10 Stress

What is stress?

Stress is not a disease: it cannot be caught. The word ‘stress’ is taken from a Middle English word stresse, which is short for distress.

Stress is a physical, chemical or psychological factor, or a combination of factors, that may arise and pose a threat to the overall homeostasis of the internal environment of the body. Such factors could include worry, injury, infection or disease, which will then act on the body which produces a defensive response. In fact it is anything that is a threat to our mental or physical well-being.

Stress is a part of everyday living and no two people respond to stress in the same way. Virtually everyone has to cope with stress at one time or another; how we respond is the key question. The body adjusts to normal homeostatic changes during stress. It is only in the case of extreme stress there may be a problem. Being over competitive at work or in everyday situations, at home or in our leisure pursuits, may make you more at risk of becoming stressed and then developing a related disorder. We cannot cure stress, get rid of stress or even alleviate stress but what we can do is to manage it correctly; this helps us to cope with the pressures that life puts upon all of us, so that our health and general performance are less affected.

Stress is increasingly common and people vary in the amount of stress they can tolerate. ‘Stress disorder’ is now a common diagnosis in the medical profession. There are many ‘stress-related’ symptoms such as high blood pressure, increased heart rate and poor digestion, which can be caused by long arduous working hours and continually driving on the body. This stimulates the action of the adrenal glands. Disease, worry and emotional stress can lead to many so-called psychosomatic disorders, which can cause physical symptoms. Extreme stress, for example wounds from accidents and operations, can cause great changes in the body, even circulatory collapse. This is where Western medicine can be so beneficial. However, stress can also be a prime factor in causing many other physical diseases such as stomach ulcers, duodenal ulcers, migraines, eczema, heart attacks and even cancer; the list is long. The medical profession often treat parts of the body. We as holistic healers know that the parts get better if the whole is well. So one can see the need to tackle and identify a stress-related disorder holistically. One only has to read the many case histories in this manual to see that stress is a common cause of many problems.

Physiology of stress

There are two ways that the body may respond to stress: fight or flight. A stressful situation causes sympathetic nervous impulses to flood the hypothalamus; these nervous impulses then travel to the adrenal glands via the sympathetic nerves. The adrenal medulla is the only endocrine gland to have a rich nerve supply. Nervous stimulation of this causes the release of adrenaline and noradrenaline; these prepare the body for immediate action. While this is very helpful in emergency situations, too much of this stimulation may result in anxieties developing. Clinically, this is how anxiety, nervousness and tension are caused as the balance between certain chemicals in the brain and body is disrupted.

Adrenaline and noradrenaline are released in response to any short burst of activity or stress; the body is then prepared for fight or flight. This alarm reaction can often get us out of a dangerous situation, as the immediate response is mobilization and some physical activity. Adrenaline and noradrenaline act on all the tissues throughout the body. This effect of nervous stimulation is helpful in an emergency, since it helps to divert blood to areas where it is needed most. There is an increased breakdown of glycogen in the liver, increasing cardiac output, dilatation takes place in the bronchioles, blood pressure increases, as tone is raised in the walls of all larger blood vessels. The pupils dilate, increasing alertness. Activity is increased in the sweat glands in anticipation of production of more heat from the boost in physical activity. There is a decrease in the peristaltic action within the alimentary canal; digestion is slow when the body is very active.

If there is such a shock to the nervous system and no activity takes place, then the blood pressure may fall rapidly and the person is liable to faint. Increased activity of the fight or flight system over a period of time (e.g. the workaholic or someone constantly verbally berating you so that you are angry and tense) without any physical activity can lead to the many harmful stress-related disorders developing. Adrenal stimulation over a long period will deplete the body’s systems, so the organs do not function as efficiently as they should. These stresses are first felt in the heart and blood vessels; hence elevated blood pressure is a response to stress. Frequently also the adrenaline produced in response to this stress is not dissipated properly owing to insufficient physical activity. Exercise helps excess adrenaline to be burnt off. Constant stress can even change the balance of hormones in the body. Medication can help the problem of stress but it will not cure it until you remove the stress factor.

Stress as a cause of illness

The pace and pressures of modern-day living are tremendous. Stressful lifestyle is quite common. If there is a continual force on the body’s internal mechanisms, many other physical conditions and disorders may arise such as pain in the neck and in the lower back, cystitis, dermatitis, diarrhoea, eczema, urticaria, ulcers, heartburn, indigestion, irritable bowel syndrome, migraine, repeated sore throats, stomach and duodenal ulcers, sleep disorders and palpitations, to name but a few. Healing cannot take place, regardless of what medication is given, unless the offending problem is addressed. Many people realize that tranquillizers are only a crutch and these can cause many other serious problems, as there are often unwanted drug-induced effects. Most people now realize that relaxation is a must and should be part of their everyday lives.

Stress in women can completely upset their hormonal cycle; the right balance between oestrogen and progesterone is essential. Imbalance of hormones is thought to create premenstrual syndrome (PMS) including symptoms of water retention, anger, depression, fatigue, irritability and tension, tender and enlarged breasts, and headaches. If the correct balance of these hormones is maintained there is a comparatively trouble-free cycle.

Persistent anxiety is harmful to the physical body. Reflexology can help people to relax, thereby balancing the whole biological system on which health depends.

Stress shows the way our physical and mental system respond; our emotions and temperament often change under stress. Many situations such as shock, fear, loneliness, even surprise, can cause the heart rate to speed up, while blood pressure may rise, and we perspire more. Most stress produces a defensive response; this can be physical and emotional trauma or ill-health or disease, which is taken from an old French word ‘disease’, ‘des’ like ‘dis’ being a prefix that forms the opposite of the word, and ‘aise’ meaning comfort, hence disease – we are not comfortable with something. Being at ease is a state of being relaxed without worry or anxiety.

Stress can lead to disease or distress quite quickly if we do not recognize its onset or we are unaware of its causes. Road rage is a phenomenon that has reared its ugly head; it is due to stress, irrational anger and increased irritability over traffic problems and delays. The person loses all common sense, and there is immediate wild uncontrollable anger that may last only a few moments, but in that time something dreadful may happen, like a physical attack on the person whom they felt had caused the problem. The deep breathing exercises below will always help in any emergency, when anger may overcome reason. Relaxation techniques should be practised whenever possible. Tolerance is also a keyword, and making sure that sufficient time is left so that you can get from A to B.

Chronic stress can also be caused by long-term emotional problems. These may be due to pressure or difficulties in everyday life, such as working with a manager who harasses or does not support the person. This can cause biochemical changes in the body, which may play a part in many occurrences of frequent headaches or neck pain or lower back problems. The old adage ‘You are a pain in the neck’ or ‘You are a pain in the backside’ has a lot of truth in it. Indirectly this may contribute to high blood pressure, digestive disorders, anxiety and depression.

Depression is often a term used to cover a range of emotional states. It can be a passing phase, or it can become a burden and life can become a problem. There is often a feeling of inner emptiness and despair. This state is often caused by bereavement or break-up of a relationship, and the person feels unable to move on. (See case history under Depression in chapter 8.) Everyone feels sad at some time or another, and even the most successful people may harbour fears or doubts and suffer anxiety at times. (See plate 13 of a person suffering from anxiety.) However, understanding our psychological distresses is part of the healing process. For relaxation or relief of stress, many of us reach for another alcoholic drink or smoke too many cigarettes, or drink too much coffee. All of these are stimulants and bring about only artificial relief. If depressed we may require antidepressants or tranquillizers. The widespread use of these drugs is questionable. It is much better to try an alternative way to cope.

Physical and mental indicators of stress

The different physical manifestations that may arise from stress include the following:

       •  You are hot and sweaty in your body.

       •  You are aware of your heart beating and palpitations, and you get butterflies in your stomach.

       •  You feel breathless, with a lump in the throat, and have rapid, shallow breathing.

       •  Your mouth feels dry.

       •  Diarrhoea, constipation, flatulence are just part of your everyday life and you suffer from indigestion or nausea.

       •  You suffer general muscle tenseness, particularly of the jaws, and you grind your teeth.

       •  Often you find you have your fists clenched, you hunch your shoulders and suffer general aches and pains in your muscles. You may also suffer night cramps.

       •  You are very restless, you are hyperactive and cannot sit still; you bite your nails and you find yourself finger drumming, or foot tapping, and your hands shake.

       •  You often feel tired, fatigued, lethargic, totally exhausted.

       •  You may have sleeping difficulties.

       •  You may feel faint and suffer frequent headaches, or frequent illnesses such as colds and upset stomach.

       •  You may be sweaty, especially on the palms and upper lip, with a hot flushed feeling all over.

       •  You have cold hands and feet.

       •  There may be a frequent desire to urinate.

       •  It is quite possible that you overeat, or suffer loss of appetite.

       •  There is an increase in your cigarette smoking, or in your alcohol consumption.

       •  There is a loss of interest in sex.

       •  There is an urgency in everything you do.

The different mental manifestations include the following:

       •  You feel distressed and often worried and upset; you may be tearful, often deflated, with a feeling of helplessness and hopelessness, or hysterical.

       •  You may be withdrawn, feeling unable to cope, anxious, depressed.

       •  You feel very impatient and you are easily irritated and aggravated. You are often angry, hostile and aggressive.

       •  You feel frustrated, bored, inadequate, guilty, rejected, neglected, insecure and very, very vulnerable.

       •  There is a loss of interest in self-appearance, in your own health, in the right diet; you have low self-esteem and no interest in other people.

       •  You feel you are doing too many things at once. You are rushed and you jump from one task to another, often failing to finish any task before moving on to the next. Because you feel you have so much to do you end up not knowing where to start, so you do nothing.

       •  You have difficulty in thinking clearly or concentrating and making decisions.

       •  You are often forgetful. There is a lack of creativity and you feel irrational. In general you feel you are non-productive and inefficient.

       •  You are prone to making silly mistakes and having accidents; you spill or drop things.

       •  You are hypercritical, often inflexible and unreasonable; you overreact to most situations.

The role of reflexology in stress

Reflexology is the most wonderful stress buster. By definition it is a science based upon the principle that there are reflex areas in the hands, feet and ears that correspond to all the internal organs of the body. Reflexology deals with internal energies if these become blocked because of stress factors such as death of a loved one, marital breakdown, losing your job, moving home, monetary problems, pressures at home or at work, all of which may create a block in the energy flow.

Reflexology may not be the first remedy a person thinks of, but it is the most natural non-invasive holistic therapy, and is a means of relieving many of the stress-related symptoms and balancing the internal energies. With reflexology a person is more able to cope. There is a general change in temperament, and the person has much more interest in all situations at home and work or in recreational pursuits. Energy levels improve. All the senses are more relaxed and there is less feeling of nervousness or panic. A more positive attitude follows, with less negative imagination and emotional sensitivity such as tearfulness. The hormones become balanced and the metabolic rate is stabilized as the thyroid function is facilitated. Even though this gland has its own internal control system, the hormones produced must be kept within narrow limits as the slightest disorder can easily upset their function.

Relaxation is the key to good health. A good well-balanced diet should also be maintained, with less of the addictive stimulants, like caffeine, or nicotine from smoking, and comfort foods containing sugar, like chocolate, cakes and fizzy drinks. A gentle regular exercise programme should be upheld. Together these factors will combat stress. Relaxation can be anything that will release built-up tension and anxiety, from sport to whole-body relaxation like reflexology, which not only helps balance the mind and body but can generate energy as well.

Reflexologists will use their skills in assessing what a patient needs. As the treatment commences, and the patient begins to relax and totally unwind, a unique experience evolves. Tranquillity and relaxation, together with the reflexology and soothing music, create a powerful ambience to calm the inner emotions, and help to refresh the mind. The head relaxes, the eyes close, and the shoulders release their tension so the neck and head start the relaxation process. During a treatment many relaxation techniques are used. There is a focus on breathing allowing the patient’s body to feel it is sinking into the treatment couch. These techniques help release muscular tension to bring about a state of complete calmness. Stimulation to the brain reflexes helps to release serotonin, which is a natural tranquillizer and mood enhancer. This substance is present in many tissues of the body and in the hypothalamus and basal ganglia of the brain, and is believed to affect behaviour; it also plays a part in the biochemical mechanism of sleep, thus helping sleep patterns. It acts as a neurotransmitter (see chapter 2).

I often feel that reflexology should be referred to as nature’s tranquillizer as it helps to alleviate many stress-related disorders such as anger, anxiety, depression, hypertension, insomnia and irritability. Overall harmony and well-being are achieved and stress responses are more under control. People sleep naturally and more soundly, and wake up fresh and relaxed and full of energy without the use of any other aids. It is a very effective method of reducing and helping in the prevention of disorders developing. It is also remarkably effective in alleviating many problems that people would normally go to their GP for. Patients should, however, realize that it usually takes a series of treatment sessions to bring about total relief. People who have reflexology develop an holistic approach because they become aware of the factors that cause the stress responses. This gives a much broader perspective to plan for any future stressful occasions that may arise.

Encourage all patients to pause and ask themselves how often they relax. Often their only relaxation is sitting in front of the television after work and this is insufficient. They should be encouraged to look around; there are enough yoga relaxation classes, sports halls, dance classes, books and tapes on relaxation. It takes practice to become a cool, calm and collected person, but relaxation is a prerequisite to good health. Remember that 80 per cent of the ailments common to most of us are caused by tension or stress.

Simple stress management techniques

1 Mental relaxation

The aim of this is to produce a relaxed state of mind. Ideally the person needs privacy and quiet surroundings, but with practice it can be used anywhere. This should always be combined with deep breathing. A visualization is used as follows.

In your imagination try to visualize your own ideal stress-free situation and then concentrate on this image for 3 or 4 minutes. It may help if you consciously try to discard any problems from your mind first – you might, for example, visualize an open window through which all your problems are passing, to be replaced by an image that gives you a sense of peace and well-being. Imagine being stretched out on a beach, with the water lapping at your toes. Or imagine floating on a cloud.

2 Simple breathing exercises

These are essential as most people when tense or agitated tend to breathe shallowly, often using only the upper part of their lungs. This often provides the body with insufficient oxygen.

Good deep breathing from the abdomen uses the lungs to their full capacity. This should be done whenever there is a feeling of stress or anxiety. One should always inhale through the nose, not the mouth; patients can be advised to put their hands on the abdomen to ensure that they are using it. (The chest should barely rise.) Then very, very slowly they should exhale, again feeling the abdomen.

Another good tip is to put the arms in front of the body on a support at about shoulder level, while doing the deep breathing exercise. This enables the diaphragm and rib cage to relax.

There are many variations, but the following exercise is one of the simplest. The person should ideally lie flat on the floor but it can also be practised sitting in a comfortable position.

Breathe in through the nose, slowly and deeply, for three counts, hold for three counts, then breathe out slowly through the mouth for three counts.

Continue like this, maintaining a steady rhythm, for 3 or 4 minutes.

As you breathe, particularly when holding the breath, make sure your muscles are relaxed. Then repeat, this time holding a finger over one nostril so that it is blocked; then change over and hold the other nostril.

3 Progressive muscular relaxation

The aim of this is to work through each of the main groups of muscles in the body, first tensing and then relaxing. The person should lie on their back, on the floor with their arms by their sides, and feet uncrossed. The following is a reflexology technique.

Rotate your wrist, then first with your fingers tense, hold for 5 seconds and then relax. Allow the sense of relaxation to travel up the arms and into the shoulders. Clasp your hands together and hold for a few minutes. All these simple exercises will relax the neck and calm the mind.

Starting now with the toes and feet, tense and hold for a few seconds, then slowly relax. Breathe deeply. Repeat this with the toes, wriggling them this time. Then move to the ankles, stretching them and then relaxing. Repeat with the calf muscles, then the thighs and buttocks, clenching them tightly then relaxing them.

Now arch the back gently and relax it. Next pull your stomach in and hold to the count of three, then push out. The arms and shoulders should be flat on the floor. Now take the elbows out to the side at right angles from the body; this allows the scapular to lie completely flat. The face muscles now need working. Accentuate a grin, and do this several times to relax the face muscles. For the mouth, suck in the cheeks then puff them out, and slap them to make a popping sound – this exercises the mouth, nose, eyes and forehead.

Finish with the deep breathing exercise given above.

Self-help exercises with another person

These stress-dissolving exercises can be performed in the home or in the workplace; they help to relieve tight and fixed muscles. There is no need to remove any clothes. (See plates 36–8 for massage sequence.)

       1. Support the person’s shoulder with the hand opposite to the one you are going to work with. Use the heel of your hand and apply a circular movement over the whole area of the shoulder and upper back.

       2. Work the other shoulder, making sure the person’s chest is supported as this shoulder and the scapular area are massaged.

       3. Both hands can be placed on the shoulder and, using the thumbs, apply small circular movements over the whole area, right up to the nape of the neck. Gentle pressure is the secret. This contacts vital parts on the hairline, to release stress and tension.

       4. Finish the shoulders by gripping and releasing, and gently squeeze to relax the area; this eases tension. The shoulders usually relax considerably.

       5. Now support the head and work with one hand. Points on the face, head and neck (see chapter 7) can be worked using thumb and fingers, with slight rotation on all points. By moving the fingers and thumb apart, you can stretch the skin away from the midline of the neck. Repeat but this time draw the skin towards the midline of the neck; this procedure relaxes the neck area. Pick up the tissue and relax it.

       6. Lean on the recipient’s shoulders with your forearms; this applies gentle pressure and encourages them to relax their shoulders even more.