people were afraid to talk about their feelings in the workplace. Now it's seen as OK for people to say they are feeling stressed; it's like ringing an alarm bell. Then the management can say, something's wrong here, how do we sort it out?'

Dr Briner and Ms Reynolds claim that not only is the stress gurus' psychological snake oil of little benefit to the workers, it is also highly unlikely to boost employers' profits. 'The stress-reduction myth is that the interests of the employer and employee are the same. I sometimes see clients who say they are stressed at work and after a few sessions they realise the answer is to leave their job,' Ms Reynolds says.

'If someone's work is making them feel bad, let's begin by asking how. Let's look at how they see the world - if they normally see everything as bad, they probably feel bad as well; if they believe that work is the only thing to live for, they are going to be more vulnerable to change at work; if they don't know how to relax, they will probably have problems. Psychologists can help with all these, but they have nothing to do with stress.'

Surely stress-management techniques or courses that teach people to relax without having to reach for the bottle are a good thing? Ms Reynolds is adamant. 'None of the courses has ever been tested properly. Tests that have been done show that people enjoy them and some of them are more relaxed afterwards. But the effect vanishes after three months.'

Dr Briner asks: 'What are these courses trying to achieve? A young executive working 15 hours a day has different problems from a secretary bullied by her boss. Both are different again from the pressure on an air-traffic controller who might kill hundreds with a single mistake. Yet they are all described as being stressed.'

Ms Reynolds says it is not generally realised that many of the methods used on courses - such as being assertive or defining problems as opportunities - were first developed to deal with severe depressives. 'They can work well in a clinical setting, but there is a world of difference between one patient, who has a real incentive to improve, having intensive weekly sessions and a group of ordinary people trying out a ragbag of tricks over a weekend.'

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