“Describe and evaluate one theory of stress as a bodily response.” (18 marks)
Selye 1956 put forward a very influential biological theory. He did not conceive stress to be a stimuli
but a response. He believed that stress was a non-specific response, that is, the body responded in
the same way to any stressful happening.
In other words, there was a general-purpose emergency response- the fight or flight response- to
any demanding situation; this emergency response put the body into a highly energised state. The way
the body responds to stress does fit the theory’s description. During any emergency routine
maintenance of the body is stopped to divert energy to activities that could deal with the emergency.
So food is not digested and the repair of injuries is stopped. The sympathetic division of the
autonomic system (SAS) stimulates the neuroendocrine system to produce many hormones which
make the body better able to deal with an emergency. And the heart beats faster and blood pressure
is raised and more sugar is released into the blood. The faster heart rate and increased sugar give the
body more energy for extreme effort.
However, this theory claims that the stress response is an automatic biological response and does
not depend upon what the person thinks about the situation. So it ignores individual differences. Not
all people are upset to the same degree by the same things. There is evidence that people’s cognitive
appraisal plays a role in the physiological response to stress. For example, Tennes 1985 found that
the stress hormone cortisol was raised in above intelligence children on days when they had a test but
was not raised in below average children. This is probably because academic success was more
important for children of above average intelligence.
And the theory also claimed that we respond the same to all stressful situations. But Mason 1975
produced a lot of evidence to show that the body did not respond in a non-specific way to stress, that
is, it responds in different ways to different stressor. For example, for some stressful events the body
produced three important hormones and for others two. The reason for this difference is that some
stressful events are more emotionally upsetting than others.
This theory also oversimplifies in that it ignores many factors that influence the response to stress. For
example it ignores individual differences in the stress response. Kobasa 1986 did a study of executives
who were in highly stressful situations. Some felt stressed and developed physical illnesses, whereas
others did not. The ones that did not become ill had a greater sense of control and commitment and
regarded things going wrong as a challenge.
And it also ignores gender differences. Frankenhauser 1991 pointed out that there are gender
differences in the response to stress, for example, men release more adrenaline under stress. And
Brannon 1996 reports that women’s friendships are much more likely than men’s are to include
emotional intimacy and thus the possibility of emotional support.
Although Selye’s work has been criticised, there is evidence for his idea that there is a
generalpurpose emergency response - the fight or flight response - and this idea makes
evolutionary sense.
Describe and evaluate the idea that stress damages the cardiovascular system. (18 marks)
It is widely believed that stress leads to heart attacks. The physiological effect of stress is the
sympathetic branch of the autonomic nervous system is activated and makes the heart beat faster and
raises blood pressure. In addition hormones which damage the cardiovascular system are released. So
the physiological effects of stress make the idea plausible and there is a lot of evidence for the idea.
Rahe 1974 carried out a retrospective study on people who had died of a sudden heart attack. He
found that relatives reported that they had suffered more life changes than those who did not have a
fatal heart attack and there is evidence that life events are a source of stress. However, this study is
retrospective and retrospective studies rely on people’s memories which are unreliable. So Rahe
carried out a prospective study which also supported the idea that stressed people were more likely to
have a heart attack.
Further Karasek 1990 interviewed a range of people in different jobs. The interview was a structured
interview designed to measure job demands and job control. Job demands refers to how emotionally
involving the job was and how skilled it was. Control refers to how much the workers could pace the
flow of work. The workers were also asked about any symptoms of heart disease. Karasek found that
having a demanding job was positively correlated with heart disease. This was interviewing people
about their real job so the study had a high degree of ecological validly.
And stress does not only seem to have effects at work. Sarafino reported that dozens of studies have
been done using a structured interview and they have provided good evidence that Types A people
who are rushed, competitive and hostile, so more likely to be stressed, are more likely to have a heart
attack.
However both the Karasek’s and the Rahe’s study are correlational and from correlation you cannot
infer causation. Perhaps for some reason people who are overweight do not get high status jobs and
so get jobs with high demands and low control. So the correlation between demanding jobs and heart
attack would be due to overweight and not the job stress
So you need to do an experiment: experiments are the only way to show that one thing causes
another, in this case that stress causes heart attacks. In an experiment you would manipulate the level
of stress as the independent variable and expect to see an increase in the dependent variable- heart
problems.
However, it is not ethically permitted to do experiments on humans in which you deliberately try to
harm them. However, it is allowed to do that to nonhuman animals.
Kaplan 1989 did a study, which showed that social stress could damage the blood vessels in
monkeys. He showed that in a stable monkey group the lowest ranking monkeys had the worst
hearts and blood vessels because they were at the mercy of all the other monkeys. However, he then
started to move the monkeys into new groups every month. It was now the monkeys at the top who
showed the most damage to their cardiovascular systems. The monkeys at the top now had the most
stress because they had to fight for their position.
However, a problem with animal studies is that you cannot necessarily generalise from animals to
humans.
And it could be argued that the idea that stress causes heart problems is rather simplistic in that it
ignores a large number of variables that affect the stress response. For example, there is evidence
that people’s cognitive appraisal plays a role in the physiological response to stress. In particular,
Tennes 1985 found that in above intelligence children the stress hormone cortisol was raised on days
they had a test but was not raised in below average children.
And it also ignores gender. Men are much more at risk from heart attacks. The reason might be
physiological: men release more adrenaline under stress. Or the difference might be due to their
coping mechanism: Brannon 1996 reports that women’s friendships are much more likely than men’s
are to include emotional intimacy and thus the possibility of emotional support. On balance, the
evidence supports the idea that stress is bad for the heart. However, the theory tends to ignore
individual differences and gender. And it is possible that the effect of stress is indirect: stressed people
tend to smoke more, to take less exercise, and eat more junk food. All of these are risk factors for heart
attack.
“Discuss the idea that stress damages the immune system”. (18 marks)
The immune system is the body’s defence against disease. It “remembers” the bacteria which have
invaded the body. It stores the information about the bacteria in memory-T cells and memory-B cells so
that the body is better prepared to fight these bacteria. And it can send different types of cells such as
killer T cells to destroy the bacteria. After the bacteria are killed the immune system clears up and
restores the body.
Ader 1975 provided good evidence that the immune system of rats can be affected by psychological
events and so could be damaged by stress. He conditioned rats to associate an immune suppressing
drug with the taste of saccharine and found that the mere taste of saccharine made significantly more
of these rats die and also reduced their level of antibodies significantly. They were not given the drug,
they were merely given the taste which they associated with the drug and so they got the “idea” they
were being made ill and the idea was enough to actually make them ill.
However it is possible that this cannot be generalized from rats to humans, as the physiological
systems might be too different. For ethical reasons you cannot do experiments in which you
deliberately aim to harm the health of the human participants.
But there is evidence from a natural experiment on humans, which do not increase the stress levels
but merely take advantage of a naturally occurring situation. Jemmott 1983 took blood samples from
students during their examination period and showed that they had lower levels of antibodies in their
blood during examinations. So the stress of the examination had reduced the efficiency of their
immune system.
Overall this research can be criticised as it does not show that damage to the human immune system
leads to illness. As Eysenck 2000 points out, stress has been shown to reduce the level of immune
functioning but not by a dangerous amount so the level of immune system functioning is still within the
normal range. In other words, the immune system functioning is statistically worse in the stressed
group but is not reduced to a dangerous level.
But Cohen 1991 showed that the more stress people had the more likely they were to catch a cold.
He got people to fill in a questionnaire about the amount of stress in their lives. He then exposed them
to the cold virus. The more stress, the more likely they were to catch a cold.
However, this research is only correlational and from a correlation you cannot infer causation. And
there is a lot of evidence from research on memory that people who are feeling low remember more
negative events. So there is a very real possibility that the people who were physically run down, that is
about to get ill, remembered more negative events.
So since stress lowers the body’s immune system and the immune system is the body’s defence
against illness, it is likely that stress makes the person more liable to a variety of disorders. But so far
no one has shown that stress causes an immune system related disease.
“Describe and discuss the idea that life changes are a major source of stress”. (18 marks)
Holmes and Rahe 1967 believed that major changes - life events such as bereavement, getting
married, etc - were a source of stress, which could be damaging to a person’s health. They accepted
Cannon’s idea of homeostasis. Homeostasis refers to the fact that the body works best in a middle
range and attempts to return itself to that middle range so, for example, if we are hot we sweat to return
our temperature to the range where we function best. Holmes and Rahe believed that a similar idea
applied to people’s minds and that any major changes would lead to the mental state of stress. For
example, Parkes showed that bereaved people are 50% more likely to die in the first year.
There is evidence for this view that life changes are stressful and damaging to health. Rahe got a
large sample of male sailors to record their life changes over a six-month period. A record of the sailor’s
health was also kept. There was a small positive correlation between the number of life changes and
the number of illnesses.
However the scale Rahe used does not take any account of the subjective meaning of the events for
the person. For example, a $10,000 dollar mortgage is scored as being equally stressful for everyone
regardless of income. Evidence for the importance of the event’s meaning for the individual was
provided by Tennes 1985. He found that in above intelligence children levels of the stress hormone
cortisol was raised on days when they had a test but was not raised in below average children. This is
probably because academic success was more important for the above average intelligence children.
Another weakness is that the scale is retrospective. And people’s memories are unreliable. Not only
are people’s memories unreliable but also the memories are biased towards the person’s present
mood.
There is a lot of evidence from research on memory that people who are feeling low remember more
negative events. So there is a very real possibility that the people who were physically run down, that is
about to get ill, remembered more negative events.
The correlation between life changes and illness is low. So Sarifino says that many other factors are
involved in people becoming ill.
Consistent with Selye’s emphasis on homeostasis Holmes and Rahe believed that any change was a
source of stress. However Crandall 1977 showed unsurprisingly that undesirable events were more
related to illness.
And it ignores individual differences. Kobasa 1986 did a study of executives who were in highly
stressed situations. Some developed physical illnesses, whereas others did not. The ones that did not
become ill regarded potentially stressful situations as challenges.
The work has also been criticised as somewhat misleading in that it focuses on the rare events in life
which are very stressful as the causes of stress and ignores the common, small unpleasant events.
Lazarus suggested that daily hassles were worse for people than the uncommon major events.
“Discuss the idea that work place stress can damage people’s health”. (18 marks)
It was widely believed that executives who make a lot of important decisions would suffer from stress. It
was also believed that the stress caused by making these decisions would damage the executive’s
health.
There is evidence for this view. Brady used four pairs of monkeys and each monkey received an
electrical shock every twenty seconds but the executive monkey could press a lever which turned off
the shock for twenty seconds. The yoked control monkey could do nothing to prevent the shock. Many
of the executive monkeys developed stomach ulcers and died. None of the yoked control monkeys
showed any abnormalities of the stomach.
However, this experiment has pushed stress to the extreme. To push a lever every ninety seconds for
six hours then rest for six hours then back to lever pushing would be a demanding task for humans. For
monkeys it must have pushed them to their cognitive limits.
A study using a more realistic level of stress showed that rather than constant vigilance being the
problem lack of control was more of a problem. Weiss 1972 paired rats and gave them shocks after a
warning buzzer. Rats that were warned and could do something to escape developed fewer stomach
ulcers than rats that could do nothing to escape. This suggests that it is lack of control, helplessness
that is important.
This fits in with many studies on the importance of control in alleviating stress. Stress is a relationship
between the person and the environment in which the person appraises the demands of the situation to
be greater than their resources. So if the person has control, that is, can make clear decisions and take
effective action they can reduce stress.
So the more realistic animal study of Weiss’s suggests that it is not highranking executives who are
going to suffer ulcers but middle managers who have high demands and low control. Smith 1978
showed that this was the case. Smith used the number of stress related illnesses as a measure of
stress and found that jobs which had a high level of demand and a low level of control were the most
stressful.
Brannon 1992 reports that many studies have confirmed that it is high demand and low control that is
the crucial factor in work place stress not responsibility for decision-making. Karasek 1988 showed that
people in jobs, which had high psychological workloads and low decision making capacity, had a much
higher risk of heart attacks.
However, lack of control is not the only factor. Different jobs will have different sources of stress:
noise, pollution, social isolation, and role ambiguity are all possible sources of stress depending upon
the job.
Many jobs cause workers to work in isolation for long stretches of time. And many studies have shown,
not surprisingly, that a good social network reduces stress. LaRoco 1980 gave questionnaires to
people in a variety of jobs and found that job stress was most highly correlated with social support from
people at work rather than at home. So jobs that isolate people from social support at work will increase
job-related stress.
Role ambiguity is another source of stress. A person’s job might not be clearly defined and thus place
conflicting demands upon them. For example, a foreman might be expected to be loyal to both his/her
employer and their fellow workers.
“Discuss the idea that personality can affect the response to stress”. (18 marks)
Freidman and Rosenman 1974 believed, on the basis of their clinical observations, that people who
were competitive, rushed and angry were more likely to suffer heart attacks. On the basis of a
structured interview they divided people into Type As who were competitive, rushed and angry, and
Type Bs who were non-competitive, laidback and friendly. The Type As were twice as likely to have
died of a heart attack in the following eight years.
Sarafino reports that dozens of studies have been done using the structured interview and they have
provided good evidence that Types As are more likely to have a heart attack.
However it is possible that the difference is physiological. It is suggested that Type As show greater
reactivity. Reactivity refers to the amount the person’s arousal increases when they are put in a
stressful situation. Matthew 1986 harassed his participants while they were playing a video game and
showed that the arousal of Type As did indeed increase more than Type Bs when they were harassed.
So Type A and Type B might not really be a personality difference but a physiological one and are
likely to be an innate differences.
Another important personality difference is the degree to which people feel they have control of their
lives and the evidence for the importance of control seems stronger than that for the importance of
type A personality type.
By “sense of control” is meant that the person feels that they can influence their life so that things will
turn out all right for them. A lack of sense of control means that the person feels that too many
unpleasant things are happening to them and there is nothing they can do so they suffer from stress.
Stress is a relationship between the person and the environment in which the person appraises the
demands of the situation to be greater than their resources. So anything that increases people’s ability
to make clear decisions and to take effective action will reduce stress. And Sarafino reports that many
studies both on animals and humans have found that lack of control increase stress levels. In addition,
Kobasa has developed a programme to increase people’s sense of control and outcome research has
shown that this reduces people’s feelings of stress and reduces the severity of stress related illnesses.
In effect, Kobasa’s hardiness training programme can be regarded as a natural experiment that
supports the idea that a sense of control moderates the ill effects of stress. In her hardiness
programme you can say that increasing the independent variable - a sense of control - leads to a
reduction in the dependent variable - a sense of being stressed.
Langer 1976 provided evidence that a sense of control is important in dealing with stress in a field
experiment. She gave one group of elderly residents of a nursing home increased control over their
lives; they were, for example, allowed to rearrange their furniture. Surprisingly such a small increase
leads to short-term mental and physical improvements and in the long-term a lower death rate. It is
quite striking how such simple changes made such a difference.
However, it is possible that there was an experimental bias. The nurses knew which residents were in
which group so they had different expectations of the two groups and thus treated them differently.
For ethical reasons you cannot experiment on humans to see if lack of control damages people’s
health.
However there are experiments on animals. Weiss 1972 paired rats and gave them shocks after a
warning buzzer. Rats that were warned and could do something to escape developed fewer stomach
ulcers than rats that could do nothing to escape. This suggests that it is lack of control that is important.
“Discuss the idea that that gender moderates the effect of stress” (18 marks)
There are differences in the way men and women respond to stress. Brannon 1996 says the source
of these differences could be cultural or it could be innate. It is most likely that there is an interaction
between innate differences and what society expects.
Men are much more at risk from heart attacks. According to Brannon 1996, part of the reason for this
lies in men’s behaviour: they smoke more, drink more, etc. These risky behaviours are part of what is
expected of men and are cultural - part of the social role. Type A behaviour is much more common
among men than women.
Frankenhauser 1991 pointed out that there are gender differences in the response to stress, for
example, men release more adrenaline under stress. So the reason for men being more prone to heart
attacks might be an innate physiological one. But Brannon points out this difference may be cultural,
arising from gender roles and not from physiology: women who occupy senior positions show the male
stress response and release more adrenaline.
And men and women differ in their coping mechanisms. Brannon 1996 reports that women’s
friendships are much more likely than men’s to include emotional intimacy and thus the possibility of
emotional support. (Men’s friendships tend to be about shared activities). There is a lot of evidence that
having social supports reduces the damaging effects of stress. And it is plausible that with their more
emotionally open approach to their friendships woman would benefit more than men would.
There are basically two forms of strategies for dealing with stress. Problem solving strategies attempt to
change the situation whereas emotional strategies attempt to accept the situation. Folkman 1980
suggested that women use more emotional strategies than men and men use more problem solving
strategies. But as Brannon points out, like the physiological response to stress, later studies shows that
when you equate education and job status then this difference disappears. In other words, this was not
so much a gender difference as a reflection that women used to be employed in less demanding work
and receive poorer education.
So Brannon is pointing out that both the physiological gender difference and the difference in coping
strategies are due to differences in status and not to a difference between men and women.
And Sarafino lists a number of factors that suggests the difference between men and women is not to
do with their response to stress but due to other factors.
• Women’s sex hormones protect them against heart attack - after menopause women are as much at
risk from heart attacks as men.
• Women visit their doctors far more than men.
• Men smoke much more than women.
All of these factors would make men more likely to get ill and thus any difference between men and
women in the stress response might be illusory.
“Outline and evaluate one psychological method of coping with stress”.(18 marks)
Meichenbaum 1983 argued that people could be trained in advance to deal with stress. That is, they
can be inoculated by being trained in some skills, which will help them cope better with stressful
situations and he developed his stress inoculation as a method for preparing people. First the therapist
and the patient discuss the person’s past experience of stress and they find out what situations have
stressed the patient and how the person has coped in the past, and then the person learns and
practices skills such as relaxation and using social support.
Novaco 1978 showed, using outcome research, that the stress inoculation technique was effective in
reducing patients’ anger and feelings of stress as measured by self-report and blood pressure when
provoked. Novaco’s study has the advantage of combining both subjective – how it feels to the patient
– and objective measures.
And this method avoids the side effects of drugs. Most drugs used to treat stress make the patient
drowsy. These drugs are potentially addictive and they can also be dangerous as tranquillizers have
been shown to be a contributing factor in a lot of car accidents.
However, this programme has a rather behaviourist emphasis on sub vocalizations – the way the
patient talks to him/herself – and thus it plays down the importance of the way the person thinks.
Cognitive therapists have produced a lot of evidence that the way a person thinks can actually be the
problem and that changing the way the patient thinks about the problem can be very beneficial. For
example, the cognitive therapist Ellis directs a lot of effort at getting his patients to reframe the problem.
This means that the client is encouraged to see the problem in a different way that will make it less
stressful.
And the programme is rather oversimplified. It ignores individual differences. A programme that is
tailored to the personality of the patient might well be more successful. There is substantial evidence
that a person’s personality affects the way they experience and deal with stress. For example, Kobasa
1986 did a study of executives who were in highly stressful situations. Some developed physical
illnesses, whereas others did not. The ones that did not become ill had a greater sense of control as
well as a greater sense of commitment and of treating new, potentially stressful situations as
challenges.
Similarly, on the basis of a structured interview, Freidman and Rosenman 1974 divided people into
two types: Type As who were competitive, rushed and angry, and Type Bs who were non-competitive,
laidback and friendly. So it is likely that the stress inoculation technique would be more beneficial if it
took account of this personality difference.
The technique also ignores gender differences. These differences are both physiological and social: for
example, men release more adrenaline under stress and men tend to use problem solving strategies
whereas women use emotional strategies. Again a technique that took into account these gender
differences might well be more effective.
Moreover, Rice 2000 made a very general criticism of stress reduction techniques like Meichenbaum’s.
He suggests that stress management programmes like Meichenbaum’s may be diverting attention from
the real cause. He suggests that the real cause might be Western Society, which emphasizes
competition and achievement.
However, even if Rice is correct he it taking rather a long view. In the shortterm stress management
have been shown to help individuals feel better and to suffer less physical illnesses.
“Outline and evaluate Psychological methods of coping with stress”. (18 marks)
Meichenbaum 1983 argued that people could be trained in advance to deal with stress. That is, they
can be inoculated by being trained in some skills, which will help them cope better with stressful
situations and he developed his stress inoculation as a method for preparing people for stressful
situations. First the therapist and the patient discuss the person’s past experience of stress and they
note what situations have stressed the patient and how the person has coped in the past and then the
person learns and practices skills such as relaxation, and using social support.
Novaco 1978 showed using outcome research that stress inoculation technique was effective in
reducing the patient’s anger and feelings of stress as measured by self-report and blood pressure when
provoked.
And this method avoids the side effects of drugs. Most drugs used to treat stress make the patient
drowsy. Also they are potentially addictive and they can be dangerous as tranquillizers have been
shown to be a contributing factor in a lot of car accidents.
However, this programme has a rather behaviourist emphasis on the way the patient talks to
him/herself - sub vocalizations – and thus it ignores the way the person thinks. Cognitive therapists
have produced a lot of evidence that the way a person thinks can actually be the problem and that
changing the way the patient thinks about the problem can be very beneficial. For example, the
cognitive therapist Ellis emphasises the importance of his patients reframing the problem. This means
that the client is encouraged to see the problem in a different way that will make it less stressful.
One programme that does focus on the patient’s cognitions is Kobasa’s hardiness training. Stress is a
relationship between the person and the environment in which the person appraises the demands of
the situation to be greater than their resources. So anything that increases people’s ability to make
clear decisions and to take effective action will reduce stress.
Kobasa 1986 did a study of executives who were in highly stressed situations. Some developed
physical illnesses, whereas others did not. The ones that did not become ill had a greater sense of
control as well as a greater sense of commitment and of treating new, potentially stressful situations
as challenges. So Kobasa has developed a programme to increase people’s sense of control.
Outcome research has shown that this reduces people’s feelings of stress and reduces the severity of
stress related illnesses.
Rice 2000 suggests that stress management programmes may be diverting problems from the real
cause. He suggests that the real cause might be Western Society, which emphasises competition and
achievement.
However, even if Rice is correct he it taking rather a long view. In the short-term stress management
programmes have been shown to help individuals feel better and to suffer less physical illnesses.
“Describe and evaluate one physical method of dealing with stress”. (18 marks)
The autonomic nervous system organises the body’s arousal level and the sympathetic division is
activated in order to deal with stress. It was believed until the 1960’s that the autonomic nervous
system could not be consciously controlled but in 1969 Neal showed that it could be conditioned, in
other words it could be affected by experience. So this suggests that the arousal system of the body
could be directly taught to relax. This led to the development of biofeedback which aims to help
stress related illnesses. The technique is to give feedback to the patient about one of the body’s
indicators of stress, for example muscle tension or blood pressure. So the person sees an indicator
showing, say, their blood pressure and if they do the right thing, then their blood pressure goes down.
By practicing controlling the indicator the person learns to reduce it and be more relaxed. This gives the
person a method to use in everyday life to reduce stress. Budzynski 1973 showed that people suffering
from tension headaches who were trained to relax their foreheads had fewer headaches and this
lasted over a three month follow up period.
However, although lots of studies show that biofeedback works, it does not work for the reason that
was originally claimed, namely that we can condition the autonomic nervous system directly. Rather, as
Roberts 1985 reports, biofeedback works indirectly, that is, it works through the voluntary muscles; as
Brannon 1992 puts it, the therapeutic element is simple muscular relaxation. If biofeedback is no more
effective than simple muscular relaxation then it probably should not be used as it is more expensive
than muscular relaxation.
However, Brannon 1992 did a review of the effectiveness of biofeedback and she suggested the
possibility of individual differences. She wrote that the evidence suggests that some patients would
respond better to biofeedback as a second method of treatment after simple muscle relaxation has
failed.
Rice 2002 suggested that it might work by giving people a sense of control. One study tricked people
into believing their muscles were being relaxed when they were not. This still led to a reduction in
tension headaches.
But, if Rice is correct, then you can say that training in muscle relaxation is not only cheaper it also is
something that is more under the patient’s control. They do not need to feel that their success is due to
expensive equipment. This means their sense of control and self-esteem is enhanced. And the person
is more able to use the method of simple muscle relaxation in everyday life.
So stress is not solely and simply a biological phenomena: it is not something that automatically
happens to a person but depends upon the way the person perceives the situation. And psychologists
have shown that psychological methods which change the way the person thinks and, in particular,
increase their sense of control, reduce the effects of stress. So it can be suggested that psychological
methods might be preferable as they put the patient back in control of their lives.
“Describe and evaluate physical methods of dealing with stress”. (18 marks)
The autonomic nervous system organises the body’s arousal level and the sympathetic division is
activated in order to deal with stress. It was believed until the 1960’s that the autonomic nervous
system could not be consciously controlled but in 1969 Neal showed that it could be conditioned, in
other words it could be affected by experience. So this suggests that the arousal system of the body
could be directly taught to relax.
This led to the development of biofeedback which aims to help stress related illnesses. The technique
is to give feedback to the patient about one of the body’s indicators of stress, for example muscle
tension or blood pressure. So the person sees an indicator showing, say, their blood pressure and if
they do the right thing, then their blood pressure goes down. By practicing controlling the indicator the
person learns to reduce it and be more relaxed. This gives the person a method to use in everyday life
to reduce stress. Budzynski 1973 showed that people suffering from tension headaches who were
trained to relax their foreheads had fewer headaches and this lasted over a three month follow up
period.
However, although lots of studies show that biofeedback works, it does not work for the reason that
was originally claimed, namely that we can condition the autonomic nervous system directly. Rather, as
Roberts 1985 reports, biofeedback works indirectly, that is, it works through the voluntary muscles; as
Brannon 1992 puts it, the therapeutic element is simple muscular relaxation.
If biofeedback is no more effective than simple muscular relaxation then it probably should not be used
as it is more expensive than muscular relaxation. However, Brannon 1992 did a review of the
effectiveness of biofeedback and she suggests the possibility of individual differences. She wrote that
the evidence suggests that some patients would respond better to biofeedback as a second method of
treatment after simple muscle relaxation has failed.
Rice 2002 suggests that it might work by giving people a sense of control. One study tricked people
into believing their muscles were being relaxed when they were not. This still led to a reduction in
tension headaches.
But, if Rice is correct, then you can say that training in muscle relaxation is not only cheaper it also is
something that is more under the patient’s control. They do not need to feel that their success is due to
expensive equipment. This means their sense of control and self-esteem is enhanced. And in reality
the person has more ability to use the method of simple muscle relaxation in everyday life.
Drugs are very easy to give and take and do not require an investment of a long period of time for
patient and therapist. Sarafino 1994 points out that drugs might be used by a doctor for a temporary
measure, against the adverse effects of stress, either to help the patient in a crisis such as the first few
days following a bereavement or while the patient learn some psychological technique for coping.
There are two classes of drugs used both of which reduce arousal. Benzodiazepines such as Valium
reduce activity in the midbrain structure involved in emotion and Beta-blockers, such as Inderal, block
neurons in the sympathetic nervous system that respond to adrenaline. But as Sarafino 1994 points
out, drugs will only be used by a doctor for a temporary measure. They are, as Rice 2000 points out,
addictive and there are side effects, for example, drowsiness, loss of concentration, and impaired
memory. And as Rice 2000 points out, if the person stops taking them then the anxiety returns - they
are not a cure.
And psychologists have shown that psychological methods which change the way the person thinks
and, in particular, increase their sense of control, reduce the effects of stress. Psychological methods
are methods which will continue to work after the patient stops coming for treatment. So as a long-term
measure psychological techniques which directly target the source of the problem, namely the patient’s
thinking, seem preferable.