Friday, April 01, 2016

Stress is Good

Why Stress is Actually Good For Us—and How to Get Good at it

Why Stress is Actually Good For Us—and How to Get Good At It

It’s been drilled into all of us since childhood: Stress is at the root of every modern day ailment, it’s the primary culprit for all feelings of discomfort and dismay, it is, in short terrible and to be avoided at all costs. But here’s the other thing about stress: It is the lining of everyday life, the subtle and consistent undertone in the soundtrack of our day-to-day, an unavoidable reality.
So it was with a sense of very cautious optimism that we picked up Stanford professor Kelly McGonigal’s new book, The Upside of Stress, a fascinating and quick read on some concepts that might just recolor your entire perception of life. For one, she posits that while we tend to fixate as a culture on flight-or-flight, there are actually three other beneficial and physiologically positive types of stress; and that harnessing stress to work for you is as simple as changing your mindset, i.e. choosing to believe that your body is simply revving up in support. The studies and research she cites are hands-down fascinating. Below, we asked her some questions.

A Q&A with Kelly McGonigal

Q
There’s a discussion in the culture about how people wear “busyness,” like a badge of honor—but there’s a certain amount of shame associated with admitting that you’re stressed out and overwhelmed. Why is that?
A
My entire goal in life is to strip the shame away from anything people find shameful. Who knew stress would be one of those things?
It’s interesting how many people have told me that they’re tired of other people telling them that their lives are too stressful—that they need to go slower, or cut out things that are stressful—when they themselves know that even when things are difficult, they’re still thriving more than they would if they tried to construct some kind of less stressful life.
Q
It’s true—it seems not uncommon that in moments of everyday stress, it almost needs to reach a tipping point where you’re stressed enough to be compelled to act. It’s the precursor to getting so much done—like double-majoring, or working a full-time job, having a family, and running a house.
A
The funny thing with stress it that here, we’re talking about this wonderful meaningful stress, like double majoring, whereas in my last conversation today we were talking about the loss of a child.
How crazy is it that we use the same word to describe both situations? That stress has come to refer to almost everything that defines what it means to be human. This should give us even more reason to stop demonizing it, since almost every thing we experience as meaningful or difficult, we label as stressful.
Q
Have you always been fascinated by stress?
A
Stress was always the starting point for me. My dissertations, my research as a grad student, even my research now. It has always been centered around stress and how people adapt to life transitions and to difficult emotions. But the way that I was thinking and talking about it—it was like I was dancing around the idea of accepting and embracing stress. In the last four or five years, it took a lot of wake-up moments for me to realize that I needed to jump off a cliff and dive into a completely different way of talking about stress—a way that threw out the whole concept that if you’re stressed out, there’s something wrong with your life and you should prioritize reducing or avoiding stress.
Q
Before you wrote this book, was your perception of stress that it has a negative impact on your health and wellbeing?
A
Yes, that’s basically how I was trained. My degree is in psychology and humanistic medicine. From both of those fields I was beaten over the head with the concept that stress is a toxic state, that while helpful in the short-term, has long-term effects that are damaging. This was based on a lot of animal research from Hans Selye (see below), which doesn’t really translate to the experience of being human. Ultimately, I think it was all based on a misunderstanding of, or a very narrow definition of stress in terms of what happens in your body and in your brain. I had been taught that every time you experience anything we would call stress, your body shifts into this state that is fundamentally toxic—that flight or fight survival mode, which impairs your insight or ability to make decisions, that’s toxic for your body, that increases inflammation and hormones that in turn suppress your immune system and kill brain cells. We’ve all heard that.
If you go back 10 years to look at interviews I did about stress, I was saying all those same things in magazines and newspapers.
I’ve come to realize that there are many things about that point of view that are not true. The most basic one that’s faulty is the premise that there’s only one stress response, and that every time you experience stress you’re in a toxic state. That’s fundamentally not true. The body has a whole repertoire of stress responses. Sometimes when we experience stress we’re experiencing a state that is healthy, that makes us resilient, that makes us more caring and connected, that makes us more courageous. The experience might be physically similar in some ways to stress states that we would describe as debilitating anxiety or other negative stress states, but they are not toxic. There are a lot of different ways to experience stress.
Q
Besides fight or flight, you discuss three beneficial types of stress in the book—tend and befriend, challenge, and growth. Are those terms accepted in the scientific community or is that primarily how you bucket or perceive them?
A
The difference between a threat response (a.k.a. a fight or flight response) and a challenge response to stress is well accepted in psychology. The tend and befriend response, and the growth response to stress, are less well known, but are documented. They are emerging as areas of research.
challenge response gives you energy, helps you focus, increases motivation, and is not necessarily toxic to our hearts and our immune systems in the way that we might think a fight or flight response is. It’s the kind of stress response you have in situations where you need to rise to a challenge—and, importantly, you feel like you can do it. Not necessarily succeed or fix everything that’s wrong, but a basic confidence that you aren’t going to fall apart under the pressure. A challenge response, physiologically, looks a lot like what people experience when they exercise or when they report being in a positive flow state—which is actually a kind of stress response, despite being highly pleasurable. Your heart might be pounding, but you have less inflammation and a different ratio of stress hormones than when you experience fight-or-flight panic. Studies show this kind of stress response helps people do their best in a range of stressful situations, from athletic competitions to academic exams, performing surgery, or even having a difficult conversation.
The tend and befriend response is a radically different biological response to stress. Rather than flood you with energizing hormones like adrenaline and cortisol, a tend and befriend response is associated with strong increases in the hormone oxytocin, which helps us bond and connect with others. When you have a tend and befriend response to stress, you’re inclined to be with friends and family; you are willing to ask for help from others; and most importantly, you feel motivated to support and care for others, too. In a way, it’s a “bigger-than-self” stress response. Your own stress, or the recognition that someone you care about is suffering, motivates you to strengthen relationships and support those you care about. An oxytocin-driven stress response has all sorts of health benefits, including reducing inflammation. In fact, oxytocin is a natural antioxidant and cardioprotective. 

“Studies show this kind of stress response helps people do their best in a range of stressful situations, from athletic competitions to academic exams, performing surgery, or even having a difficult conversation.”

Researchers think that this kind of stress response explains why people who volunteer, for example, don’t show any stress-related health problems or an increased risk of mortality. They also believe it explains why people who are caregivers often don’t experience the same negative impacts from stress, depending on the caregiving experiences—or why parenting is associated with greater health and longevity. These caregiving activites seem to prime a tend-and-befriend physiology. People who choose a tend-and-befriend approach to life—by volunteering, focusing on giving back, or prioritizing caregiving all seem to have a difference physical and psychological response to stress. They are more empowered, find more purpose in the day to day, and deal better with the ups and downs of life.
Women are more likely to have this response to stress, because estrogen enhances oxytocin while testosterone inhibits it. However, men can have this type of response, and becoming a parent often unleashes it.
And then there’s a relatively new idea, which is that there’s an ability to grow from stress built into our biology. I think people have always recognized that holistically, what doesn’t kill you makes you stronger—they recognize that as a platitude. But to see it in the biology of the stress response—that your stress response can increase neuroplasticity to help your brain learn from the experience, that you can release stress hormones that function like steroids for not just your body but also for your brain—that’s an incredible and very new insight. Back in the 1980’s researchers speculated about this (for example, calling it stress-induced “toughening” or stress inoculation) but didn’t know how the biology worked. Since then, researchers have investigated something called a “growth index” of stress hormones (the ratio of stress hormones like cortisol to DHEA) that predicts whether you will be strengthened by a stressful experience.

“Your stress response can increase neuroplasticity to help your brain learn from the experience, you can release stress hormones that function like steroids for not just your body but also for your brain…”

It’s not clear yet whether a growth response to stress is physiologically different than a challenge response, or whether it just happens after the initial challenge response to stress—when the brain and body are recovering from the stressful experience. The levels and types of stress hormones typically released during a challenge response is consistent with a higher growth index.
In fact, the latest theory about why we have stress basically argues that stress is not for immediate survival, but that without stress, we wouldn’t actually have the ability to learn from experience. I think that’s a radical rethinking of why we have stress. If you think stress is to help you run away from a tiger, of course that’s not a helpful way to respond to life. But if you understand that what you experience as stress is the biological mechanism by which you are going to learn and grow and develop your strength, now that’s a totally different way to understand why your heart is pounding, or why you’re having trouble falling asleep at night because you’re thinking about something stressful that happened.
Q
That mindset shift is one of the central theses of your book—if you believe that stress is bad it does nothing to help you, but if you can come to understand that it can actually enable your performance or help you grow, that it will do exactly that. Is that the fundamental shift? Does stress still help you if you’re not receptive to it?
A
It’s a funny question, right? Is stress good for you? Or is it only good for you if you think it’s good for you?
One thing I feel comfortable saying is that if you expect stress to help you, and you recognize your own natural capacity to thrive under stress, you will be healthier than if you fear, suppress, or try to avoid stress. If you can see the upside of stress, stress can help you, and you will be more likely to thrive in stressful circumstances.
And that is coming from looking at the biology of a stress response: In studies, people who interpret their racing heart or their sweaty palms as a sign that their body is giving them energy actually do better under pressure—they perform better, they make better decisions, and they impress others more. Regardless of the type of stressful situation. People who expect stress to be an opportunity to learn and grow have a biological stress response that helps them learn and grow. So there is something to this idea that how you think about stress matters—in the book I talk about it as being the effect you expect is the effect you get. 

“In studies, people who interpret their racing heart or their sweaty palms as a sign that their body is giving them energy actually do better under pressure—they perform better, they make better decisions, and they impress others more.”

It’s similar to a placebo effect, and what makes it work is that these are already natural elements of the stress response. That no matter how much you don’t like that you’re breaking out into a sweat before a difficult conversation, your body is still going to do it because it’s trying to help you. That’s a fact. When you experience stress, there are changes happening in your brain and your body that are trying to help you connect with others, or rise to the challenge, or learn and grow.
And just like with a placebo effect, when you recognize that your body and brain are capable of responding in a way that is helpful or healing, you actually enable it to happen more effectively. You’re giving your body and brain permission to go full steam ahead with all the things they can do to help you cope. “Brain and body, I’m ready for it: Unleash your full positive stress response.” And the studies show that this type of mindset shift doesn’t calm people down. Instead, it shifts stress physiologically in a way that’s better for you and more productive.
Now, the question of whether stress is good for you even if you don’t think it’s good for you…it doesn’t necessarily mean that stress is going to be harmful. Sometimes stress will help you anyway even if you’re fighting it and trying desperately to calm down. It will insist on keeping you revved up because it knows you need the energy to get through something.

“And just like with a placebo effect, when you recognize that your body and brain are capable of responding in a way that is helpful or healing, you actually enable it to happen more effectively.”

One of the funny things that the brain can do when we’re stressed out is actually shut down the fear system. In these moments, we may still feel stressed out but we find that we’re acting courageously. You don’t want to calm down when you’re in the state of becoming almost heroic under stress. You want your body and brain to help you do it.
But there are many things that can amplify the harmful side of stress, and some have to do with the mindset that stress is bad for you. For example, if you feel stressed, and it signifies to you that you’re somehow inadequate to your life—or that your life is somehow incredibly screwed up, unfair, or beyond hope. I think that’s a judgment that we’re more likely to make when we believe that stress is always bad for us.
But I don’t want to overstate this. It’s not like if you think stress is bad for you it’s going to give you a heart attack tomorrow, so you better be careful or stress really will kill you! I don’t think that’s the case. Just in the same way that you can’t give yourself cancer by fearing cancer or thinking about cancer (which is what many people a generation or two ago believed). Seeing the upside in stress does seem to create a physically healthier stress state, but you’re not going to make your stress 100 times more toxic just because you read a magazine article that says that stress is ruining your health and happiness.

“We’ve been so inundated by this belief, this mindset, and this message that stress is toxic, that stress is harmful, that you should avoid or reduce stress, that in moments of feeling stressed out, we think: ‘I shouldn’t be stressed out right now.'”

But I do think that it sometimes happens that we’ve been so inundated by this belief, this mindset, and this message that stress is toxic, that stress is harmful, that you should avoid or reduce stress, that in moments of feeling stressed out, we think: “I shouldn’t be stressed out right now. If I were a good parent, if I were a good mom, I’d be calm right now, I wouldn’t be upset. If I were good at my job, I’d be so smooth right now under pressure. I wouldn’t be frantic, I wouldn’t be worried, I wouldn’t be overwhelmed.”
And then that leads us to cope with situations in ways that make it harder to find meaning in them. It makes it harder to solve problems that can be solved. It makes it harder to connect with others so that we know that we’re not alone. And I think that’s what makes believing stress is bad for you so toxic. It’s not a magic trick. It creates thoughts and emotions that make it harder to thrive. And it changes the way we cope.
Q
If you have a panic response to feeling stressed, is it more likely to send you into fight or flight where you’re releasing tons of cortisol? Or can you make any stressful situation more positive just by believing it can be positive?
A
Yes, there can be moments when people experience a threat response to the fact that they’re stressed. If you’re not trying to run out of a burning burning, feeling a panicked threat response is not healthy. It creates high inflammation in your body. It tends to prime you to make decisions that are often not consistent with your long-term values. Stress can lead you to make really good decisions, but a threat response is not going to help you in the same way a challenge or growth response would.
When you view all stress as harmful and you start saying things like: “I shouldn’t be stressed right now, I need to calm down, this stress is going to kill me,” you’re amplifying the harmful aspects of your stress response. A mindset shift in these moments can be very helpful, and it basically just means that you need to accept the stress and allow it to be a signal of what matters to you, and allow it to be a signal that you care. You should view it as evidence that your body is getting ready and helping you rise to the challenge. You should view it as evidence that you can trust yourself.

“You should view it as evidence that your body is getting ready and helping you rise to the challenge. You should view it as evidence that you can trust yourself.”

Let’s say that you’re worried about something and it’s creating a lot of anxiety. How many people feel that anxiety means that they can’t handle the situation? Why not think this instead: “The fact that I’m worried about this means that I can trust myself. If it were someone else having to take care of it, I would want someone who is worried about it, too, not someone who isn’t worried. Because someone who is worried about it is someone who is really going to invest themselves and be thoughtful.” The key, I think, when you start to notice yourself panicking about stress and moving in the direction of a threat or freeze response is to initiate a mindset shift—to acknowledge that the stress is merely there to help you care and respond skilfully.
Q
The other myth that you debunked is that a pregnancy without stress is not only ideal, but essential. What a revelation for women—this idea of avoiding stress is an incredibly stressful concept where you are trying to position your entire life and your career around 9-months of stress-free living that doesn’t exist and will never exist! Can you expound on this a little bit?
A
Most women have heard that stress increases the risk of outcomes that you don’t want like pre-term birth. They’ve also heard that their kid will be born sensitized to stress in a way that’s not helpful.
When you look at the research on when that’s most likely to be the case, it seems like it’s really the situations where you don’t get to have control anyway. Things like living in poverty, surviving a natural disaster that destroyed your home, the death of a very closed loved one—there are certain traumatic experiences or states of deprivation that can negatively impact a pregnancy. Being in an abusive relationship is probably the best predictor of negative outcomes. This is not the kind of stress that most women are most worried about on a daily basis, or if they are, it’s not a kind stress that they can simply avoid or make less stressful. 

“There are studies that suggest that this kind of stress actually increases the resilience of the child, that children of mothers who worried more during pregnancy are born with nervous systems that seem more able to cope with stress as if they’d been practicing getting good at stress in utero.”

Of course it would be great if we could avoid any of those traumatic experiences, but many of those situations are out of our control. Most women are concerned about the daily stress in their lives: Working late hours, moving, making some other big transition, worrying about their pregnancy and then worrying that the worrying is bad for them. There are studies that suggest that this kind of stress actually increases the resilience of the child, that children of mothers who worried more during pregnancy are born with nervous systems that seem more able to cope with stress as if they’d been practicing getting good at stress in utero.
You see the same pattern continue early in life. Infants and children who are exposed to moderate stress, like being separated from their parents every once in a while, or being put in novel situations where they have to adapt, become more resilient and develop more self-control. It’s a very important message that we need stress to grow. And it’s another strike against the argument that stress is always a problem, and that your life, if stressful, is fundamentally toxic.
Q
How did this happen? What was the foundation of this belief that stress is toxic? What is all the science of stress predicated on?
A
One thing I do want to say is that there is science suggesting that stress is harmful—and there are lots of situations where negative life events like suffering, loss, and depression have negative consequences on our physical health, relationships, or other goals. There is a reality to that. It’s not like all the science is bunk. But arguing that growing up in poverty can have a long-term negative affect on your health is not the same thing as stating that having a stressful life means that your life is killing you, and that there’s some alternate reality life waiting for you that is free from stress if only you were doing it right. And yet that’s the leap people make.
So I do want to acknowledge that there’s evidence that stress in some situations can be harmful—and even when it’s having positive affects on our lives it could also be having detrimental effects. But the message that stress is always harmful, and life is fundamentally toxic—that is, I think, a big misread on reality and it comes from Hans Selye’s work. He is the grandfather of stress research and he defined the word stress as we commonly use it. His research involved looking at all the different ways you could torture lab rats in order to first make them sick, then destroy their immune systems, and eventually cause them to die. And he did things like severing their spinal cords, injecting them with toxins and poisons, isolating them in extreme temperatures. He basically looked at different ways that you could make life incredibly difficult and unpleasant for rats and he found that pretty much any way he did it, he could make them die.

“The message that stress is always harmful, and life is fundamentally toxic—that is, I think, a big misread on reality.”

And he called this process stress. He defined stress as the body’s response to anything that requires adaptation. Which was a huge leap from his laboratory experiments. Hans Selye never took a human being into his laboratory, said, here’s a difficult problem to solve, let’s see if that kills you. Or took someone out and said here’s a kid you have to raise, let’s see if that kills you. No—he was torturing rats!
So, after defining stress as the body’s response to anything that requires adaptation, he then he toured the world telling people about stress, le stress, el stress, lo stress—every language you can think of, explaining how the effects of stress are slowly wearing down and tearing down your body. And his message was really widely received and heard and I think that’s the way most people commonly think about stress—they accepted the definition that stress is what happens anytime you have to respond—and assumed it was accurate to say that the effects were going to be like what Selye observed in his rats, which was really a closer analogy to solitary confinement and long-term abuse. There are human situations that are similar to that, but it’s not the reality that most people experience when they say that they’re stressed.
Q
Why did the science community accept and propagate this? 
A
Well, even Selye changed his tune eventually, but it was too late—by the time he started his redemption tour telling people that stress was inevitable and that stress could be good, nobody was listening anymore, which is sort of a funny sidenote of science.
Part of what we experience when we’re stressed is a desire to affect change so that we’re no longer stressed. And as a result of that, we almost always experience stress as a little bit distressing. When we’re stressed out, there’s this underlying sense that “it could be other than it is.” It doesn’t matter that after that moment of stress, when you look at how that stressful experience contributed to your life, you’re just as likely to say that it had a positive affect as a negative one—even when it comes to seriously traumatic life experiences. But that desire for things to be different, that’s part of what motivates us to act, to connect, to grow, to learn. And I also think it explains why we’ve been so receptive to this idea that stress is harmful and that we should avoid or reduce it. When stress is offered up as the enemy, and we start to believe that we shouldn’t have to feel distressed, ever, it makes sense to us that we should avoid stress.

“Ultimately, most people don’t like to be uncomfortable—so if I tell you that your stress is unhealthy, it’s almost giving you permission to seek comfort over enduring discomfort.”

Ultimately, most people don’t like to be uncomfortable—so if I tell you that your stress is unhealthy, it’s almost giving you permission to seek comfort over enduring discomfort. Unfortunately, even if you could choose that, it’s awfully hard to choose it in the way most people idealize. When you try to excise stress from your life, the type of stress that you can control is almost never the kind of stress that creates the most suffering.
In fact, the stress you can control is actually the stress that can have the most positive impact on your life. You should seek out good stress and set stress goals. Figure out what you care about and then decide to weather a bit of discomfort by putting yourself in situations that require you to show up and serve the world and serve your family or community. You can choose that kind of stress. You can’t choose to reduce the kind of stress that most people wish they could reduce—the unexpected losses, traumas, or crises. The pain of being human.

Q
So speaking of “stress goals,” who has the greatest aptitude to be good at stress? Is it people who tend to be competitive and over-achievers?
A
I’m so glad you asked that. Because one of the key messages of the book is that there are actually multiple ways of being good at stress. And your hypothesis is what I believe a lot of people think about stress. That the one way to be good at stress is to thrive under pressure, to love deadlines, to enjoy competing, to always want to push yourself. That’s the Iron Man model of stress. But that’s only one way of being good at stress. There are two other ways.
There’s a second type of stress response for people who might be paralyzed by that sort of pressure, but are really good at connecting under stress. You might be really good at asking for support, at helping others, and at deriving a sense of resilience and hope from being able to help others. You might be really good at understanding that what you’re going through is part of what it means to be human and to actually take solace in that common humanity. You might have the ability to use stress as a catalyst for compassion, for empathy, for connection, and for strengthening relationships. That’s a completely different way of being good at stress.

“If you’re the type of person who doesn’t thrive under pressure, who isn’t competitive—it doesn’t mean you can’t be good at stress.”

The third way of being good at stress is the one that comes most naturally to me: It’s the growth mindset. No matter how bad things are, there’s a part of you that’s already trying to make meaning out of it. The thinking is: “This is going to help me help others.” Or, “This has been a really good opportunity to cultivate courage even though I’m terrified right now.” Or having the ability to look back, and say, “Well, even though that was horrible and I wish it hadn’t happened, at least I can see that I’ve learned X, Y, Z.” You can be good at stress in this way even if you don’t run on adrenaline or have a tendency to isolate yourself during stress.
Part of what I’m encouraging people to do is to look at those three stress strengths and try to cultivate all of them to the degree that they serve you. But if you’re the type of person who doesn’t thrive under pressure, who isn’t competitive—it doesn’t mean you can’t be good at stress. I think there’s a limited model in society right now for what it means to be good at stress. And maybe it’s a very masculine or Type A way of being good at stress. I want people to realize that you can thrive in stressful circumstances through connection and compassion, not just through competition or aggression. And you can thrive in stressful circumstances by being really good at making meaning, and really good at appreciating yourself, your strengths, and your community. 
Kelly McGonigal, PhD, is a health psychologist and lecturer at Stanford University, and a leading expert in the new field of “science-help.” She is passionate about translating cutting-edge research from psychology, neuroscience, and medicine into practical strategies for health, happiness, and personal success. Besides the Upside of Stress, she’s also the author of The Willpower Instinct. She also gave an incredible TED talk about making stress your friend.