altThe Upside of Stress:  Why Stress Is Good for You, and How to Get Good at It  by Kelly McGonigal (Avery, 2015)

For a book that has such an important message, and which my read-through has left bristling with sticky notes, this was surprisingly hard to finish.  It's equally hard to summarize for this review.  I'd hoped that McGonigal's TED talk would be an inspiring summary, so I wouldn't have to say, "read the book."  But the talk lacks the details and documentation of the book, and, since it came before the book, lacks several key elements.  So I'll say it:  "Read the book."

Now, I know that most of you won't, so here's a taste.

Despite everything you've heard, it's not stress that's killing you.  What's killing you is believing that stress is killing you.  If you see stress as a positive force, it does you no harm.  Like grasping the nettle.

Oh, great.  So not only is stress killing me, but it's all my fault because I can't make myself pretend it isn't killing me....

Relax.  It's not that bad.  Really.

As a health psychologist, Kelly McGonigal had made a career out of telling people how bad stress is for their health, and teaching them techniques to help reduce it.  But then she came across a study that indicated that by encouraging people to fear and avoid stress, wasn't helping them, but making their lives worse.  She might have ignored, or discredited the research, but instead threw herself into investigating this crazy idea, and came away convinced.

In 1998, thirty thousand adults in the United States were asked how much stress they had experienced in the past year.  They were also asked, Do you believe stress is harmful to your health?

Eight years later, the researchers scoured public records to find out who among the thirty thousand participants had died.  Let me deliver the bad news first.  High levels of stress increased the risk of dying by 43 percent.  But—and this is what got my attention—that increased risk applied only to people who also believed that stress was harming their health.  People who reported high levels of stress but who did not view their stress as harmful were not more likely to die.  In fact, they had the lowest risk of death of anyone in the study, even lower than those who reported experiencing very little stress.

The researchers concluded that it wasn't stress alone that was killing people.  It was the combination of stress and the belief that stress is harmful.  The researchers estimated that over the eight years they conducted their study, 182,000 Americans may have died prematurely because they believed that stress was harming their health.

... According to statistics from the Centers for Disease Control and Prevention, that would make "believing stress is bad for you" the fifteenth-leading cause of death in the United States, killing more people than skin cancer, HIV/AIDS, and homicide.

But there's good news:  very small changes can have a great effect on how we look at stress.  A brief lecture on the benefits of stress, ten minutes spent writing about what values we find important; such brief interventions have been shown again and again to have long-lasting effects.  This isn't a think-and-get-rich plan, nor a placebo effect, but more of a butterfly effect.

[T]o many, these results sound more like science fiction than science.  But mindset interventions are not miracles or magic.  They are best thought of as catalysts.  Changing your mindset puts into motion processes that perpetuate positive change over time.

A belief with this kind of power goes beyond a placebo effect.  This is a mindset effect.  Unlike a placebo, which tends to have a short-lived impact on a highly specific outcome, the consequences of a mindset snowball over time, increasing in influence and long-term impact.

I'm very bad at doing the "exercises at the end of the chapter" in any book, but even so, simply reading through this one has already made a difference in my life.  How much remains to be seen, but the butterfly has flapped its wings, and I'm looking forward to seeing what happens.

And now for the quotes.  Extensive, yes, but I'm still leaving too much out.  If you can get the book from a library, as I did, it will be well worth your while; it's repetitive enough that you can skim and get the major points.  Is it worth $13 for the Kindle version?  I don't know; maybe it depends on how stressed you are....

Fear, stigma, self-criticism, shame—all of these are believed, by many health professionals, to be powerfully motivating messages that help people improve their well-being.  And yet, when put to the scientific test, these messages push people toward the very behaviors the health professionals hope to change.

The new science also shows that changing your mind about stress can make you healthier and happier.  How you think about stress affects everything from your cardiovascular health to your ability to find meaning in life.  The best way to manage stress isn’t to reduce or avoid it, but rather to rethink and even embrace it.

[H]ow you think about aging affects health and longevity not through some mystical power of positive thinking but by influencing your goals and choices.

[P]eople who endorse a stress-is-harmful mindset are more likely to say that they cope with stress by trying to avoid it.  For example, they are more likely to:

  • Try to distract themselves from the cause of the stress instead of dealing with it.
  • Focus on getting rid of their feelings of stress instead of taking steps to address its source.
  • Turn to alcohol or other substances or addictions to escape the stress.
  • Withdraw their energy and attention from whatever relationship, role, or goal is causing the stress.

In contrast, people who believe that stress can be helpful are more likely to say that they cope with stress proactively.  For example, they are more likely to:

  • Accept the fact that the stressful event has occurred and is real.
  • Plan a strategy for dealing with the source of stress.
  • Seek information, help, or advice.
  • Take steps to overcome, remove, or change the source of stress.
  • Try to make the best of the situation by viewing it in a more positive way or by using it as an opportunity to grow.

I call this the stress paradox.  High levels of stress are associated with both distress and well-being.  Importantly, happy lives are not stress-free, nor does a stress-free life guarantee happiness.  Even though most people view stress as harmful, higher levels of stress seem to go along with things we want:  love, health, and satisfaction with our lives. … The best way to understand the stress paradox is to look at the relationship between stress and meaning.  It turns out that a meaningful life is also a stressful life.

[R]aising a child under eighteen significantly increases the chance that you will experience a great deal of stress every day—and that you will smile and laugh a lot each day.  Entrepreneurs who say that they experienced a great deal of stress yesterday are also more likely to say that they learned something interesting that day.  Rather than being a sign that something is wrong with your life, feeling stressed can be a barometer for how engaged you are in activities and relationships that are personally meaningful.

When you believe that stress is harmful, anything that feels a bit stressful can start to feel like an intrusion in your life.  Whether it’s waiting in line at the grocery store, rushing to meet a deadline at work, or planning a holiday dinner for your family, everyday experiences can start to seem like a threat to your health and happiness.  You may find yourself complaining about these experiences, as if your life has gone off course and there is some stress-free version of it out there waiting for you. Consider that in a 2014 survey by the Harvard School of Public Health, the most commonly named sources of everyday stress included juggling schedules, running errands, commuting, social media, and household tasks such as cooking, cleaning, and repairs.  These are normal and expected parts of life, but we treat them as if they are unreasonable impositions, keeping our lives from how they should really be.

It was this mindset—not some objective measure of stressful events—that best predicted the risk of death among the mean in the Normative Aging Study over five decades.  Summing up the study as “stress kills” (which plenty of media reports did) doesn’t make sense. … The same experiences that give rise to daily stress can also be sources of uplift or meaning—but we must choose to view them that way.

A bunch of Stanford students agreed to keep journals over winter break. Some were asked to write about their most important values, and how the day’s activities related to those values.  Others were asked to write about the good things that happened to them. … [After the break,] the students who had written about their values were in better health and better spirits. Over break, they had experienced fewer illnesses and health problems.  Heading back to school, they were more confident about their abilities to handle stress. … Writing about values helped the students see the meaning in their lives.  Stressful experiences were no longer simply hassles to endure; they became an expression of the students’ values. … [S]mall things that might otherwise have seemed irritating became moments of meaning.

It turns out that writing about your values is one of the most effective psychological interventions ever studied.  In the short term, [it] makes people feel more powerful, in control, proud, and strong.  It also makes them feel more loving, connected, and empathetic toward others.  It increases pain tolerance, enhances self-control, and reduces unhelpful rumination after a stressful experience.

In the long term, writing about values has been shown to boost GPAs, reduce doctor visits, improve mental health, and help with everything from weight loss to quitting smoking and reducing problem drinking.  It helps people persevere in the face of discrimination and reduces self-handicapping.  In many cases, these benefits are a result of a onetime mindset intervention.  People who write about their values once, for ten minutes, show benefits months or even years later.

When you can’t control or get rid of stress, you can still choose how you respond [to] it.  Remembering your values can help transform stress from something that is happening against your will and outside your control to something that invites you to honor and deepen your priorities.

When stress is part of what makes something meaningful, shutting it out doesn’t get rid of the stress.  Instead, taking the time to fully process and make meaning from what is stressful can transform it from something that drains you into something that sustains you.

A few things stood out about people who thrived under stress.  First, they thought about stress differently.  They saw it as a normal aspect of life, and they didn’t believe that it was possible or even desirable to have an entirely comfortable, safe life.  Instead, they viewed stress as an opportunity to grow.  They were more likely to acknowledge their stress and less likely to view every struggle as a catastrophe headed toward a worst-case scenario.  They believed that difficult times require staying engaged with life rather than giving up or isolating oneself.  Finally, they also believed that no matter what the circumstances, they must continue making choices—ones that could change the situation or, if that wasn’t possible, that could change how the situation affected them.  People who held these attitudes were more likely to take action and to connect with others during stress.  They were less likely to turn hostile or self-defensive.  They were also more apt to take care of themselves, physically, emotionally, and spiritually.  They built a reserve of strength that supported them in facing the challenges in their lives.

This is what it means to be good at stress. It’s not about being untouched by adversity or unruffled by difficulties.  It’s about allowing stress to awaken in you these core human strengths of courage, connection, and growth.  Whether you are looking at resilience in over-worked executives or war-torn communities, the same themes emerge.  People who are good at stress allow themselves to be changed by the experience of stress.  They maintain a basic sense of trust in themselves and a connection to something bigger than themselves.  They also find ways to make meaning out of suffering.  To be good at stress is not to avoid stress, but to play an active role in how stress transforms you.

Although most people believe that the best strategy under pressure is to relax … [often]  the opposite is true.  [W]elcoming stress can boost confidence and improve performance. ...

[The football team] described their pre-game stress as being “amped up” and “excited.” They even tried to increase their adrenaline, knowing it would help them perform.  But when [they] talked about the same adrenaline rush before exams, they used completely different language.  Then it was “nerves,” “anxiety,” and “choking under pressure.” ...

Even in situations where it seems obvious that calming down would help, being amped up can improve performance under pressure.  For example, middle school, high school, and college students who have greater increases in adrenaline during exams outperform their more chilled-out peers.  Green Berets, Rangers, and Marines who have the highest increases in the stress hormone cortisol while undergoing hostile interrogation are less likely to provide the enemy with useful information  And in a training exercise, federal law enforcement officers who showed the greatest increases in heart rate during a hostage negotiation were the least likely to accidentally shoot the hostage.

[A] tend-and-befriend response makes helping others a surprisingly effective way to transform stress.  For example, researchers at the Wharton School of the University of Pennsylvania were interested in finding a way to relieve time pressure at work.  you know the feeling:  There’s too much to do and not enough time to do it.  Time scarcity is not just a stressful feeling; it’s a state of mind that has been shown to lead to poor decisions and unhealthy choices.  In this study, the Wharton researchers tried out two different ways to relieve the feeling of not having enough time.  They gave some people an unexpected windfall of free time and asked them to spend it however they wished.  Others were asked to spend that time helping someone else.  Afterward, the researchers asked participants to rate both how much free time they had available right now and how scarce a resource time was for them in general.

Surprisingly, helping someone else decreased people’s feeling of time scarcity more than actually giving them extra time did. Those who had helped someone else reported afterward that they felt more capable, competent, and useful than people who had spent the time on themselves.  This, in turn, changed how they felt about what they had to accomplish and their ability to handle the pressure. …  Their newfound confidence also changed how they perceived something as objective as time; after helping someone else, time, as a resource, expanded. ... The Wharton researchers summarized their findings whith this advice:  “When individuals feel time constrained, they should become more generous with their time—despite their inclination to be less so.”

[P]eople who can find a benefit in their struggles show a healthier physical response to stress and a faster recovery. … [T]his research doesn’t suggest that the most helpful mindset is a Pollyannish [sic] insistence on turning everything bad into something good.  Rather, it’s the ability to notice the good as you cope with things that are difficult.  In fact, being able to see both the good and the bad is associated with better long-term outcomes than focusing purely on the upside.

Stress caused by the news, as opposed to stress caused by your life, is unique in its ability to trigger a sense of hopelessness.  Watching TV news after a natural disaster or terrorist attach has consistently been shown to increase the risk of developing depression or post-traumatic stress disorder.  One shocking study found that people who watched six or more hours of news about the 2013 Boston Marathon bombing were more likely to develop post-traumatic stress symptoms than people who were actually at the bombing and personally affected by it.  It’s not just traditional news programs that instill fear and hopelessness; stories of tragedy, trauma, and threats dominate many forms of media.  In fact, a 2014 study of U.S. adults found that the single best predictor of people’s fear and anxiety was how much time they spent watching TV talk shows.

We all tell stories, and the stories we choose to tell can create a culture of resilience.  How do you tell the stories of your family?  Your community?  Your company?  Your own life?  Consider how you might make room for stories that reflect the strength, courage, compassion, and resilience in yourself and in your community.

Posted by sursumcorda on Thursday, September 10, 2015 at 8:30 am | Edit
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Very interesting.

What does it mean to "write about your values"?

Posted by joyful on Friday, September 11, 2015 at 8:10 am

I'm relying on memory here, but as I recall the participants were asked to write about what they valued in life, things like family, honesty, courage, generosity, etc. I get the impression the particular values didn't matter as much as awareness of them, and connecting them to events in everyday life. The book doesn't mention what happens if your values happen to be selfish pleasure, greed, and stomping other people's faces.

Posted by SursumCorda on Friday, September 11, 2015 at 5:34 pm

Does the advice to give more of your time apply to mothers who already give all their time to their family? Something to ponder for sure.

A few places recommended writing a family mission statement, and even though Stephan was sceptical, we all enjoyed the exercise, though we rarely quote what we came up with. Somehow thinking about the big picture gave the mundane more eternal weight.

Posted by Janet on Saturday, September 12, 2015 at 11:46 am

The book doesn't specifically address parenthood, but I could see the applications all over, particularly in the areas of working for larger, enduring goals outside oneself, giving to others, and focusing on growth opportunities.

Posted by SursumCorda on Saturday, September 12, 2015 at 11:57 am

I still don't fully understand her definition of stress. It seems that stress isn't bad for you, but things that cause stress are, if you're stressed about them, that is. Somehow stress is okay in that it drives us to seek a solution to a problem but if we avoid the problem the stress it causes is harmful. It seems like we need more terms to clarify stress, stress-makers, and the feeling of stress. It's certainly thought-provoking in any case..

Posted by Janet on Saturday, September 12, 2015 at 12:00 pm

There's no doubt that the book is less than clear in many areas, even a bit contradictory, and of course I've not really done it justice here. But even without the book I'm pretty sure I remember the gist of her working definition of stress: When something you care about is at stake.

My greatest take-away from the book is that you can tip stress toward the positive, rather than the negative, by viewing it as a growth opportunity, a chance to make an important contribution, and/or a reminder that you have valuable people and work in your life. Even saying, "this is an opportunity" rather than "I'm so stressed" supposedly helps.

Posted by SursumCorda on Saturday, September 12, 2015 at 12:36 pm
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