Stress in the fax age: stress need not be harmful.

Two women came to see me. The son of the first had just made a serious attempt to end his life because of the pressure of his forthcoming school exams. The son of the second has lost his motivation and stopped going to college. As a doctor, I regularly see people whose lives are affected by stress.

Stress is not always harmful. During World War II Britain's health was better than it had been in times of peace. In his memoirs, Winston Churchill wrote that on the night after he took over the reins of power as Prime Minister he slept peacefully for the first time in many months.

There are not many presidents or prime ministers who have died from illness while in office. Most people with power relinquish it with reluctance. Orchestral conductors and soloists, whose lives encompass moments of great stress, seem to be blessed with longevity. Mountaineers thrive on adrenalin. In certain circumstances, stress can be invigorating and healthy.

Some consider that the apparent increase in stress-related illnesses is caused by the increasing pressures of modern life. I remember my old headmaster complaining that the telephone, which had been described as a labour-saving device, brought in work which in the past he would have avoided. Gone are the days when it took months for messages to go to and from the far-flung corners of the world. Fax and email mean that today's politicians and tycoons have more decisions to make in a day than their predecessors had in a week.

On the other hand, decisions which are made quickly do not have to be agonized over. Technology reduces tension as well as creating it. People carry cell phones so that they can be reached when they are out (more stressful) and have answerphones so that they cannot be reached when they are in (less stressful). The motor car gets blamed for road rage, but makes it possible for busy people to escape to the solitude of the wide open spaces. Television brings the world's problems into our living rooms, yet offers us light relief.

The case for increased stress in our Western nations is not proven. In the past many suffered from the pain of losing babies in childbirth or infancy. Life expectancy was lower, poverty more widespread. Moreover, stress is not the only cause of serious mental illness, and may often be one of a cocktail of factors. For example, many who experience depression have a parent or grandparent who suffered similarly.

But if stress itself has not increased, its profile has certainly risen. I read about a couple whose plane got into difficulties on an internal flight in the US. Their pilot reacted skilfully and landed the plane safely--but the couple successfully sued the airline for damages for the stress of nearly crashing.

Perhaps the real problem is that we are not as good at dealing with pressure as our forebears were.

Although many people talk to me first about external pressures, what is doing the damage is often internal pressures. The busy entrepreneur has external pressures, but is rarely seen in the surgery. The unemployed man faces internal ones, such as feelings of failure and worthlessness, and may well need help. Fear, anger, uncertainty, grief, loss, hurt, guilt and disillusionment seem to be the most damaging pressures.

One of my patients had been given the job of making men he had worked with for years redundant. His boss, who made the decision, probably felt little stress. My patient believed the decision to be unjust but risked losing his job if he refused to carry it out. He felt guilty and afraid. These internal pressures had made him ill.

Is there a reason why we are less resilient than our ancestors? Were they protected by factors which are less universal today?

One which springs to mind is family life. Most of the people I see with stress problems are having difficulties at home. All breakdown produces terrible stresses--and this is true however `easy' legislation manages to make divorce. As well as the hurt experienced, there is the loss of support--because it is normally from within the family that we gain our strength.

The erosion of family life is linked to the steady decline in the hold of religion. The family has been the crucible of religious belief, and in turn that belief has protected the family.

Apart from reinforcing the family, faith seems to relieve stress in three ways. Firstly, it has inspired and furnished great aims, which take people out of themselves in the service of God, humanity and ideals.

Nelson Mandela, for instance, emerged unscathed from nearly 30 years of harsh imprisonment. His vision of freedom both sustained and protected him. A similar vision of freedom, and the all-embracing task of defeating fascism, kept Britain healthy through the dark days of World War II. Such purpose--which of course is not a monopoly of the religious--appears to protect against stress.

Secondly, faith speaks to the inner pressures which do the most damage. For instance, if someone asks what the New Testament is about, the short answer is `Jesus'. But if the answer is given in terms of the human condition then it is about how to deal with fear, anger, uncertainty, grief, disillusionment, failure and worthlessness. It gives a moral framework which, like great aims, is stress protective.

But true religion does more than this, for it offers the means, the power, for overcoming difficulty. There is a story often told about someone who dreams that they are walking on a beach with God. They look back over their life and see two sets of footprints in the sand. But at times there is only one set of prints, and the dreamer begins to question God's faithfulness.

God replies, `My precious, precious child, I love you and I could never leave you during your times of trials and suffering. Where you see only one set of footprints, it was there that I carried you.'

Protection

This experience of the nearness of God, the sense that we are never alone, is without doubt the strongest protection against stress.

A sadness of our time is that so many who know so much in other spheres have no idea of the riches which they could discover if they explored their spiritual roots. It would be a tragedy if the generations who discovered how to communicate ever more quickly to ever greater audiences were also those who had nothing really worthwhile to say.

The doctor's surgery offers a window on the world. Our age can be compared to a tree. The branches, fed by technology, grow prodigiously. But a tree can only withstand the storms if its roots go as deep and wide as its branches grow tall. The experience of the surgery shows just how precarious so many people's lives are. We have given too much attention to the branches.

Life has not become more stressful, but we have become more vulnerable. Fortunately, we are also much better at treating the illnesses precipitated by stress. But if we want to reduce our vulnerability, we must look to our roots.