STRESS & BURNOUT - An Overview
How the Brain Understands and Manages Stress
Stress is a Response by the Body and Mind
To Pressure That Cannot be Managed
… Prof. Stephen Palmer
People have very different ideas with respect to their definition of stress. The most common is, “physical, mental, or emotional strain or tension”. Another definition is, “a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilise.” The ‘human function curve’, illustrated below, shows the build-up of stress as demands build and our resources struggle to cope.
The Human Function Curve graphs the relationship between stress (good and bad) and performance (physically and mentally). Although it represents the limits of the human being in general, everybody has their own individual limits for stress. But we all have stress – only those who are dead or are dysfunctional are stress free. The reason why a little stress is “good” is because each of us has a degree of “healthy tension” in which our body and mind function throughout the day.
The Human Function Curve mentions two important parts of the brain, the Amygdala and the Pre-Frontal Cortex. Everything we see, hear, smell, taste or feel is sent to the Thalamus first where the signal splits, firstly to the Amygdala where it rapidly assesses the perceived threat, and erring on the side of caution, responds accordingly. As it has an indelible memory of negative experiences it will respond as in past experiences even if only vaguely similar. It is our ‘Fight or Flight’ response and is unconscious.
Secondly to the Pre-Frontal Cortex which uses conscious memories to provide context and has the capacity for logic, inference, problem solving and planning. It takes longer to reach the Pre-Frontal Cortex by which time the Amygdala has already given it’s rough and ready response. One of the objectives of therapy when addressing stress is to learn to engage the pre-frontal cortex before the amygdala has responded.
It is important to note that stress has physiological as well as psychological implications and we would do well to listen to our bodies to identify the early onset of stress. Tense mussels, lower back pain, upset stomach are all possible indicators of stress ahead. Help is needed before fatigue and ill health creep up on us and panic, breakdown, burn out and depression step in.
Treatment of Stress
Stress that is becoming unmanageable is often a sign of strength and not a sign of weakness. Those who go the extra mile, are diligent and hardworking, caring and conscientious are the ones that are susceptible to stress. When the signs of the build-up are clear, perhaps to others rather than ourselves, it’s time to take action before burnout occurs.
In many ways the workings of our brain and in particular the parts most involved in management of stress are similar to an electric circuit in the home. We can overload a plug socket until the fuse blows. If we don’t reduce the load the fuse will continue to blow. Likewise in stress if we don’t reduce the overload the lights will go out, nothing will function and we will be ‘out of it’ for weeks to come.
To avoid this happening we need to identify and alter areas of our lives which are causing stress. We need to get balance back into our lives including relaxation, exercise, structured sleep and support.
Often it is helpful to engage in therapy to support the changes that need to be made; changes in our thinking, feelings and behaviour. Cognitive Behavioural Therapy (CBT) or Mindfulness based Cognitive Therapy have shown to be very helpful. Both these therapies focus on resolving emotional and behavioural problems and disturbances. In therapy clients usually learn and begin to apply this premise by learning the A-B-C-model of psychological disturbance and change. The A-B-C model states that it normally is not merely an A, adversity (or activating event) that contributes to disturbed and dysfunctional emotional and behavioural Cs, consequences, but also what people B, believe about the A, adversity.
A, adversity can be either an external situation or a thought or other kind of internal event. In short if we can change our thinking, our feelings and behaviour will change automatically.
At this stage understanding the medical science behind stress and the brain or understanding what psychological disturbance and the treatment of it is, is not so important. What is important is to recognise that stress is often not a sign of weakness, but a sign of strength and doing something about it is taking responsibility.
There are several advantages of therapy and in particular CBT. It is a therapy that predominantly looks at the ‘here and now’ – the problem today rather than looking too far back into history or childhood. It helps the client to understand the origin of the perceived threat and this ‘informs’ the pre-frontal cortex (the part of the brain that deals with logic, inference, problem solving and planning). By challenging the client’s beliefs the amygdala is dampened down (the part of the brain that gives the rough and ready immediate responses that are not always appropriate). In addition new coping strategies for dealing with stress can be learned and the client can begin to enjoy a new life with reduced or normal levels of stress.
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