Stress and Coping

Introduction
The mind and body relationship is an issue that has been acknowledged since
ancient times. The mind-brain problem poses the question of whether the mind is no
more than a nuisance to our brain processes or whether the mind can, to some extent,
influences our behaviour. ‘Dualism’ is the approach in psychology, which stresses the
mind and body as being two existing and interconnected entities. According to one of the
first dualists, Descartes, the mind influences the body and not vice versa1, whereas the
‘interactionists’ claimed that both the mind and body have influence on one another.
Hence, by the means of applying the interactionist point of view, the psychophysiological
correlates of stress and illness can be studied. How psychological factors such as stress
can lead to psychophysiological effects has been and will continue to be a fundamental
topic of research in psychology. It is interesting to investigate the issue of stress and its
causes and effects on humans, since stress is copious in our modern society. Therefore
this essay intends to deal with following research question: What do we know about the
relationship between stress and physiological illness and can we use that knowledge to
cope with stress?

Stress, according to physicists, stress would simply be defined as ‘the pressure or

force that is exerted to a body.2’ However, according to psychologists, stress is a more
complex factor, which is looked upon in terms of ‘the demands it possesses on an
organism and how the organism attempts to adapt or cope with the specific demands’3. A
definition of stress that has been widely accepted was established by Lazarus and
Folkman (1984). According to these researchers, stress is ‘a pattern of negative
physiological states and psychological responses occurring in situations where
individuals perceive threats to their well-being, which they may be unable to meet.’ 4
Whether stressors are harmful or not depends solely on individuals appraise the stressors
and how the mind interprets them (Lazarus, 1975).

It would seem appropriate here to define what is meant by physiological illness.

Illness itself is a broad concept, but in general it refers to problems and challenges to the
health and well-being of humans5. A physiological illness is any illness in which physical
symptoms are assumed to be the direct result of psychological or physical factors6.
Eminent studies conducted by Friedman and Rosenheim (1974), Sweeney (1995) and
Cohen et al. (1996) focusing on the relationships between stress and its influence on the
weakening of the immune system and on cardiovascular disorders, have led psychologists
to establish the concept that there is a clear relationship between stress and physiological
illness. Furthermore, studies that measure the efficacy of the methods to cope with stress,
as such performed by Holmes and Rahe (1978) and Jacob et al. (1977) have also
presented support for the view that, specific coping methods such as: social support,
biofeedback, meditation and anti-stress drugs, can reduce the effects of stress and thus

1
Gross, Richard. Psychology-The Science of Mind and Behaviour. Page 872
2
Gross, Richard & McIlveen, Rob. Biopsychology. Page 169
3
Gross, Richard & McIlveen, Rob. Biopsychology. Page 169
4
Gross, Richard & McIlveen, Rob. Biopsychology. Page 169
5
Flemming, Tom. Health Care Information <URL:http://www-hsl.mcmaster.ca/tomflem/ill.html.>
6
Spine-Health <URL: http://www.spine-health.com>

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 Stress and Coping

prevent physiological disorders. To determine what we know about the relationship

between stress and physiological illness and whether we can use that knowledge to cope
with stress, it is firstly important to outline the causes of stress, which include life
changes, frustrations, hassles and uplifts of everyday life. Subsequently, the reactions to
stress, which encompass both physiological and psychological features, should be
explained, since evidence has shown that they lead to physiological illness. Furthermore,
in order to counterbalance stress, there are specific coping methods have been suggested
and these methods are devised by the means of using the knowledge that is obtained
about the stressors and their effects.

What causes stress?

Lazarus’ transactional model of stress emphasizes the notion that whether stimuli
are stressful or not, depends only on how the individuals appraise them. It is therefore
important to describe the causes of stress in terms of potential stressors that are typically
perceived as stressors by everyone, and these include stressors such as life changes,
frustrations, hassles and uplifts of everyday life. So rather than simply categorizing
stressors in groups such as ‘philosophical stressors or bio-chemical stressors’ we will
look into more generalized aspects to the causes of stress. The first main cause of stress is
‘life changes’.7 Life changes include change in schools, death of a relative, etc. Holmes
and Rahe (1967) studied the effects of life changes and investigated whether they are in
any way involved in causing stress. The researchers devised a ‘Social Readjustment
Rating Scale,’ which was aimed to measure severity of stressful changes in a scale from
one to a hundred life change units. According to the scale, the death of a family member
counted as 100 units, whereas change in school counted as 20 units. A number of studies
have shown that those individuals, who had a score over 300 life change units, were more
susceptible to have stress related illnesses.8 However, the SRRS has been criticized,
mainly for the reason that as Lazarus (1975) pointed out that some life changes may be
perceived as being more stressful to some people; and since the scale is based on a fixed
number of units on certain life changes, the scale does not have a great validity.

Other potential sources of stress that are typically witnessed by almost everyone
are ‘frustrations’ According to Coon (1983), frustration is defined as a ‘negative
emotional state, which occurs when one is prevented from reaching a certain goal.9’
Frustrations typically occur due to some environmental factors that one has usually no
control of, such as flight being cancelled, stormy weather, etc. ‘Hassles and uplifts of
everyday life’ can also be classified as potential sources of stress. These sources of stress
include hassles such as not being able to hand in an essay, concerns about weight, etc.
Finally another source of stress that is worthy to mention is ‘work-related stressors.’ This
source of stress encompasses all the social and environmental conditions at the work
place, such as noise, co-worker relationships, but they depend on the nature of the job.

7
Gross, Richard. Psychology-The Science of Mind and Behaviour. Page 138
8
Gross, Richard. Psychology-The Science of Mind and Behaviour. Page 138
9
Gross, Richard. Psychology-The Science of Mind and Behaviour. Page 138

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 Stress and Coping

Reactions to stress

Walter Cannon (1927) proposed one of the earliest models of physiological

reactions to stress. He acknowledged the sympathetic branch of the Autonomic Nervous
System of organisms as being the region that stimulates the adrenal medulla to produce
hormones such as adrenaline and nor-adrenaline that are underlying factors in the
increases of heart rate, blood flow and sugar levels, and thus preparing the body for
emergency by means of triggering the fight-or-flight response. The instinctive response to
an external stressor causes the organism either to escape or defend itself from the
threatening situations, so in many situations, stress can be very advantageous. The fight-
or-flight response was studied in an unethical, yet influential study conducted by Lord,
King and Pfister (1976).10 The researchers found that when animals were given certain
chemicals that inhibit the neurotransmitters of the sympathetic branch of functioning
optimally, it was quite challenging for the animals to learn to escape from an electric
shock. These findings suggest that, if the functions of the sympathetic branch are
inhibited, then fight-or-flight response is not activated, even though the situation one is
exposed to is life-threatening. Consequences for an organism could be physiological
disorders and also psychological disorders, such as ‘learned helplessness’ as suggested by
Seligman (1975).

Another model based on the physiological reactions to stress was suggested by

Dr. Hans Selye. According to Selye, stress is the ‘non-specific’ physiological response of
the body to any demands that are made upon it, which means that the body responds to
stress in the same way, despite the nature of the external stressor.11 Selye introduced his
concept of the body’s physiological defense against stress and called it: ‘General
Adaptation Syndrome,’ which consists of three main stages. The first stage is the ‘alarm
reaction,’ where an individual is exposed to the stressor. This leads to an overall increase
in activity of bodily processes, due to the stimulation of the sympathetic branch. If the
stressor is not removed, the individual experiences the second stage, which is referred to
as the ‘resistance stage.’ Here the individual attempts to cope with the stressor and
reverse the effects of the alarm reaction.12 However, if the individual is still exposed to
the stressor, then he/she will undergo the most critical stage, known as the ‘exhaustion
stage.’ During the stage important bodily resources, such as sugars will eventually run
out due to the continuous sympathetic-adrenomedullary activity. According to Selye,
these are the deficiencies that will be the cause of physiological disorders, which include
heart disease, stomach ulcers, asthma or possibly death.13

Both Cannon’s fight-or-flight model and Selye’s general adaptation syndrome

only stressed the notion that individuals are merely automatically responding to their
external environment, and ignored psychological factors involved in stress and also the
view that the individual have the ability to interact with these stressors, rather than

10
Gross, Richard & McIlveen, Rob. Biopsychology. Page 25
11
Anthony J. Curtis. Health Psychology. Page 129
12
Ogden, Jane. Health Psychology-A Textbook. Page 232
13
Gross, Richard. Psychology-The Science of Mind and Behaviour. Page 142

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 Stress and Coping

passively eliciting the stress response.14 However, Lazarus’ transactional model of stress
contradicted this approach and Lazarus (1975) claimed that whether certain stimuli cause
stress depends solely on the individual and how they perceive the stressors and that
individuals possess the ability to interact with the stressors. He claimed that individuals
perceive stressors differently and that some people perceive some stimuli as stressful,
whereas others do not and thus took a more psychological aspect to the study of stress.
According to Lazarus, whether the individuals perceive certain factors as stressful
depended on how they appraised them. In an empirical study performed by Speisman et
al. (1964), which was aimed investigate how participants appraise different situations,
participants were shown a film involving an unpleasant genital surgery in three different
conditions. The first condition involved the film being showed with a soundtrack that
stressed the pain in the surgery, whereas in the second condition, had a soundtrack that
emphasized people being happy. And the last condition involved a soundtrack which
gave a medical interpretation of the surgery. As assumed by Lazarus’ appraisal theory,
the most stressful condition was the first condition, which was also known as the trauma
condition. These findings suggest that it is not necessarily the events that cause the
individual to be stressed, but the way the individuals perceive or appraise the stressors.15
However, due to the experimental design, there were a few weaknesses in the study, for
instance, there participants could have showed demand characteristics and may have
acted so as to please the experimenter or simply to spoil the experiment. But in spite of
the limitations, this study does to a large extent substantiate Lazarus’ appraisal theory.

Does stress cause illness?

To investigate whether stress causes illness, there has been put great emphasis on
the role of evolution and how our responses to stress are merely due to instinctive
behaviour that our ancestors have passed on. Since we already know from Cannon’s and
Selye’s stress model, that whether one is exposed to internal or external stimuli; the
sympathetic branch of the Autonomic Nervous System is always stimulated in a same
way, regardless of what the stressor may be. This suggests that even though one is not
exposed to a harmful or negative stressor, the body reacts to the stressor with same
‘fight/flight’ response and thus the mind perceives it as life-threatening. These
predetermined responses can be explained in terms of our ancestral history. Since our
ancestors were presumably frequently exposed to harsh conditions, where alertness and
self-defense were quite necessary, so as to be aware of predators, it is assumed that our
nervous and endocrine system have evolved in ways that they react to stressors in the
same way as our ancestors did, despite the nature of the stressor. For that reason, our
ancestors’ adaptive responses have led to be maladaptive responses for us at present,16
since these innate responses can lead to both physiological and psychological disorders.

Psychoneuroimmunology is a scientific approach focusing on the issue of ‘mind

over body.’ This approach stresses the notion that an individual’s psychological state can

14
Ogden, Jane. Health Psychology-A Textbook. Page 233
15
Ogden, Jane. Health Psychology-A Textbook. Page 236-237
16
Gross, Richard. Psychology-The Science of Mind and Behaviour. Page 143

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 Stress and Coping

influence the immune system. The immune system is ‘the body system responsible for
resisting disease.’17 Cohen et al. (1996) studied the effects of stress on the immune
system, and asked a group of volunteers to fill out stress- and life- events questionnaires,
who were then given nasal drops containing mild cold virus. After taking blood samples
from the participants, the researchers found that stress had increased the risks of
respiratory illnesses, in ways that there was an overall decrease in resistance to the
common cold. Even those participants who felt that they were not stressed, the life events
that the researchers claimed as stressful, showed an increased vulnerability to the
common cold.18

Furthermore, another study that corroborates the assumption that stress has a
remarkable effect on the functioning of the immune system was reported by Sweeney
(1995). The purpose of the study was to verify whether stress had any effects on the time
taken for wounds to heal. In the study, two groups of participants agreed to take part in an
experiment, where they were to have a small skin biopsy on their arms. After the biopsy,
one of the groups was exposed to stressful conditions, whereas the other group was not.
As assumed by the researchers, they discovered that it took approximately nine days
more for the wounds of the stressed group to heal, when compared to the non-stressed
group. This implies that the stress had negative effects on the participants’ immune
system, since the healing of their wounds had slowed down. By using these two studies
conducted by Cohen et al and Sweeney, it can be stated that there is a relationship
between stress and the functioning of the immune-system and this causes an individual to
be more susceptible to become ill, since the body’s internal defense mechanisms are not
functioning optimally. However, since there is use of the correlational research in these
two studies, there are a few limitations, such as, there cannot be established a definite
conclusion about the cause and effect relationships and it is quite difficult to control
extraneous variables, which could have influence on the results. And since the two
studies are case studies, as in they are conducted on a small sample of people, the results
can therefore not be generalized to the rest of the population.19 In addition it is not
possible to replicate the studies, which makes it difficult to check the reliability of the
results.

Another way to investigate whether stress causes physiological illness, there have
been conducted studies investigating the relationship between stress and cardiovascular
disorders. This was done in a longitudinal case-study progressed by Friedman and
Rosenheim (1974).20 The study took place over a period of nine years and the researchers
aimed to investigate whether the stress had any influence on cardiovascular disorders and
whether the differences in personality of individuals played any role in determining
whom are more likely to develop these cardiovascular disorders. A large sample
consisting of several thousand physically healthy men between 39 to 59 years of age were
used and they were categorized by the researchers as ‘Type A’ or ‘Type B,’ depending on
their eating habits and how they dealt with stressful conditions. Type A personalities

17
Kent, Michael. Advanced Biology. Page 326
18
Gross, Richard. Psychology-The Science of Mind and Behaviour. Page 145
19
Searle, Ann. Introducing Research and Data in Psychology. Page 35
20
Gross, Richard & McIlveen, Rob. Biopsychology. Page 173

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 Stress and Coping

tended to be competitive, time-conscious, short-tempered, constantly striving for

achievement and were recognized as maintaining high-levels of stress. On the contrary,
Type B personalities tended to be more easy-going, relaxed, more understanding and less
stressed. The researchers found that nine years after the study had begun, 257 men died
and 70% of them were members of the Type A category. These findings suggest that
there are distinct correlations between stress and cardiovascular illness and that an
individual’s personality type has an influence on whether one developed these
cardiovascular disorders. However, this study has been criticized by many psychologists,
such as Ragland & Brand (1988), since they have been unable to get the same results as
the ones suggested by Friedman and Rosenheim. And once again there is the use of
correlational research, which has its disadvantages.

It is also important to mention, that it has been suggested that there is also an
indirect way in which stress can through general behaviours of people cause illness.
According to Wiebe and McCallum (1986), high levels of stress cause people to adapt
unhealthy behaviour, which could eventually lead to illness.21 These behaviours include
excessive consumption of alcohol, coffee or cigarettes and lack of exercise, where the
consequences can thus include breast cancer, damage of the liver, etc. So therefore it can
be stated that stress has both a direct and indirect link to physiological illnesses.

If we know the possible causes and effects of stress, it can therefore be

exceptionally advantageous to apply this knowledge to devise or learn methods that could
possibly help to cope with the stress. Coping refers to the attitudes and behaviors that one
uses to maintain ones emotional well-being and to adjust to the consequences of stress.
To cope with stress can be exceedingly beneficial and in some situations, even life saving
and some of these potential coping strategies that have shown to be quite beneficial
include: social support, meditation, biofeedback and drugs. Cohen and Lazarus (1979)
have generalized the coping strategies that a person may use in order to reduce stress into
five main categories.22 The first main coping strategies are referred to as the ‘direct
action responses,’ where the individuals change their attitudes towards the stressors and
attempt to either defend themselves against it or simply flee from it. The next strategy
involves the individual trying to understand the stressful situation better, which is termed
as ‘information seeking.’ Another coping strategy involves the individual simply not
taking any action and is known as the ‘inhibition of action.’ The fourth strategy is termed
as ‘palliative coping,’ where the individuals change their internal environment by using
drugs, alcohol or simply by using relaxation techniques. The last coping strategy is
‘turning to others’ for emotional support or simply to get things of one’s chest, also
known as ‘catharsis.’

‘Turning to others’ is believed to be a useful natural stress coping technique, since

it does not require any drugs or prolonged therapy sessions. According to Brown and
Harris (1978), individuals who know that they have social support, tend to have less
physiological stress effects, whereas those whom perceive that they have no support are

21
Ogden, Jane. Health Psychology-A Textbook. Page 241
22
Gross, Richard. Psychology-The Science of Mind and Behaviour. Page 148

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 Stress and Coping

more likely to be affected by stress23. In a cross-cultural study reported by Marmot and

Syme (1976),24 the differences in American and Japanese cultures were being studied and
its aim was to verify whether the social differences were the cause for any differences in
health. Some of the fundamental differences in the two cultures were that the Japanese
culture emphasizes good relations with others, good interpersonal skills and value social
interaction more that the American culture. To verify the effects of these differences,
Marmot and Syme compared the Japanese who lived in California, whom had assimilated
quite well into the American lifestyle, with native Japanese. It was found that even
though the individuals being studied had similar diets, the Japanese living in California
had a higher rate of coronary disease. These findings suggest that there are considerable
differences between the two cultures, since the Japanese are recognized as being less
stressed, and hence stress has less effect on their health. Therefore social contact has been
shown to be a useful tool to cope with stress.

However, according to Wheatley (1997) there are certain factors that can inhibit
the effects of the natural coping methods of stress, such as depression.25 Therefore the use
of anti-stress drugs can be beneficial, since it can instantaneously relieve depression.
There are a range of drugs, but the ones that are most effective act on the sympathetic
branch of the nervous system and inhibit its functions. However, the use of drugs to cope
with stress, according to Lazarus is ineffective in the long run. Since Lazarus emphasized
that whether some factors were stressful depended on how the individuals appraised them
and the way individuals can cope with them is to learn to appraise them in positive ways.
So the use of drugs can merely alleviate physiological symptoms and not abolish them.
Furthermore, there are many harmful side-effects that accompany the use of drugs. An
alternative biological technique that is known to reduce stress is ‘Biofeedback.’ It works
in the way that the individuals are given information about their own internal
physiological states and bodily processes such as heart rate and blood pressure, by the
means of using biofeedback machine. Biofeedback has been shown to beneficial in
relieving stress related physiological and psychological symptoms, however there are
some disadvantages with this therapeutic method, because it typically takes a long period
of time, before any beneficial effects occur.26

Western scientists refer to breathing techniques as relaxation therapy and found

that it is very effective in reducing pain and stress. There are different forms of
relaxation, including breathing exercises, progressive relaxation, meditation and yoga. To
relax is to ‘rest deeply,’ where there are no physical movements and the mind is clear and
in a state of tranquility. Jacob et al (1977)27 found that both progressive relaxation and
meditation have shown to be quite beneficial in reducing blood pressure, which is a great
cause for many illnesses. However according to Green et al. (1994), progressive
relaxation is only beneficial if it is practiced regularly, therefore in the short term is not as

23
Hill, Graham. Oxford Revision Guides-A’ level Psychology. Page 262
24
Marmot and Syme. (1976). American Journal-Epidemiology. Vol.104. Page 225-247.
25
Wheatley, David. (1997) Stress Medicine. Vol. 13. Page 173-177
26
Gross, Richard & McIlveen, Rob. Biopsychology Page 175
27
Gross, Richard & McIlveen, Rob. Biopsychology. Page 175

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 Stress and Coping

effective as the other coping techniques.28

Recent research has shown that women cope differently with stress than men.
After analyzing data based on numerous behavioural studies of humans and animals,
researchers from UCLA concluded that women cope with stress by the means performing
behaviour that results in the protection of oneself and one’s children. This is more
commonly known as the ‘Tending and Befriending’ coping method, which are assumed
to be evolutionary responses, that our ancestors have passed on. Tending refers to the
taking care of oneself and others, and befriending refers to creating social networks, so as
to reduce stress, by the means of ‘social support.’ On the other hand, it is suggested that
men respond to the stressor by expressing the fight-or-flight response and either confront
the stressor or flee from it. To substantiate these assumptions, a study reported by Repetti
and Wood (1997) 29 suggested that, mothers are particularly caring and loving to their
children, when they experience high levels of stress at work, which stresses the nurturing
response. Furthermore, in another study conducted by Repetti (1992) 30, it was found that
men who experience high levels of stress at work, they tend to keep themselves away
from home, and thus expressing the ‘flight’ response. These findings suggest that women
cope with stress differently than men and therefore it can be stated that there are, to some
extent, gender differences in the ways of coping with stress between male and females.

Despite the limitations and weaknesses of the empirical studies conducted by

Friedman and Rosenheim (1974), Sweeney (1995) and Cohen et al. (1996), it can be
stated that there is a clear link between stress and physiological illnesses, in terms its
influence on the weakening of the immune system and on cardiovascular disorders and
also indirectly by the means of performing unhealthy behaviours.31 According to Frese
(1985), stress is involved in almost 50-70% of all physical illnesses.32 This statement
gives a concrete account of the relationship between stress and physiological illnesses.
These findings also substantiate the ‘interactionist viewpoint,’ since it has been shown
that the mind and body both influence each other. From the studies reported by Friedman
and Rosenheim (1974) on personality, Repetti and Wood (1997) on gender differences
and Marmot and Syme (1976) on cultural background, it can be acknowledged that stress
is universal. However there are remarkable differences in how individuals with different
cultures, personalities and gender are affected by stress and how they tend to cope with it.
Some coping methods require practice and long procedures, whereas others work
instantaneously. The coping methods that have been developed have shown to quite
effective in reducing stress, but however this depends on the type of stressor that is
involved. So the only point where we will be totally stress-free is perhaps when we die,
therefore it is especially important to learn how to cope with stress, since stress is copious
in our modern society.

28
Gross, Richard & McIlveen, Rob. Biopsychology. Page 175
29
Repetti, R.L. & Wood, J. (1997). Journal of Family Psychology. Vol. 11.Pages: 90-108.
30
Repetti, R. L. (1992). Hostility, Coping, and Health. Pages: 151-165
31
As suggested by Wiebe and McCallum (1986)
32
Gross, Richard & McIlveen, Rob. Biopsychology. Page 175

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 Stress and Coping

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