Ronald Reagan was right to be cautious. After
decades of exhaustive research, it has
been proved that there is a link between stress and a whole range of medical
conditions. Stress triggers hormonal and chemical defense mechanisms, and
mobilizes the nervous system for the `fight or flight' response. As one study
concluded: `The process enhances one's
level of arousal because the cognitive, neurological,
cardiovascular and muscular systems are stimulated as the body prepares for an
emergency in response to a sudden shock. The heart rate is increased . . .
glucose stored in glycogen in the liver is released for energy, blood supplies
are redirected from the skin to the brain and skeletal muscles and the secretion
of sweat increases.'
The theory is that this evolutionary response
to danger was dissipated by fighting or running – options not available to
people at work, who instead have to endure the threatening or hostile
conditions. This can cause stress, which is `characterized by emotional
vulnerability, persistent negative emotions, elevated
hormonal base levels, hyperactivity of the
automatic nervous system so that the
body never relaxes and tendencies to experience psycho-somatic symptoms. Over
time this state of affairs may cause illness due to wear and tear on tissues.'
Stress can promote an already existing cancer
or heart disease, or it can trigger these conditions where there is an existing
vulnerability. There is evidence that low control in the work environment, and
the stress it can cause, is associated with an increased risk of coronary heart
disease; one study found that exposing workers to stress for at least half their
working lives made them 25 per cent more likely to die from a heart attack, and
increased their odds of a fatal stroke by 50 per cent. It concluded that
`long-term work-related stress is worse for the heart than ageing thirty years
or gaining forty pounds in weight'. Another study found that men who work over
sixty hours a week without regular sleep may be doubling their risk of heart
attack, while those working forty-eight hours a week are doubling the risk of a
serious heart condition.
Giving employees more variety in tasks and a
stronger say in decision-making may decrease the risk, according to the HSE's
Whitehall II Study of British civil servants; a Finnish study found that `people
who faced a combination of high demands at work, but poor control over their
job, had double the risk of death from heart disease compared with colleagues
who had less stressful occupations. Workers whose job involved high demands,
but had low salaries and a lack of social approval, had a risk of death from
cardiovascular disease that was 2.4 times higher than those whose jobs involved
low stress.' That finding ominously describes the position of many
public sector workers. At its worst, stress can kill.
The more common impact of stress on health is
to lower immunity. The Bristol study found a much higher incidence of a wide
range of medical conditions amongst those reporting high stress, from high blood
pressure, nervous trouble and depression to breast cancer. Those with high
stress were more likely to have had back-ache
or sciatica, indigestion, Irritable Bowel Syndrome, constipation
and piles. There are strong links between stress and ulcers, and those with high
stress were more likely to have difficulty sleeping, more vulnerable to coughs,
sore throats and headaches, and more likely to complain of chronic tiredness.
Surveys of people working long hours
routinely show a high proportion reporting that they feel very tired, and this
is twice as likely to affect women as men. Cumulative tiredness can result in
fatigue, which is used as a medical term for the deterioration of physiological
or mental faculties caused by working long hours. It can be exacerbated by the
interruption of the body's own natural rhythms by night shifts. The
result of mental fatigue is that the mind's reasoning powers and reactions slow
down. The impact of such fatigue is keenly felt by long-hours workers, of whom
25 per cent claim that their hours have led to some physical ailment, while the
same proportion say it has had a detrimental effect on their mental health. Yet
ill-health didn't stop these long-hours workers: 71 per cent admitted that they
had carried on working even when they felt unwell.
The response to such fatigue can often make
the problem worse; the `slob-out' tendency complicates the causal link between
stress and disease, because a stressful job often leads to behavior which
contributes to heart disease. You come home after a stressful day and slump on
the sofa with a bottle of wine or several beers, or you smoke more; you depend
on biscuits, sweet fizzy drinks or grab some chips at lunch to give you the
temporary energy surge you get from sweet or fatty foods. There's less time and
energy to get some exercise, or to cook a proper meal.
Stress is also closely associated with back
pain – the second biggest cause of lost working days. One American study found
that psychosocial job-stress factors such as mental workload, work pressure and
lack of job control can contribute to musculoskeletal pain because of chronic
low-level muscle tension; stress-induced overbreathing may also be a factor.
Another study found that a lack of pauses in
muscle activity can contribute to musculoskeletal disorders; that would explain,
the study argued, why their incidence is higher among women, because of their
double shift of work and caring; it would also explain the increase in such
disorders as a result of work intensification.
Go to the doctor complaining of stress, and
you're most likely to end up leaving with a prescription for anti-depressants.
They will help you sleep, and will help you feel more cheerful, but they will do
nothing to slow the pace of your work,
or ease the volume of emails or the
pressure from the boss. In one survey of doctors, work-related problems were the
second most common reason for surgery visits. If you don't like the idea of
taking anti-depressants, there's little
the doctor can offer except a few minutes of
sympathy.
The inadequacy
of conventional medicine in dealing with psycho-physiological conditions such as
stress, chronic tiredness and tension is driving the boom in complementary
health. In particular, people turn to complementary treatments for that most
elusive of essentials required in the twenty-first-century workplace – energy.
The quest to boost our energy levels has fuelled a boom in multivitamins and
herbal medicines. It has driven a high street revolution in coffee shops, and
revitalised the sales of energy drinks like Lucozade and given birth to new ones
such as Red Bull.
Our need for energy to keep `coping' has
spawned a preoccupation with well-being and a
new service sector numbering thousands – it
has been put at 100,000 – of
therapists in Britain to maintain our physical and emotional well-being. Energy
has become second in importance only to time, claim futurologists at the Henley
Centre, and more important to us than money, information and space. One in four
of us think that within five years, energy will be our single most important
resource. Two of the four key ingredients of successful managers, claimed former
GE Chief Executive Jack Welch, are energy – having lots of it yourself – and
being able to energize others.
Dr Mosaref Ali has built his career on
treating stress in his Harley Street
clinic. It was Mike Harris, Chief Executive of internet bank egg, who told me
about the wonders of Dr Ali and urged me to
interview him. Dr Ali has built up a devoted
and influential clientele, from Prince
Charles to Kate Moss and Geri Halliwell. He had just returned from taking a
group of chief executives hiking in the Himalayas and, not surprisingly, his
calmness was palpable.
The source of his appeal is not hard to
understand: he offers to transform stress into vitality, promising that the body
can heal itself: `Stress and energy are very closely related; stress can give a
false sense of energy, and people can be euphoric with it. They work hard and
work out hard, and then need alcohol to knock them out to sleep instead of
taking time to calm down the body, and that will end up burning you out. The
human mind doesn't like being speeded up – it doesn't like deadlines. The brain
operates in cycles inherited from nature. And the brain doesn't like
multi-tasking – it wants to focus on one thing.'
The answer, explains Dr Ali, is regular neck
massages to improve the blood supply to the brain, yoga for physical and
emotional stress management, and a diet with a reduced yeast content. `The men
who come to me are doing more work than ever, and they
feel fine. The Japanese aren't fools; they
follow special diets, do Tai Chi and
take rests in their workplace, and yet the intensity of their work is much
higher. If you stop panicking and relax, you will do the same amount of work
without tiring. I work all day and I write
books in the evenings – it is possible to
work very hard. The human brain
doesn't like speed, but with adaptation it can work faster.' The
secret, he claims, is to calm the mind; only then can it make the necessary
connections. `The chief executives I work with can
do lots of work and aren't stressed.' He
smiles as he adds, `Although they may
stress their staff.'
At which point I'm bustled out – there are
clients waiting. But one can see exactly why Dr Ali is so successful – he seems
to offer a solution within the individual's grasp: you may not be
able to change deadlines and workloads, but you
can make yourself more efficient.
Ancient wisdoms can be adapted to speed up
human beings: this is the kind of individualized response which fits neatly into
a neo-liberal market ideology. It draws on Eastern contemplative traditions of
yoga and meditation which place the emphasis on individual transformation, and
questions the effectiveness of collective political or social activism.
Reflexology, aromatherapy, acupuncture, massage – these alternative therapies
are all booming as people seek to improve their sense of well-being and
vitality.
Much of it makes sense – although trips to
the Himalayas are hardly within the reach of most workers – and the
complementary health movement plays an important role in raising people's
under-standing of their own health and how to look after themselves. But the
philosophy of improving `personal performance' also plays into the
hands of employers' rationale that well-being and coping with stress are the
responsibility of the individual employee. It reinforces the tendency for
individuals to search for `biographic to structural
contradictions', as the sociologist Ulrich Beck put it: forget the barricades,
it's revolution from within that matters. This cultural preoccupation
with personal salvation stymies collective reform, and places an onerous burden
on the individual. It effectively reinforces the anxieties and insecurities
which it offers to assuage.
