             Emotions and Health - Are you worrying yourself sick?

                                Matthew Probert

                            (c)1996 Matthew Probert


Most of us have experienced "stress". That odd feeling of worry, perhaps 
resulting in loss of appetite or more worrying loss of sex drive! I remember 
after my divorce feeling pretty grotty and seeking solice in copious 
quantities of real ale, other people may make use of heroin, cocaine, crack, 
speed, LSD or cannabis to escape the feelings. And yet we might consider 
stress to be an all bad thing, how then can we account for those individuals 
who enjoy bungee-jumping, horror films, fairground rides and other activities 
which all create that apparent feeling of stress? Firstly we must consider 
what stress is. Psychologists have no single clear definition of what "stress" 
is, however Cox (1975) defined three models of stress around which research 
has subsequently revolved. Basically these three models are: 

        1) The engineering model which sees external influences and events 
           causing stress or strain within an individual. 

        2) The physiological model which is concerned with what happens within 
           an individual, that is what responses occur as a result of stresses. 

        3) The transactional model which sees stress as arising from an 
           interaction between people and their environment. 

From the Cox model, psychologists generally believe "stress" to be caused by 
frustrations arising from an individuals perceived inability to satisfy a 
demand - feeling "pissed off" that we can't do something we want to do. As a 
graphic illustration observe a child trying to build a house of playing cards. 
After numerous attempts which result in the precarious structure plummeting to 
the ground many children will become frustrated, angry and upset. They 
experience stress as a result of their own inability to satisfy the demand of 
their desire to construct the object. This should be viewed as a distinct, and 
yet natural progression of "worry" which is the condition where we are unsure 
of our ability to satisfy a demand. So stress is not actually the same as 
excitement or invigoration, which are in fact the feelings experienced by 
participation in dangerous sports or watching horror films. Nor is stress the 
same emotion which motivates us in the event of a challenge. A salesman 
seeking to make a tough sales target may claim he is under stress, but all the 
time he feels capable of succeeding he is not stressed, simply stimulated. 
This distinction is important to silence the critics who claim to thrive on 
stress. They don't thrive on stress, they thrive on challenge. 

Now that we understand what stress is, and how it differs from the excitement 
of a challenge, the effect of stress upon health may be considered. The effect 
of stress upon health has been widely researched by the psychology and 
immunology communities, but is still not fully understood by the public as a 
whole. A study by Greer et al in 19791 of  women in England who had been 
diagnosed as having breast cancer, and actually had a mastectomy found that 
those who reacted by denying what had happened or by demonstrating a "fighting 
spirit" were signifcantly more likely to be free of cancer five years later 
than women who stoically accepted the cancer or felt helpless. Although all 
the women undoubtedly endured fear as a result of their experience, only some 
of the women felt incapable of beating the situation - they suffered stress. 
The other women, the women who took a decision to fight the cancer or blindly 
refused to accept it, did not endure stress in the true sense of the word as 
they did not feel incapable of battling it. If you need further convincing may 
I offer the true story of someone I know. A man, whom we shall simply call 
"John", because that's his name, recently lost his wife to cancer. He was 
deeply upset by the loss and friends of his say he seemed to lose the will to 
live. A few months later he was diagnosed as having cancer. It was while 
suffering from cancer that he met and fell in love with a younger woman. This 
woman counselled him, as only a true lover can (I say true lover because he 
was at the time unable to affect an erection). Within a few months the cancer 
had gone, and I am happy to say they are now happily married and John is now 
able to "get it up". 


Other studies done by psychologists have also shown a correlation between 
"worry" and "stress" and both illness and immune suppression. A study by 
Jermott et al in 1981 found that students with a hard-driving personality 
suffered more "stress" during exams, and had the lowest antibody levels and 
caught more colds following exams than more relaxed students. This would seem 
to correlate other research which links immune defciency with stress. Indeed 
Locke, 19822 found that "poor copers" showed a diminished level of a certain 
type of white blood cell (which fights viruses and cancer cells) during major 
life changes. One might consider that the difference between "worry" and 
"stress" is simply the ability to cope. A more self-confidant individual will 
perhaps worry, whereas some one else might become stressed believing that they 
simply cannot achieve the required goal. We all know that the immune system is 
the armament our bodies uses in fighting infection and disease. It follows 
therefore that if our armament is weak or damaged that infection and illness 
may break through. But were you aware of  the evidence that adrenalin inhibits 
the ability of lymphocytes to release chemicals which fight invading germs or 
cells (including cancer cells)?3 Adrenalin being a chemical which is released 
into the blood system when we are frightened. So prolonged fear, such as 
living in a hostile environment will also weaken a person's resistance to 
illness. 

It is not just stress and fear which can have a detrimental effect upon a 
person's health. Depression and neglect (parental and/or peer deprivation) can 
also make one more vulnerable to physiological illness as statistical evidence 
from Parkes et al (1969) clearly demonstrates. Parkes and his colleagues 
evidence clearly shows that in the 18 months following the death of a spouse 
or close relative, a person is at increased risk of death from a number of 
illnesses including cancer and heart attacks than other people of the same age 
and gender4. 

Psychologists know that certain events which occur during a person's life have 
a more profound effect on the person than others. A table of significant life 
events and the relative impact which they have upon an individual with special 
attention to the likelihood of that individual contracting a serious illness 
was drawn up by Holmes and Rahe in 1967 (see fig 1). They examined 5000 
patients and made a list of 43 life events, of varying seriousness, which 
seemed to cluster in the months preceeding the onset of their illness.5 
Subsequent research has found that if a persons life change unit count exceeds 
300 that person is more susceptible to physical and mental illness than other 
people. The correlations are small, but are significant and common illnesses 
suffered include: cardiac death, non-fatal heart attacks, TB, diabetes, 
leukaemia, accidents and athletics injuries. It is perhaps no coincidence that 
the groups most at risk from AIDS: Haemophiliacs, homosexual men and IV drug 
users, are also the groups most likely to endure pressure from significant 
external forces. Homosexual men in the West are often treated as abnormal, and 
whilst many of them may dispute that, I would defy any of them to stand in an 
ordinary pub and declare in a loud voice; "I AM GAY!". 


Rank    Life Event                                              Mean Value

 1      Death of spouse                                          100
 2      Divorce                                                   73
 3      Marital separation                                        65
 4      Jail term                                                 63
 5      Death of close family member                              63
 6      Personal injury or illness                                53
 7      Marriage                                                  50
 8      Fired at work                                             47
 9      Marital reconcilliation                                   45
10      Retirement                                                45
11      Change in health of family member                         44
12      Pregnancy                                                 40
13      Sex difficulties                                          39
14      Gain of new family member                                 39
15      Business readjustment                                     39
16      Change in financial state                                 38
17      Death of close friend                                     37
18      Change to different line of work                          36
19      Change in number of arguments with spouse                 35
20      Mortgage over $10000                                      31
21      Foreclosure of mortgage or loan                           30
22      Change in responsibilities at work                        29
23      Son or daughter leaving home                              29
24      Trouble with in-laws                                      29
25      Outstanding personal achievment                           28
26      Wife begins or stops work                                 26
27      Begin or end school                                       26
28      Change in living conditions                               25
29      Revision of personal habits                               24
30      Trouble with boss                                         23
31      Change in work hours or conditions                        20
32      Change in residence                                       20
33      Change in schools                                         20
34      Change in recreation                                      19
35      Change in church activities                               19
36      Change in social activities                               18
37      Mortgage or loan less than $10000                         17
38      Change in sleeping habits                                 16
39      Change in number of family get-togethers                  15
40      Change in eating habits                                   15
41      Vacation                                                  13
42      Christmas                                                 12
43      Minor violations of the law                               11

Fig 1: Social Readjustment Rating Scale


During late October and through November 1995 I visited Jamaica to research 
the AIDS situation there. Whilst in Jamaica I visited a hospice for AIDS 
patients run by the charity Jamaica AIDS Support. The patients at this hospice 
past and present had, without exception, suffered from abuse and neglect this 
wasn't the criteria for them being admitted, that criteria was that a) they 
had AIDS and b) no one else would care for them. Many had been sexually 
abused, others had been rejected by family and friends and left to die. The 
effect of neglect on a gregarious animal such as a human is well documented. 
The effect on orphans left in Rumanian orphanages has recently been in the 
news and remember the conditions described by Dickens of the English 19th 
century work houses. Indeed a study of children in orphanages and residential 
nurseries during the 1930s and 1940s led to the publication of Bowlby's 
"Maternal Deprivation Hypothesis" in 1951.6 Although Bowlby's theory has been 
critized, the criticisms attack not so much the effect of maternal 
deprivation, as argue that deprivation from peers and love and care (a lack of 
bonding is known as privation by psychologists) should also be taken into 
account. In simple terms, people need love! Deprive a baby or child of love 
and attention and they become listless and disinterested in their 
surroundings. Evidence from the high mortality rates in English 19th century 
orphanages, and the high incidence of AIDS amongst rejected people in Jamaica 
today would seem to indicate a link between privation and physical health as 
well as mental health. 

I have now discussed the negative effects upon health of certain emotions: 
worry, stress, depression, privation. You will not be surprised to hear of the 
positive effects upon health and recovery of: happiness, relaxation and 
laughter. This area has not been so well researched, but is none the less 
being practised in a number of hospitals where clowns are employed to make 
patients laugh as an active aid to their recovery. The effects of privation 
can be turned around by the adoption of a neglected child into a loving 
family. The psychoses caused by abuse and neglect can be cured by a caring 
environment, as is demonstrated at Jamaica AIDS Support. Cancer can be fought 
by will power and a desire to live. What of AIDS? Is AIDS a terminal illness 
from which there can never be recovery? I don't believe so. And even if it so, 
it doesn't help a patient to be told that. The stress which being told "you're 
going to die" places a person under cannot possibly be helpful in the care of 
that patient, and evidence from the past reveals that some people will allways 
survive "incurable" diseases, whether they are Bubonic Plague, Small Pox or 
more recently AIDS. 

For more details about surviving AIDS (yes it can be cured), contact

        Continuum
        172 Foundling Court
        Brunswick Centre
        London
        WC1N 1QE

        Telephone 0171 713 7071


References

1 Greer A, Morris T. & Pettingale K.W. (1979) Psychological response to breast 
cancer: Effect on outcome, Lancet 13, 785-7 2 Locke, S.E. (1982) Stress, 
adaptation and immunity: Studies in humans. General Hospital Psychiatry, 4,49-
58 3 Selye, H. (1956) The Stress Of Life, New York: McGraw-Hill 4 Parkes, 
C.M., Benjamin, B. & Fitzgerald, R.G. (1969) Broken Heart: A statistical study 
of increased mortality among widowers. British Medical Journal, 1, 740-3 5 
Holmes, T.H. & Rahe, R.H. (1967) The Social Readjustment Scale, Journal of 
Psychosomatic Research, II,213-218 6 Bowlby, J. (1951), Maternal care and 
mental health. Geneva: World Health Organisation 

