One of the main concerns patients voice out during our sessions, is that the stress they experience will harm them physically. Indeed, stress is considered as one of the main factors causing physical and mental illnesses. We all look for peace and serenity, but we also have desires and we aspire towards growth and experience. As life brings us different circumstances, and since growth requires effort, the stress is inevitable. Nevertheless, not every person who experiences traumatic events and difficult times develops diseases. So exactly when and how does stress become dangerous?

 

Many researchers discuss the topic of stress, and their work provides a partial answer. Studies in recent years have shown that the effect of stress is indirect and in fact, our perception of stress is the real risk factor. Researchers from Stanford University found that in stressful periods, people who viewed stress as harmful to their health were truly at a greater risk of developing stress-linked diseases. Conversely, people who believed that stress is a positive thing showed proactivity and a better coping ability during stressful periods, and on the physical level, displayed a decline in risk factors.

 

In consequence, two further questions emerge:

1. What affects our perception of stress?

2. What characteristics distinguish the stress that is frightening, erosive, and exhausting from the stress that leads to self-motivation, initiation, and action?

 

I will answer by describing a case.

 

Jenny immigrated to Israel from the U.S. as a 30-year old single mother of a two-year-old girl. The initial period was very difficult. She was alone, without the support of her family. In addition to taking care of her daughter, she worked and studied to be a registered nurse.

 

Jenny graduated, started her professional career, and even advanced to a managerial position. Soon, she entered a relationship, which became a marriage. Her daughter grew up, was very successful in her studies, and was accepted, after completing her military service, to study in a sought-after university department. Jenny viewed her achievements as a success from all standpoints: a high standard of living and a supportive and loving family.

 

Around the age of 50, Jenny suffered a heart attack. It happened suddenly, and in the absence of apparent risk factors. She had been in good physical shape, without any background diseases. She loved working out and maintained a balanced, healthy diet. Many concerns and fears appeared following this event, building up to severe emotional distress. During our first session, Jenny shared her concern that the distress itself would cause another cardiac event and asked to learn how to calm down and not “take things to heart”.

 

She described the year preceding the heart attack as a period with nothing unusual. The most prominent thing was that she experienced a certain pressure at work because of a conflict within the team of nurses. In the course of that year, the conflict resolved itself in her favor, when the nurse she had friction with was dismissed.

 

In our first sessions, Jenny recalled the difficult, stressful period she experienced after her immigration to Israel. She felt that although it was challenging and hard, it was also empowering. Alongside feeling fearful, missing her family, and despairing at moments, she was highly motivated and ready to make an effort. Despite the scantiness of sleep, running around, and worries, she was healthy and felt strong. And she did achieve impressive accomplishments.

 

In contrast, the year prior to the heart attack was characterized by excessive worry, especially about her health and overall feeling of weakness. By introspection, Jenny identified the connection between the stress she experienced at work and the deterioration in her general condition. This connection was new to her because she didn’t believe she should be emotionally affected by those circumstances and throughout the period of conflict, she tried to intervene as little as possible. Her internal argument  was that she had no influence on the situation (since the management had not responded to her previous complaints), and therefore, no responsibility. The surprising element was that she began to feel the deterioration only after the conflict was resolved and the nurse had been dismissed. She had previously felt troubled and sometimes frustrated, but it was only after the change, when the atmosphere had improved in the department, that feelings of anxiety and helplessness started to emerge.

 

Therefore, the question that arises is why is a woman who was able to deal with putting down stakes a new country — a stressful time in every way — suddenly significantly affected by much less dramatic circumstances at the workplace?

 

During Jenny’s treatment, joint inquiry work and internal processes brought her the realization that the conflict at work had forced her to confront fears that date back to her childhood. Those fears surfaced as a reaction to inconsiderable and offensive behavior (the nurse in her department). She didn’t know how to respond, thus reacted defensively (as was her habit since childhood). It was an unpleasant situation, but her internal balance was maintained. The moment that the department’s manager intervened and humiliatingly dismissed the nurse, Jenny’s balance was undermined and an inner conflict surfaced. On the one hand, the circumstances revealed to her that inconsiderate behavior is punished and helplessness doesn’t really exist. On the other hand, because the fear that arose in her, originated from an inner perception and from childhood experiences, it persisted within her. The internal argument that she was unable to affect the situation had stopped being validated. Most importantly, once the nurse was gone, and she had no apparent reason for the fear, the legitimacy for it was gone too. Jenny remained with the fear but without any logical reason. An emotion continued to overflow and she didn’t know what to attribute it to. Consequently, she began to blame herself for feelings she “shouldn’t” feel and tried to regain her calm and balance.

 

In her first years in Israel, Jenny knew that if she wanted to achieve a standard of living that would allow her to be secure, she must make an effort. Every difficulty fit her expectations and each emotion that emerged, whatever its intensity, provided information important for further progress and for achieving goals (even at the price of emotional agitation). When she faced a difficult situation, the emotions which arose helped her find the solution most appropriate for her. She had to be attentive to each emotion that emerged, in order to trust her decisions. For example, a workplace could seem pleasant and appropriate on the practical level but fail to satisfy her needs and ambitions. In order to be aware of this, she had to listen to her intuition. Any attempt to ignore a particular emotion was tantamount to sabotage on the path to achieving her goal.

 

At present, in a financially secure, stable relationship and with a high standard of living, encountering an emotion whose origin isn’t clear to her can undermine the balance. She considers that if she shows an emotional turmoil unsuitable to the situation, people may distance themselves from her and even her marriage might be affected by this. Therefore, Jenny was unwilling to be accepting and heedful of those fears that had arisen from the feud at work. Her defense mechanisms managed to maintain the balance as long as the circumstances didn’t change. When a change occurred, they stopped working and the inner conflict surfaced. Any attempt to suppress it took so many resources that other systems were damaged.

 

In one of the last sessions, Jenny said she had learnt to be more empathic and attentive to herself and less concerned about “taking things to heart”. As a result, she felt calmer, stronger, and more sure of herself. She described one evening in which she returned  home from work upset and angry. Her husband listened to her and commented with the usual remarks that it will be fine and that she needs to calm down. In the past, she would retreat within herself and try to calm down. This time, she explained him that she needs to understand what exactly bothers her in order to know how to exert an influence and how to make a change.

 

In that conversation, Jenny found out that her husband reacts this way not because he needs her to be calm. He made it clear that it’s important for him to provide support and help her. Thus, when he is at loss, he tries to convince her that despite the difficulties she is experiencing, her life is still very good. This message was very appropriate for her, but she interpreted the words that he said in a completely different manner. He added that he enjoys seeing her being proactive and coping even if she’s often on edge.

 

Getting back to the two questions that I mentioned at the beginning of the article:

Jenny’s story is unique to her but it contains a main theme that characterizes many people. When she arrived in Israel, willing to experience difficulties, her internal perception was that stress is unavoidable and will advance her toward her goals. That is, she viewed stress as a positive thing.

 

However, in recent years stress became a nuisance, endangering the balance that had cost her a great effort, and she perceived it as harmful. Following an inner process, Jenny redefined her goals and her view of stress transformed into a positive one.

 

Stress and life’s circumstances can be dramatic or insignificant when viewed from the outside. Their harmful effect depends solely on the person’s unwillingness to accommodate an emotional condition that accompanies stress. Any artificial attempt (without introspection) to reduce the emotional flooding – in Jenny’s words from the first session, “to stay calm” and “not take it to heart” –overloads the systems and eats up resources. In a therapeutic framework, a negative attitude toward stress is indicative of unresolved internal conflicts. It should be noted that when they are resolved, the attitude changes as well.

 

Life’s circumstances change, and progress and growth inevitably are accompanied by stressful situations. Despite the great difficulty in such situations, their presence does not increase the chances of disease. In fact, in a stressful situation our perception and our choice to be introspective are the most significant and influential elements affecting our ability (and our body’s ability) to endure.

 

The answer is that given a stressful situation, we can choose to cope and thus improve both our quality of life and our health.