Dr Serani's 6 Myths About Stress

Psychologist Dr Deborah Serani dispels six myths about stress in the hope of promoting greater understanding. It sounds a lot like being aware of the allostatic load of your life. I've borrowed this following explanation of allostasis from Dr. Salt's summary of a classic paper:

[stress has] many mechanisms, but among the most prominent are the manifestations of physiological stress responses as a result of living and working conditions, inter-personal conflict, as well as the sense of control of one’s environment and optimism/pessimism toward the future. "Allostatic load" refers to the cost of adaptation to a stressful environment, which elicits repeated and sometimes prolonged adaptive responses ("allostasis") that preserve homeostasis in the short run but can cause wear- and-tear on the body and brain. Functional symptoms and syndromes, decreased cognitive function during aging, abdominal obesity, increased risk for hypertension and cardiovascular disease, insulin-dependent diabetes and decreased immune responses are all manifestations of allostatic load.

We have powerful ways of modulating the harmful output of the stress response systems that include belief systems and behaviors. An important quote attributed to Dr. McEwen is, "We must also remember that the biggest problems for the human race in the future are those associated with our own behavior and misbehavior and the impact of the social and physical environment on our bodies and brains."

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Family Relationships Key to Happiness for Poor in Bangladesh

I was in Tower Hamlets yesterday, talking with some of the community health and well-being team (not the actual title but a reasonable description). We talked about the role of healthy breathing in relieving some of the distressing symptoms of chronic illnesses. We also discussed the importance of happiness, resilience and having a Happystance.

One of the most vigorously discussed topics was that the western concept of happiness seems to promote individualism and independence above social interdependence and group obligations. A research group recently published a working paper that reported eight out of ten people in Bangladesh describe themselves as happy: they say that their relationships with their loved ones is the key to their happiness.

Whilst achievement of individual goals and personal wealth remain the most significant contributors to happiness in Europe and North America, in Bangladesh and other parts of South and East Asia it seems to depend more on the quality of social relationships.

This finding could provide a partial explanation for the lack of success of development interventions in recent years, many of which are based on assumptions about the initiatives likely to bring the greatest benefit to individuals.

The researchers summarised the key characteristics about good relationships that were identified by the Bangladeshi people whom they interviewed. They found that:

• Older mothers valued being treated affectionately by sons and daughter-in-laws as much as receiving material support
• Participation and consultation in decision-making was singled out as an important indicator of a happy marriage
• For younger women the most crucial relationship was with their husband
• A good husband provides for his wife’s and their family’s needs, and is also respectful and acknowledges her competence
• Younger women focused on the quality of their personal relationship with members of their husband’s family, primarily their husband’s mother, sisters, and sisters-in-law
• All the groups, apart from older women, made connections between happiness and a desire to be respected and/or influential beyond the immediate confines of family relationships
• Older men valued the ability to participate in and influence the affairs of the community

Dr. McGregor commented on the report's findings:

Some of the older people we spoke to strongly valued close and harmonious relationships with family members, to the extent that they even enabled them to ignore physical hardship. Even though at times they don’t get enough food to eat, these people were still happy because they have good relationships with the rest of their family.

Now, I think that this working paper is a fascinating social description of happiness in the context of extreme poverty. However, I do not see Happystance as part of the hedonic or individualist view of happiness. I have repeatedly argued that Happystance is about resilience and that there is a lot of fine research that shows that we have greater physical and emotional resilience when we have rich social networks - otherwise known as friends and family. In good relationships, resilience and support flow back and forth over time. There is not always an equitable exchange between any one pair of friends, but over a set of relationships, these exchanges do seem to even out.

Supernanny State Or A Bold And Innovative Initiative?

The Sunday Times is trumpeting Antisocial families to get 'supernannies'. The story is a blend of some topics that have been interesting me recently because it encompasses poor social relations, difficulty relating to various bodies, antisocial behaviour, physical health, bedtimes, cooking skills and understanding nutrition, parental coaching on anger management etc. Or, allostasis.

[Social workers] will arrive early each morning to ensure the household is out of bed and youngsters sent to school. Their tasks will include ensuring children are properly fed and dressed, and encouraging layabout parents to find a job.

So, the author's never seen the trailers for those Neighbours From Hell programmes where it is typically the professional or monied classes who make each other's lives miserable over Leylandii, rights of access, parking etc.. Nor can the author have seen those desperate parents on TV who report that they have repeatedly asked their Social Services Dept. for help with their 'out-of-control' children only to be told that there is nothing available for them. My memory has faded, but I thought that there were several working couples who took part in that pioneering parent coaching course that was televised on BBC 2's Blame The Parents.

Allostasis, Sleep and Happiness

Following on from allostasis and happiness I've been thinking about the contribution of sleep to allostasis (and therefore, well-being). The Times carried a summary of El-Sheik's research into sleep quality in children. The more that children are exposed to parental conflicts, the worse they sleep. And, the worse children sleep, the more likely they are to be tired when awake, have difficulty focusing and be irritable and badly behaved. All of which sounds like it could make a contribution to a diagnosis of ADHD, particularly the need to have the behaviour documented in a variety of settings. And, as the children would be tired for most of the day, I think that that criterion would be met.

I wrote about the diabetic children with uncontrolled ketoacidosis who prompted Salvador Minuchin to say that "behavioral events among family members can be measured in the bloodstream of other family members". It seems as if that could also be adapted to "behavioural events among family members can be measured in the diagnoses of other family members".

Allostasis and Happiness

I've been reading a lot about allostasis and allostatic load lately. Primarily because I am trying to understand where happiness and its beneficial effects fit in. Leading advocates of the concept claim that it makes sense of why some societies (such as the UK, the rest of Europe and the US) are experiencing a surge in the numbers of people who are developing obsesity, metabolic disorders (e.g., Syndrome X or type II diabetes) or addictions. At its highest level, allostasis implies that social policies have a critical impact on how we experience our lives, and therefore influence our resilience and ability to withstand disease and to recover from illness.

I've borrowed this following explanation of allostasis from Dr. Salt's summary of a classic paper:

[stress has] many mechanisms, but among the most prominent are the manifestations of physiological stress responses as a result of living and working conditions, inter-personal conflict, as well as the sense of control of one’s environment and optimism/pessimism toward the future. "Allostatic load" refers to the cost of adaptation to a stressful environment, which elicits repeated and sometimes prolonged adaptive responses ("allostasis") that preserve homeostasis in the short run but can cause wear- and-tear on the body and brain. Functional symptoms and syndromes, decreased cognitive function during aging, abdominal obesity, increased risk for hypertension and cardiovascular disease, insulin-dependent diabetes and decreased immune responses are all manifestations of allostatic load.

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