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As a psychoanalyst who has specialized in working with cancer patients, I hear the word “stress” frequently. When a new cancer patient comes into my office, I will generally ask the person why they think they have cancer. Some patients are puzzled by the question, and say that they don’t know. But a fair number of them will speculate, and many of them will use the word “stress” to describe emotional situations that they had felt themselves to be in some time before the cancer diagnosis. They describe their situation as untenable- an emotional “dead end” that they couldn’t find their way out of. One of my cancer patients stated that getting cancer was “the only way out” for her because her life had become intolerably “stressful.”
I have wondered about the frequent reference to the concept of stress, and its ubiquitous prevalence. It is used, most often, to refer to some external situation, an agent outside the person’s control. Pundits on contemporary culture suggest that it is inherent in modern life, we are all susceptible to it, and it surrounds us all the time. According to this way of thinking, a portion of us develop serious, even life-threatening diseases because of it.
Yet, this usage and understanding of stress as an external agent impinging on us contradicts the original meaning of the concept, which was developed as both a scientific and medical concept. Hans Selye did the initial research on the concept, and coined the term. He was searching for a new hormone, and thought that he had discovered it when he injected a substance into rats, and, indeed, they produced a triad of symptoms at the site of the injection that had never been seen before. Then he injected a known hormone into more rats, and they reacted in precisely the same way. And then he injected a third hormone, also a known hormone; same reaction. It didn’t matter what substance he used; the rats were all getting sick in the same way. Selye began to understand that there was a general principle in operation that was more powerful than the specific substance that was being used. He called that principle “stress”, by which he meant the body’s response to any change that creates a demand on the organism. Selye put the responsibility of the stress response clearly on the organism itself-not on the specific nature of the stimulus.
It is important to understand the implications of this difference between what Selye meant, and what my patients mean when they say their cancer is caused by stress. If stress is simply exposure to a “bad” or “toxic,” or “noxious” stimulus, then the trick to staying healthy would be to avoid all such stimuli or situations. We can do that in some situations. If we are fearful of snakes, for instance, we can stay out of the woods. But if not having enough money is stressful, or if having a mother suffering from Alzheimer’s is stressful- there are situations like these that are unavoidable. Often, in these kinds of situations, we feel helpless to control our own emotional destinies; this sensation leads to a rather disempowering notion of what life means.
Selye’s definition of stress is a much more hopeful concept; it lays the power of avoiding stress not on some external situation that may be beyond our control, but rather on our own selves, our own reactions. We determine whether we are in stress or not by our responses.
It is the brain that determines whether we will experience the sensation of stress. The brain has evolved to have the capacity to deal with stress for about 30 seconds. If you are under threat–for instance by a hungry crocodile–in under a minute, your stress sensation will be over. You will either have escaped or you will have been eaten. The brain has not yet adapted to the sensation of long-term stress. The sensation of chronic stress damages virtually every aspect of brain functioning. It damages memory, executive function, perception, and motor skills. The brain actually shrinks in size.
If we look at the history of science, we see that it keeps forgetting, and then re-discovering basic principles. Selye’s research harkens back to the issue that permeated the medical labs at the time that Pasteur was discovering the germ. Pasteur developed the idea that germs, in the form of microorganisms, were causing disease. The germs attack us as innocent by-standers, who just happen to get ourselves unknowingly in the wrong place at the wrong time. But Claude Bernard, a contemporary of Pasteur’s had a different idea. He felt that the germ itself was not the problem; the problem was the host terrain that either accepted the germ and let it go rampant toward its destructive capability, or whether the organism that was hosting the germ mounted a sufficient defense against this toxic invading intruder that there was, as we might say today, damage control.
Pasteur realized on this deathbed that his whole life’s work had been barking up the wrong tree, and he uttered one of the most frequently cited phrases in medical history: “Bernard avait raison; le germ n’est rien; c’est le terrain qui est tout;” (Bernard is right; the germ is nothing; the host terrain is everything). Unfortunately for medical history, and for cancer research specifically, Pasteur’s idea took hold, and this country has spent billions of dollars researching thousands of substances to see which ones “cause” cancer. It is only within the last few decades that research has gotten serious about understanding the role of the immune system in the development of disease. And, there is almost no research on understanding the nature of what I call the “psychological immune system”–a concept I developed and refer to in my book, The Psychotherapeutic Treatment of Cancer.
Selye also developed the concept of “eustress.” As there is distress, which causes discomfort and even disease, there is its opposite, eustress, which is stimulative, beneficial and promotes health. Selye was clear: stress itself is not bad. To the contrary, being exposed to stressful situations can improve the organism, make it healthier and even promote longer life. We can see this eustress principle at operation in our everyday lives. A student studying for a test feels stress, but the stress motivates him to master the material, and he ends up with more knowledge – as long as he doesn’t pull multiple all-nighters. Similarly, moderate exercise strengthens our bodies while excessive exercise debilitates our bodies. One of the best researched effects of eustress has to do with food deprivation. Moderate reduced food intake leading to longer life is a well-established finding; however, prolonged food deprivation (as in anorexia) leads to undue stress, and eventual death.
In evoking the concept is eustress, Selye was referring back to an older principle called “hormesis.” Like eustress, hormesis describes that there can be a beneficial adaptation to stress. In referring to the hormesis effect, the 16th century physician Paracelsus said, “The dose makes the poison.” Paracelsus meant that the intensity, or the quantity of the stressing agent is a critical variable in determining whether the reaction to the stress will benefit the organism, or damage it. Since then, science has repeatedly documented this effect to be universally applicable. For instance, in World War II, when supplies of penicillin were limited, it was demonstrated that at low doses, penicillin actually stimulated the growth of Staphylococcus. In hormesis, as in eustress, less is more: a small dose activates, stimulates, and facilitates health; a large dose causes degeneration and destroys.
The science of homeopathy is based on this hormetic principle. Minute doses of substances–even minute doses of what would be an actual poison in a larger dosage–can cure. And while homeopathy has not yet entered mainstream medicine, research into the hormetic effect has recently influenced the fields on anti-aging and disease, and in surprising ways. We now understand that any organism–as small as a cell, as large as a human being–rallies a defense mechanism in response to a threat. And once this defense mechanism is activated, the organism is better prepared to deal not only with that specific threat, but with other threats as well. This activation of defense happens on a molecular level. Recently, the role of a class of herbs called adaptogens has been studied for their hormetic effect. The adaptogens mimic eutress in the body, turning on various hormetic-response molecules, and thereby stimulating the whole body into a healthier and longer lifespan.
The moral of the story: 1) Take your stresses in low doses but don’t avoid them altogether, 2) recognize the stressing agent is within. Blame doesn’t work. Recognition of the responsibility for your own responses carries the day.