Environment provides man with certain harsh incentives and demands which, as long as their intensity and frequency are within the limits of human tolerance, can stimulate his motivation and enhance his productivity. However, when these environmental demands become excessive or, conversely, when they become scarce, the balance of incentives for creativity will be upset and as a result neither the excess nor the absence of these stimuli will be compatible with and conducive to a healthy adaptation in life.2
Hans Selye holds that although the stress producing factors or stressors are of diverse qualities, they basically elicit the same biological response. He maintains that:
...it is immaterial whether the agent or situation we face is pleasant or unpleasant; all that counts is the intensity of the demand for readjustment or adaptation. The mother who is suddenly told that her only son died in battle suffers a terrible mental shock; if years later it turns out that the news was false and the son unexpectedly walks into her room alive and well, she experiences extreme joy. The specific results of the two events, sorrow and joy, are completely different, in fact, opposite to each other, yet their stressor effect the nonspecific demand to read just herself to an entirely new situation may be the same.3 [emphasis in original]Selye identified two kinds of stress: Eustress and Distress. Eustress is the positive and essentially valuable form of stress that will contribute to the well-being of an organism. When stress becomes unpleasant or harmful, it will result in discomfort and distress.4 Caplan defines stress as a "condition in which there is a marked discrepancy between the demands made on an organism and the organism's capability to respond, The consequences of which will be detrimental to the organismic future in respect to conditions essential to its well-being."5 A person may anticipate such a discrepancy between the demands on him and his ability to respond before the actual transaction takes place. Such dreadful anticipation of a possible failure, however unrealistic it might be, is frequently observed among students
* 'ABDU'L MISSAGH GHADIRIAN, M.D., FRCP(C), is an associate professor of psychiatry at McGill University and an associate psychiatrist at the Royal Victoria Hospital, Montreal. He is also Director of Medical Education at Douglas Hospital Centre in Montreal.
prior to exams and in persons awaiting special task performance.
Although the concept of stress was originally defined in terms of its physiological mechanism, human response to stress or any threat of that nature is complex. In this paper the stress response is discussed primarily in the context of the psychosocial and spiritual reality of human life. Furthermore, the term stress is used to include a broader meaning such as suffering, which is a personal response to painful circumstances and deprivation.
Responses to Stressful Life Events
A person is not only in constant interaction with the world around him, but also in continuous contact with his inner reality. Human responses to life stress of diverse nature can, therefore, be divided into four groups as foIlows: psychological, physiological, social, and spiritual.
1. Psychological Responses
The way that we perceive and react to an event or crisis is largely responsible for the ultimate effect of that event upon us. If we can understand and make sense out of an event and draw some objective conclusion from it which could give meaning to our life, the impact of that event will be less dreadful. Meaninglessness, on the other hand, can be very disturbing. Sometimes religious truth and cultural beliefs give society certain explanations and meaning to life events which otherwise could not readily be achieved by science or reason.
Although intellectual insight alone may not completely eliminate or alleviate the tension generated from a threatening event, it will reduce the anxiety of ignorance. When an awareness is confirmed by spiritual knowledge and spiritual conviction or faith, unfettered by prejudices and superstition, human capacity for tolerance and acceptance of stressful events will expand. Tolerance is a virtue which stems from the spiritual nature or human reality and develops during early education through identification with important exemplars endowed with such a quality in the world. Intellectual knowledge can explain its dynamics but cannot necessarily expand its scope. The psychological responses are coping mechanisms, which, depending on the emotional, physical and genetic predisposition of an individual and the nature and intensity of the threat, can be divided into adaptive and reactive response.
(A) Adaptive Responses
A person facing critical threat, whether of a physical or psychological nature, uses certain emergency measures to protect his well-being and integrity. Some of these measures are based on instincts and neurophysiological reflexes and come into action with such rapidity that the person has no chance to reflect upon their consequences. These are emergency responses which nature devised to protect the species facing unexpected dangers. Reactions such as flight or fight which characterize fear or rage in the face of inevitable threats of life also occur as a result of arousal of emergency defense mechanisms for
As humanity advances towards a balanced material and spiritual civilization, one expects that the violent circumstances which are conducive to physical responses of a primitive nature will also be reduced. Mankind will evolve into a higher plane of maturity and tolerance, and will acquire a greater capacity for love and acceptance than for hate and violence.
In day-to-day life, however, the art of mastering stress and coping with life disturbances remains a challenge for everyone whether child or adult. When faced with a stressful life event, particularly one which will threaten the bond of an intimate relationship, the individual's need for affection and his affiliation with the social support system will increase.6 Similarly, the person's sensitivity to rejection or any threat of that nature will rise. The affected individual, depending on his childhood experiences, education and personal resources, may tend to become more suggestible and show a higher degree of compliance to the demands of others. As a result of these experiences, the individual under stress may move toward a stronger integration and involvement in the life of the family and community. If the community is well integrated and sensitive to his needs for support, it will respond with a greater measure of caring and sharing. The result is the strengthening of the bond of unity within the family or community. However, if the person's hope for a positive response is denied, he may alienate himself from others (see Table I).
Another facet of the adaptive response is the use of defense mechanisms at the time of crisis.7 In an attempt to overcome the pain and anxiety generated by stressful circumstances, the individual, very often unconsciously, may resort to one or more of the following psychological defenses: denial, amnesia or selective attention, withdrawal (e.g., escape), counter behaviour (e.g., aggression, prejudice), rituals, somatic complaints and altered state of consciousness. Depending on the personal and cultural attitudes and values, the choice of these or other defense responses may vary from person to person. Objectivity, problem-solving and decision-making processes are other facets of adaptive measures to be used at the time of crisis. A certain amount of emotional discomfort and anxiety is normally experienced in any response to stressors.
In the event of grief due to a loss, one may pass through some or all of the following phases of mourning experience: shock, denial, despair, recognition, and acceptance. The individual's perception of the reality of death and his belief in life after death can make a difference in the intensity and nature of distressful experiences that he will go through following the loss of a loved one. Moreover, the supportive attitudes of the family, friends and community will undoubtedly accelerate the healing process in a grieved person.
Sociocultural orientation and personal belief and expectations will influence the individual's tolerance and ability to cope with the reality of life crisis. The advance of modern technology has, however, distorted man's perception of pain and suffering. As a result, the individual's expectations for comfort and security have risen in every facet of life. Moreover, scientific achievements may give man a false sense of omnipotence over his environment. Thus, failure in attaining control over life circumstances becomes a new source of stress. In view of the fact that some of the stressful life events manifest themselves in crisis
proportions beyond human control, attempts of individuals with a compulsion to control will place them in a sorry plight. The high incidence of alcoholism, drug abuse, suicide and violence in some societies may, in part, reflect this dilemma.
Coping through control is a learned behaviour, the roots of which can be traced to the family education and societal attitudes and value systems. In authoritarian families, the children will learn how to face or defuse a crisis by means of domination and control over others. When this measure of control fails, considerable tension and anger will prevail.
A sense of urgency with respect to time and competitive striving for achievement constitute some of the striking features of the North American lifestyle. These characteristics are implicated in Type A behaviour patterns. Individuals predisposed to this type of behaviour respond to life stress and its challenges with the following extreme characteristics:8 striving excessively for achievement, leading a competitive lifestyle, being constantly preoccupied with deadlines and time urgency, being hard-working and often successful in profession, showing explosive variations in speech, being hyperalert and impatient in interpersonal relationships and having a tendency towards hostility and aggressive behaviour particularly when the attainment of a goal is not assured.
The incidence of coronary angina is reported to be disproportionately high among this group.9 Contrary to general opinion, this behaviour pattern is not unique to the affluent and successful upper socioeconomic class, but can be observed in a socially deprived population as well. Type B pattern is characterized by a relative absence of Type A behaviour pattern and a greater objectivity and moderation in work habit. Some investigators10 are of the opinion that Type A behaviour is basically a coping style to maintain control over life events and to ward off anxieties generated by stressful incidents. Individuals with Type A behaviour are products of a society in which material success and production are overemphasized as the goal of existence. Hence, progress of this kind arouses considerable awe and admiration and failure to produce becomes unacceptable.11 In such a society even happiness, like a product, is subject to measure and display. If one is not happy, he should pretend to be happy, otherwise he has not succeeded in his life. Consequently life becomes a series of true or feigned acts of production and loses its meaning beyond productivity.
(B) Reactive Responses
Reactive responses are nonadaptive or distressful responses which consist of severe anxiety, fear, grief, despair, rage and depression. To a mild or moderate degree, these feelings may be experienced as part of adaptive responses in coping with stress, but are more likely to be dominant when the stress is extensive (see Table I).
2. Physiological Responses
Physiological responses may appear in two parameters: adaptive neurohormonal changes in response to stress, and maladaptive psychophysiological disorders such as bronchial asthma, peptic ulcer, or
migraine (see Table II). There are now some indications that the brain makes natural anxiety- inducing and anxiety-reducing substances. Medicine has yet to understand how to turn on the release of the natural anxiety-reducing elements in order to avoid the use of chemical agents such as tranquilizers. It is possible that biofeedback and meditation have a role to play in the release of these substances.
One of the natural substances which is believed to reduce pain and anxiety and cause euphoria is endorphin. This is the brain's own opioid product which is released spontaneously or in response to physical and psychological stress and suffering. These research findings, yet to be confirmed, unravel some of the mysteries of natural remedies available in the physiology of the human organism for coping with distressful circumstances. Future scientific discoveries may explain the biological aspects of the blissful tolerance and excitement experienced by martyrs of religion and pioneers of science at the moment of their persecution or death.
3. Social Responses
Social responses may vary on the basis of culture and social values and attitudes. In general, a stressful event will increase an individual's affiliation and integration into his sociocultural system. The stronger the bond of love and unity within the members of a family or community, the greater will be its healing power at the time of crisis. Conversely, isolation from society, for example imprisonment, may render that person more vulnerable to stress. Caplan points out the central importance of guidance and support that a distressed individual receives from those important to him in his coping process.12 When this principle is applied to family life, one can appreciate the salient role of parental communication and guidance in the problem solving effort of their children at the time of crisis.
4. Spiritual Responses
The soul is an active and progressive facet of human reality and thus will not remain unaffected by the consequences of our interaction with the environment. According to 'Abdu'l-Bahá, the soul, like the body, has its own "individuality."13
The spirit is changeless, indestructible. The progress and development of the soul, the joy and sorrow of the soul, are independent of the physical body. If we are caused joy or pain by a friend, if a love prove true or false, it is the soul that is affected. If our dear ones are far from us, it is the soul that grieves, and the grief or trouble of the soul may react on the body.14'Abdu'l-Bahá elaborates on the two sentiments of joy and sorrow which affect everyone. He states that sorrow and grief originate in the material world and will affect the person, while "the spiritual world bestows only the joy If we suffer it is the outcome of material things, and all the trials and troubles come from this world of illusion."15 Under stress of a diverse nature and intensity, one may experience the following spiritual responses:
Some Aspects of Coping with Stress
Certain degrees of stress and strain are essential ingredients of life, and an entirely stress free life does not exist. Moreover, a mild to moderate amount of stress will stimulate human growth and creativity. As pointed out earlier, Hans Selye, the celebrated pioneer in this field considers stress as the spice of life, without which life would be a state of boredom.16
Students of a Canadian community college were asked to participate in a research project aimed at reduction of their stress-related exam anxiety. The volunteer students followed an intensive and systematic relaxation program. At the end of their academic year, they were reported to show a substantial improvement in their exam-related anxiety, but they also showed a drop in their motivation and their academic performance. Coping with stress may begin:
Successful coping with social stress will depend on a number of factors, some of which are:
Society must develop a system of education whereby children will gradually acquire knowledge and skills in facing and responding effectively to stressful life events. For example, children and youth in a family should be allowed, each one in his or her own capacity, to experience and handle some stressful life events under the guidance and support of their parents. This will enable them to acquire coping skills for their future. This is like a psychological immunization process, the
acquisition of which is essential for individual growth and maturity. 'Abdu'l-Bahá, referring to this point in the education of children, advises the parents to bring their children up "to work and strive, and accustom them to hardship."18 Yet the general orientation of today's society is based largely on avoidance of hardship and discomfort at any cost. Consequently, when the children in such a society grow into adulthood, they lack basic experience of facing and coping with hardship and adversities of life. As a result, they are more likely to become vulnerable to these events in the future.
In addition to psychological defense mechanisms which a human being applies at a time of stressful experiences, it should be noted that in the process of adaptation it will eventually be necessary to come to terms with the reality of the stressful events, and their meaning. This is a process of making an internal adjustment to a difficult and often painful reality of eternal nature.
Behavioural scientists expect that when coping responses to stressors fail, psychological defenses may break down with resultant neurosis, psychosis or severe psychophysiological disorder. Yet, history shows that human tolerance for suffering during a life crisis may go far beyond the psychological formulation of defenses and adaptation and in some instances surpass the usual limits of physical pain and suffering. Suffering in some circumstances is not perceived as pain or even a grievous blow to human defenses, but is welcomed with positive emotions such as joy and gratitude without psychotic or psychosomatic disturbances. In this case, the principle of pleasure and pain, which is based on the organism's attraction toward pleasure and avoidance of pain, is overruled by the principle of love and spiritual attraction, which leads the individual to accept pain, not for masochistic satisfaction, but for spiritual fulfillment.
The spiritual nature of human reality and its potent influence on behaviour is not treated in current psychological textbooks as it is not considered "scientific." If the objective of science is discovering truth and its qualities, then I feel that contemporary psychology, as a field of science, has ignored a fundamental truth. Faith and belief in a spiritual truth, whether it is affected by superstition or maintains its purity, comprises an integral part of human personality. When such an integral part is threatened, the result may not always follow the conventional pattern of stress-response paradigm as outlined above. The response may surprisingly be the opposite.
An example very close to our time is the persecution and martyrdom of Bahá'ís in Iran. In the life of these martyrs, one can recognize an extraordinary sense of acceptance and blissfulness at the hour of suffering and death. This observation raises some questions concerning the validity of stress response theory in the face of crisis. The explanation could be that when the life threat, whether psychological or physical, can be explained and accepted in the light of a belief and conviction of scientific or spiritual nature, that enlightenment will arouse courage which, in turn, abates fear and anxiety for whatever the consequences may be. With true, unprejudiced spiritual affiliation and faith, one sees in death a fulfillment and a birth into a new spiritual
reality long awaited. Thus, faith gives a new meaning to suffering, transforming fear into joy, a process in which love is an important ingredient.
The reactions of some of these Bahá'í martyrs can best be understood in terms of a social stressor we have not yet discussed: persecution. The aims of persecution are 1) to invalidate or undermine the basic beliefs and precepts of the victim; 2) to violate the right and dignity of the subject by means of physical attack, imprisonment, starvation and death or psychological abuse such as false accusation, humiliation and deprivation of personal and social rights and privileges. Distortion of truth and manipulation of the public conscience as a means of discrediting the subject and justifying the hatred toward him is quite common. In such a society, public ignorance and lack of search after truth becomes an ideal vehicle for accomplishing any prejudicial objectives.
In the religious persecution in Iran, the equality of male and female rights in the Bahá'í community is misinterpreted and attacked by the clergy as immoral deviation in a society where male domination has ruled for centuries. Yet the Bahá'ís did not follow the common path of response, which is violence and hatred. Instead they found, in the fire of ordeal and hatred, an opportunity to proclaim the truth of their belief and their love for mankind at a time when, by the appearance of their Prophet, a new civilization is being born and the old world order is bound to be rolled up as happened in past religious dispensations. Thus, pain and suffering for them became acceptable means in fulfilling a noble purpose.
Table III shows a comparison of stress responses influenced by spiritual enlightenment as compared to responses due to psychological defenses. The strength of spiritual responses will largely depend on the individual concerned and his reliance on his faith and his capacity to reflect this reliance in deeds when his will is challenged. Therefore, as individuals differ, the strength of their spiritual response may not be the same. Indeed, many may fail or falter at the time when they are subjected to atrocities and are unable to respond with spiritual strength.
According to the Bahá'í teachings, the creative words of a divine revelation can transform the heart and the soul of individuals as a result of receiving a new vision of life and its purpose in this universe. This new meaning and purpose will dissipate their fears and anxiety and replace them with tolerance and tranquillity. When this vision is blurred with doubts or superstition, these individuals will no longer be able to maintain that sense of tolerance and blissfulness at the time of trials and tribulations.
Bahá'u'lláh reveals that the sufferings his followers experience are preordained in order to proclaim the Cause of God in this new dispensation. He, therefore, empathizes with them in their suffering in these emphatic words in his prayer:
Help them through Thy strengthening grace, I beseech Thee, O my God, to suffer patiently in their love for Thee, and unveil to their eyes what Thou hath decreed for them behind the Tabernacle of Thine unfailing protection, so that they may rush forward to meet what is preordained for them in Thy path, and may vie in hastening after tribulation in their
love towards Thee.19
Moreover, he elucidates that one's love of God will enable one to resist the powers arising against one and to overcome any fear.20
In today's world, love is commercialized and pain has lost its meaning. In the Bahá'í writings there is a significant association between true love and pain as is reflected in these words from The Seven Valleys by Bahá'u'lláh:
The steed of this Valley [Love] is pain; and if there be no pain this journey will never end. In this station the lover hath no thought save the Beloved, and seeketh no refuge save the Friend. At every moment he offereth a hundred lives in the path of the Loved one, at every step he throweth a thousand heads at the feet of the Beloved.21Conclusion
In conclusion, the following words of Viktor Frankl are most befitting: "Suffering ceases to be suffering in some way at the moment it finds a meaning, such as the meaning of a sacrifice."22 Science has yet to learn how true spiritual enlightenment can transform sorrow into joy.
/----- Reality oriented problem- / solving measures / / //- Emotional discomfort approp- / // riate to stress Adaptive_/_// Responses\ \\ / \ \\ Increased suggestibility and / \ \\- compliance / \ / \ Mechanisms of defense and / \----- self-preservation / / / Psychological Response \ \ \ \ /----- Anxiety, fear \ / \ / \ / //- Grief, despair \ / // Maladaptive/_// Responses \ \\ \ \\ \ \\- Rage, aggression \ \ \----- Guilt, depression
Release of hormones: ------ ACTH, Endorphins, / Norepinephrine... / / / Cardiovascular: Changes Adaptive---------- in pulse, respiration, / \ blood pressure... / \ / \ / \ / ------ Central nervous system / and other systemic changes / / Physiological Response \ \ \ ------ Bronchial asthma \ / \ / \ / //- Hypertension \ / // \ /_// Maladaptive---------- Peptic ulcer \-\\ \ \\ Angina, other coronary \ \\- heart diseases \ \ ------ Migraine
SOME RESPONSES TO SEVERE SOCIAL STRESSORS
Denial or perplexity
Amnesia or selective
Avoidance and withdrawal
fight or flight
Dependence solely on
Coping through reason
Perceptively and full
Affiliation and acceptance
Expression of love and
Certitude and contentment
Submission to Will of God
Reaching beyond reason: faith
2. Joseph E. McGrath, ed. "A Conceptual Formulation for Research on Stress," Social and Psychological Factors in Stress (New York: Holt, Rinehart and Winston, 1970), p. 18.
3. Hans Selye, Stress Without Distress (Scarborough: New American Library of Canada, 1974), pp. 15-16.
4. Laurence Cherry, "On the Real Benefits of Eustress," Psychology Today, vol. 12, March, 1978, pp. 60-70.
5. Gerald Caplan, Mastery of Stress: Psychosocial Aspects," American Journal of Psychiatry, vol. 138, No. 4, April, 1981, p. 414.
6. Ibid., pp. 415-16.
8. C.D. Jenkins, S.J. Zyzanski and R.H. Roseman, "Progress Toward Validation of a Computer- Scored Test for the Type A Coronary Prone Behavior Pattern." Psychosomatic Medicine Journal, vol. 33, No. 3, May June 1971, p. 194.
9. L.D. Young, and J.J. Barboriak, "The Relationship of Coronary Prone Behavior and Neuroticism to Coronary Occlusion." Abstracts, The 6th World Congress of the International College of Psychosomatic Medicine, September 13-18, 1981, Montreal, p. 149.
10. David C. Glass, Melvin L. Snyder and Jack F. Hollis, "Time Urgency and the Type A Coronary-Prone Behavior Pattern," Journal of Applied Social Psychology, vol. 4, No. 2, 1974, pp. 137-38.
11. Meyer Friedman and Ray H. Rosennan, "The Key Cause--Type A Behaviour Pattern," Stress and Coping: An Anthology, Alan Monat and Richard S. Lazarus, eds., ( New York: Columbia University Press, 1977), pp. 203-8.
12. Caplan, pp. 415-16.
13. 'Abdu'l-Bahá, The Reality of Man (Wilmette: Bahá'í Publishing Trust, 1966), p. 26.
16. Selye, pp. 11-21.
17. Joseph E. McGrath, ed. "Major Substantive Issues: Time, Setting and the Coping Process," Social and Psychological Factors in Stress (New York: Holt, Rinehart and Winston, 1970), pp. 33-35.
18. 'Abdu'l-Bahá quoted in Bahá'í Education: A Compilation (Thornhill, Ontario, 1977), p. 30.
19. 'Abdu'l-Bahá, The Bahá'í Revelation: A Selection from the Bahá'í Holy Writings (London: Bahá'í Publishing Trust, 1955), p. 171.
20. Ibid., p. 175.
21. Bahá'u'lláh, The Seven Valley and the Four Valleys (Wilmette: Bahá'í Publishing Trust, 1952), pp. 8-9.
22. Viktor Frankl, Man's Search for Meaning: An Introduction to Logotherapy (New York: Simon and Schuster, 1963), p. 179.