contents
introduction
IF YOU HAD to sum up how you feel about stress, which statement would be more accurate?”
A) Stress is harmful and should be avoided, reduced, and managed.
B) Stress is helpful and should be accepted, utilized, and embraced.
Five years ago, I would have chosen A without a moment’s hesitation. I’m a health psychologist, and through all my training in psychology and medicine, I got one message loud and clear: Stress is toxic.
For years, as I taught classes and workshops, conducted research, and wrote articles and books, I took that message and ran with it. I told people that stress makes you sick; that it increases your risk of everything from the common cold to heart disease, depression, and addiction; and that it kills brain cells, damages your DNA, and makes you age faster. In media outlets ranging from the Washington Post to Martha Stewart Weddings, I gave the kind of stress-reduction advice you’ve probably heard a thousand times. Practice deep breathing, get more sleep, manage your time. And, of course, do whatever you can to reduce the stress in your life.
I turned stress into the enemy, and I wasn’t alone. I was just one of many psychologists, doctors, and scientists crusading against stress. Like them, I believed that it was a dangerous epidemic that had to be stopped.
But I’ve changed my mind about stress, and now I want to change yours.
Let me start by telling you about the shocking scientific finding that first made me rethink stress. In 1998, thirty thousand adults in the United States were asked how much stress they had experienced in the past year. They were also asked, Do you believe stress is harmful to your health?
Eight years later, the researchers scoured public records to find out who among the thirty thousand participants had died. Let me deliver the bad news first. High levels of stress increased the risk of dying by 43 percent. But—and this is what got my attention—that increased risk applied only to people who also believed that stress was harming their health. People who reported high levels of stress but who did not view their stress as harmful were not more likely to die. In fact, they had the lowest risk of death of anyone in the study, even lower than those who reported experiencing very little stress.
The researchers concluded that it wasn’t stress alone that was killing people. It was the combination of stress and the belief that stress is harmful. The researchers estimated that over the eight years they conducted their study, 182,000 Americans may have died prematurely because they believed that stress was harming their health.
That number stopped me in my tracks. We’re talking over twenty thousand deaths a year! According to statistics from the Centers for Disease Control and Prevention, that would make “believing stress is bad for you” the fifteenth-leading cause of death in the United States, killing more people than skin cancer, HIV/AIDS, and homicide.
As you can imagine, this finding unnerved me. Here I was, spending all this time and energy convincing people that stress was bad for their health. I had completely taken for granted that this message—and my work—was helping people. But what if it wasn’t? Even if the techniques I was teaching for stress reduction—such as physical exercise, meditation, and social connection—were truly helpful, was I undermining their benefit by delivering them alongside the message that stress is toxic? Was it possible that in the name of stress management, I had been doing more harm than good?
I admit, I was tempted to pretend that I never saw that study. After all, it was just one study—and a correlational study at that! The researchers had looked at a wide range of factors that might explain the finding, including gender, race, ethnicity, age, education, income, work status, marital status, smoking, physical activity, chronic health condition, and health insurance. None of these things explained why stress beliefs interacted with stress levels to predict mortality. However, the researchers hadn’t actually manipulated people’s beliefs about stress, so they couldn’t be sure that it was people’s beliefs that were killing them. Was it possible that people who believe that their stress is harmful have a different kind of stress in their lives—one that is, somehow, more toxic? Or perhaps they have personalities that make them particularly vulnerable to the harmful effects of stress.
And yet, I couldn’t get the study out of my head. In the midst of my self-doubt, I also sensed an opportunity. I’d always told my psychology students at Stanford University that the most exciting kind of scientific finding is one that challenges how you think about yourself and the world. But then I found the tables were turned. Was I ready to have my own beliefs challenged?
The finding I had stumbled across—that stress is harmful only when you believe it is—offered me an opportunity to rethink what I was teaching. Even more, it was an invitation to rethink my own relationship to stress. Would I seize it? Or would I file away the paper and continue to crusade against stress?
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TWO THINGS in my training as a health psychologist made me open to the idea that how you think about stress matters—and to the possibility that telling people “Stress will kill you!” could have unintended consequences.
First, I was already aware that some beliefs can influence longevity. For example, people with a positive attitude about aging live longer than those who hold negative stereotypes about getting older. One classic study by researchers at Yale University followed middle-aged adults for twenty years. Those who had a positive view of aging in midlife lived an average of 7.6 years longer than those who had a negative view. To put that number in perspective, consider this: Many things we regard as obvious and important protective factors, such as exercising regularly, not smoking, and maintaining healthy blood pressure and cholesterol levels, have been shown, on average, to add less than four years to one’s life span.
Another example of a belief with long-reaching impact has to do with trust. Those who believe that most people can be trusted tend to live longer. In a fifteen-year study by Duke University researchers, 60 percent of adults over the age of fifty-five who viewed others as trustworthy were still alive at the end of the study. In contrast, 60 percent of those with a more cynical view on human nature had died.
Findings like these had already convinced me that when it comes to health and longevity, some beliefs matter. But what I didn’t know yet was whether how you think about stress was one of them.
The second thing that made me willing to admit I might be wrong about stress was what I know about the history of health promotion. If telling people that stress is killing them is a bad strategy for public health, it wouldn’t be the first time a popular health promotion strategy backfired. Some of the most commonly used strategies to encourage healthy behavior have been found to do exactly the opposite of what health professionals hope.
For example, when I speak with physicians, I sometimes ask them to predict the effects of showing smokers graphic warnings on cigarette packs. In general, they believe that the images will decrease smokers’ desire for a cigarette and motivate them to quit. But studies show that the warnings often have the reverse effect. The most threatening images (say, a lung cancer patient dying in a hospital bed) actually increase smokers’ positive attitudes toward smoking. The...
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