A Cabinet of Stress Therapies

In my previous post, I investigated the diverse concept of stress. Stress management is also known for a fascinating panoply of techniques. In this post, I present a selection of popular stress management therapies.

Item number 1: The Stress Ball.
2011_08_12_19_39_11_stress_ball

The stress ball was a staple of the office environment in the late 20th century, along with ‘Newton’s cradle’ and Bonsai trees. The underlying logic was that squeezing the ball would ‘release your stress’, but the science never followed. Today, stress balls are seldom prescribed as stress therapy. 

Item No. 2: Exercise

jogging_workout_beginners

Exercise is a common prescription for stress management. The notion here is that exercise induces wellbeing (naturally this depends somewhat on your attitude to the subject) and wellbeing reduces stress.  

Item No. 3: The Sensory Deprivation Tank

tank

The Sensory Deprivation Tank is a soundproof chamber filled with warm salt-water, which allows you to float (hence its other name, flotation tank). Once the lid is closed, the inside of the tank is pitch black, but you can exit at any time you choose.

What distinguishes the tank from simply taking a bath in a soundproof, dark room? The answer is that the extent of the reduction of auditory and visual information coming in from your senses tends to induce vivid daydreams, such as beautiful imagery and, in some cases, entire pieces of music! The proposed reason for this internal effect is that once the brain lacks input, it will ‘fill in the blanks’ through the imagination/memory. This daydreaming state of mind is said to reduce stress. 

Item No 4: Progressive Muscle Relaxation

relaxation day

Pioneered by Dr. Edmund Jacobson in the early 20th Century, Progressive Muscle Relaxation (PMR) is a technique where participants are instructed to tense — and then relax — a set of body parts in succession. Tensing the muscle prior to relaxation is meant to deepen the relaxation, thus reducing stress. 

Item No 5: Meditation

meditation

Meditation is one of the most popular stress-busting treatments today. Interestingly, most meditation experts emphasize that meditation is not relaxation. That is, the goal of meditation is not primarily to relax your body (although that may be a side-effect). Rather the goal is more psychological nature, such as practicing mindfulness, loosely defined as the ability to stay present in each moment, as it occurs to us. This presence is meant to reduce stress. 

Final words

Wellbeing, relaxation and mindfulness are meant to treat the same problem. Therefore, there is reason for skepticism. It is not clear, for example, how the wellbeing derived from exercise relates to the daydreams of the flotation tank, other than the fact that these therapies often induce generally ‘positive’ experiences. 

The different goals of PMR and meditation demonstrates this problem. In his original book, aptly titled ‘You Must Relax’, Dr. Jacobson warned that the word stress was much to vague to be useful, urging his colleagues to use the word tension to discuss the problem treated by relaxation. On the other hand, meditation is a stress treatment, but is not meant to relax you. Thus, PMR and relaxation treat different problems, yet these problems are referred to using the same word. Imagine if the word influenza referred to two different types of problems, yet you could choose either treatment A or treatment B (where only one would actually solve your problem). How would you know which treatment was best for you?

In any event, I hope you have enjoyed this short tour through the often strange world of stress therapy, and that it has promoted healthy skepticism about the relationship between stress and its treatment.

========

Jacobson, E. (1946). You Must Relax: a Practical Method of Reducing the Strains of Modern Living. Garden City, N.Y: Blue Ribbon Books.

Advertisement

The Problem with Stress

I present to you a stressed person, according to Psychology Today:


97330-93928

Scary.

Yet, I wonder, what really is stress? I decided to have a conversation with the internet to investigate this matter.

========================================================

F: Government of Victoria, as an important authority on health matters, what is this concept which is referred to as stress?

Better Health Channel: ‘[s]tress is a feeling you have when you face a situation you think you cannot manage’.

F: Interesting. Stress is a feeling of being unable to cope. That really clears things up!

Psychology Today: We thoroughly object! Stress is simply a reaction to a stimulus that disturbs our physical or mental equilibrium.

F: That seems like a slightly different definition. What about you, (US) National Institute of Mental Health? How do you define stress?

NIMH: We are of the opinion that both the previous definitions were too specific. Instead, we say that ‘[s]tress can be defined as the brain’s response to any demand’.  

F: … Now I am confused again. Apparently, there are many definitions of stress. It can refer to a specific feeling, a change in either mental or physical equilibrium, or just any non-specific human response to a demand. If mental health experts cannot agree on a definition, how do I know what stress is?

=============

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/stress
https://www.psychologytoday.com/basics/stress
http://www.nimh.nih.gov/health/publications/stress/index.shtml

The Stress-Cheese Connection

‘If psychiatrists decide that eating cheese is a symptom of stress, we will get a cheese-eating epidemic!’ – Minds and Madness tutorial joke.

In this post, I invite you to imagine that, ten years ago, the American Psychological Association claimed to have discovered a new symptom of stress — eating cheese. People eat cheese because it calms them down. Today, it is common knowledge that eating cheese is a symptom of stress, and every health professional in the world is taught to be aware of excessive cheese-eating. Children are taught in school that stress can lead to eating cheese. Entire books have been written about the Stress-Cheese Connection.

Given this scenario, will people begin to eat cheese when they feel stressed?

The Symptom Pool

Throughout the subject Minds and Madness, we have had discussions of transient mental illness (meaning illnesses that appear during one period of history and then virtually disappear, such as 19th century fugue states). Interestingly, symptoms of mental diagnoses can also change over time. At least that is the logic underlying historian Edward Shorter’s concept of the symptom pool. The symptom pool is essentially a collection of symptoms (behaviors, thoughts and feelings) that people engage in/experience, in order to signal their distress to others (Shorter, 1987). These symptoms, according to Shorter, constitute cultural expressions of distress, not underlying organic illness. They are thus subject to historical change.

Shorter described early presentations of anorexia to illustrate his concept. Although Shorter suggests that self-starvation has been a part of the symptom pool since early religious fasting practices, he suggests that anorexics have historically shown different symptoms, such as simply losing your appetite (contrasted with the often hungry, modern anorexic). He cites the case of 19th century French woman who completely lost her appetite and simply stopped eating, putting her health as serious risk. Her physician prescribed eight sequential half-an-hour cold baths, upon which she apparently promptly recovered her appetite. Shorter believes this case, as well as many others, constituted presentations of anorexia with different symptoms from today’s anorexics, and that the woman’s rapid recovery was evidence that she was suffering from a psychological disorder, not an organic illness.  

Today, loss of appetite is not part of the diagnosis of anorexia nervosa in the DSM. Rather, the manual focuses on the fat phobia (being terrified of gaining weight) and distortions in the perception of one’s body (commonly denying that one is getting dangerously skinny). Thus, it seems that the symptoms of anorexia have changed over time, although self-starvation has been a consistent expression of distress.  

==========

Shorter, E. (1987). The First Great Increase in Anorexia Nervosa. Journal of Social History, 21(1), 69-96.

20th Century Tonic Man

I have become curious about the diagnosis of the nervous breakdown, an antiquated label which today would refer to anxiety, fatigue and/or depression. As it turns out, ‘nerve tonics’ were a popular treatment for nerves in Victorian times. Below is a picture of a nerve tonic label. It contains at least two disconcerting ingredients, can you spot them?

Nerve_tonic

That’s right: Throughout the 19th and way into the 20th century, people were willfully ingesting arsenic and strychnine (the latter of which is commonly used to kill rodents) to fix their ‘weak nerves’. The weird thing is, it clearly says
poison on the label!

I can just imagine the amount of trust I would need to have in a physician in order to poison myself. Especially if I knew the rationale behind the treatment: Basically, if your nerves were weak, poison would give them a jolt, and make them strong again.

Now that is speculation!

======================

Oppenheim, J. (1991). ” Shattered Nerves”: Doctors, Patients, and Depression in Victorian England. Oxford University Press.