The Role of Stress

Even though Freud demonstrated the role of psychological factors in illness,
the medical field has still focused upon the biological roots of illness and has
still largely rejected or ignored the role of emotions and personality. Nevertheless,
the ascending line of thought can be described as a biopsychosocial
view of illness, which begins with the basic assumption that health and illness
result from an interplay of biological, psychological, and social factors.
This view provides a conceptual framework for incorporating human elements
into the scientific paradigm. A man who suffers a heart attack at age
thirty-five is not conceptualized simply as a person who is experiencing the
effects of cellular damage caused by purely biological processes that are best
treated by surgery or the administration of drugs. The victim, instead, is
viewed as a person who also has engaged in practices that adversely affected
his health. In addition to drugs and surgery, therefore, treatment for this
man might include changing his views on the relative value of work and family
as well as emphasizing the importance of daily exercise and diet. If he
smokes, he will be encouraged to quit smoking. He might receive training in
stress management and relaxation techniques.

Few people today would argue with the proposition that stress is a fact of
life. Most have far more experience with stressors—those events that humans
find stressful—than they would willingly choose for themselves. Stress
is one of the major causes of psychosomatic disorders. Stressors are often assumed
to be external events, probably because stressful external events are
so easily identified and recognized. Many stressors, however, come from
within oneself. For example, an individual alone often sets strict standards
for himself or herself and, in failing to meet those standards, often makes
harsher personal judgments than anyone else would make. Especially since
the late 1970’s and early 1980’s, cognitive psychologists have focused attention
on the internal thinking processes, thoughts, values, beliefs, and expectations
that lead people to put unnecessary pressure on themselves that results
in the subjective sense of stress.

Another contribution made by cognitive psychologists was the realization
that a situation can be a stressor only if the individual interprets it as stressful.
Any event that people perceive as something with which they can cope
will be perceived as less stressful than an event that taxes or exceeds their resources,
regardless of the objective seriousness of the two events. In other
words, it is the cognitive appraisal of the event, coupled with one’s cognitive
appraisal of one’s ability to deal with the event, rather than the objective reality
of the event, that determines the degree to which one subjectively experiences
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