The problem isn’t stress, but how we relate to it

We try to fight against stress when it might not be the main problem.

CBT has long focused on negative emotions, with the goal of helping patients to soothe these emotions whenever they become too difficult to handle. Considerable outcomes have been achieved and a significant number of patients with a variety of difficulties have been and are still being helped with CBT. However as its design allows (and almost imposes), CBT is still evolving. Among those changes, the third wave of CBT has proposed a rather radical proposition: no longer directly combating negative emotions, but focusing on the individual’s relationship to his or her emotions. It is no longer shame, anger, sadness, fear, etc. that are considered problematic, but what the individual does with them, how he or she reacts when these emotions appear within him or her. In this approach, which could be described as “meta-emotional”, these primary emotions are validated, with the idea that they don’t represent a problem as long as we don’t fight against them unnecessarily.

A good example of the interest of this distinction between “primary” emotions and those which are the of the fight against what we don’t like to feel comes from a study in the domain of cardiovascular illness. A large group of 7268 participants was followed for 18 years as part of the Whitehall II study. Participants were asked at the beginning of the study to indicate at which point they felt stressed, but also how much they thought their stress was having a negative impact on their health. Eighteen years later, twice as many deaths and myocardial infarctions were reported among people who believed that the stress they felt had adverse effects on their health. At equivalent stress levels, and after controlling for socioeconomic variables and other risk factors (e.g. tobacco use), people who considered their stress as dangerous for them were more likely to suffer from coronary heart disease.

It would then appear, from the results of this study, that the level of stress felt has less influence on physical health than the value attributed to it. We could hypothesize that people who think that their stress is harmful and dangerous are more likely to fight against these sensations, which then certainly leads them to grow increasingly stressed, according to the good old polar bear mechanism so dear to Daniel Wegner.

The full article is available here.

Nabi, H., Kivimäki, M., Batty, G. D., Shipley, M. J., Britton, A., Brunner, E. J., … & Singh-Manoux, A. (2013). Increased risk of coronary heart disease among individuals reporting adverse impact of stress on their health: the Whitehall II prospective cohort study. European Heart Journal34(34), 2697-2705.

Translated by Chelsea Davis-Laurin

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