JEFFREY MISHLOVE, Ph.D.: Hello and welcome. Today we're going to be examining one of the major factors that affects modern life, and that is stress. Stress is something which is reported throughout our environment. It is something which is being discussed more and more as part of our own physiology, and responsible for our health and well being. Yet what is stress, really, and what kind of control do we have over stress? We're going to be examining the topic of stress management, and my guest, Dr. Janelle Barlow, is an expert on stress management. She's been teaching stress management to business executives for over ten years now. She is the chief trainer in the United States for Time Manager International, the largest European management training company, and she is also the author of a management training manual called The Stress Manager. Welcome, Janelle.
JANELLE BARLOW, Ph.D.: Thank you.
MISHLOVE: It's a pleasure to have you here.
BARLOW: It's nice to be here.
MISHLOVE: Let's talk about stress specifically. Many people have heard of the fight-or-flight syndrome, when you get really tensed, and you don't know quite what to do. That's been rather specifically delineated at this point in time, hasn't it?
BARLOW: Yes, it was, by Walter Cannon. That was a number of years ago, and it's pretty well stood the test of time. Basically what happens is that when the body is exposed to something from the outside that it feels it needs to get activated towards, then the brain does that for the body automatically.
MISHLOVE: But more than just arousal.
BARLOW: Oh yes, more than arousal, that's right. The whole purpose of the stress response is to enable the human to survive.
MISHLOVE: For example?
BARLOW: Well, for example, if a dog attacked you -- that's much more reasonable than the tiger that's always talked about -- if a pit bull came after you, your body would need to do certain things for you to survive. If you're nearly killed in a car crash, your body needs to do certain things, to enable you to organize yourself in such a way that you can survive. So basically it's a survival response.
MISHLOVE: In other words, people's hands get cold because the blood leaves the extremities, in case a tiger might bite them off, or something of that sort.
BARLOW: Well, it's basically to protect the body's blood supply, and also the blood needs to go to specific places. That's the technicalities of it.
MISHLOVE: So the stress response is a normal human response.
BARLOW: Absolutely. You know, I talk with a lot of people about it, and they say, "Well, maybe we can get rid of it." But if you got rid of it you wouldn't be human. It's part of defining who we are, is to have this response.
MISHLOVE: And you in your work focus in on the practical things that people can do in dealing with stress in their lives. You're a trainer, you're not really a research scientist.
BARLOW: That's right.
MISHLOVE: When you work with people, I think one of the most important things that comes up is their awareness of whether or not they're having a stress response, and just how it manifests for each individual.
BARLOW: That's right. The awareness, in my mind, is the biggest part of the battle. If you can get people to be aware of how they're responding, because in today's world -- and there's quite a bit of research now to support this -- it seems as if the things that are really getting to us are not the big things, the identifiable, big things. It's the little tiny things that go on all the time. It's missing a parking place; it's the person in the grocery line with eleven items in their basket and they're only supposed to have ten items.
MISHLOVE: Having the phone ring when you're trying to concentrate.
BARLOW: Or calling up somebody and you can't even hear who it is because the receptionist has been saying this name so many times, and then you get put on hold without wanting to be put on hold, and then you get disconnected, and then the computer doesn't work. There are so many small things that are going on all the time.
MISHLOVE: These things that activate or trigger the stress response are called stressors.
BARLOW: That's right, you can think about them as stressors. And then what the body does, is it does something in relationship to these stressors. That's a really useful model to have, because then you can always do one of two things. You can either change the stressor, if you can, but sometimes you can't; or you can change the way that you respond to it. And you probably always have something you can do about that.
MISHLOVE: So would you say then that stress always exists in the body, not outside of it?
BARLOW: Well, stress is a definition of what humans do in relationship to something else; so yes, it is inside the body. The stressors are outside the body, and that's what the body is responding to.
MISHLOVE: Now, when a person is experiencing a lot of stress, does that mean they're not managing their stress response very well? For example, two people under identical conditions -- one person might be fuming, and with hunched shoulders, and barking at people, and another person might appear to be for all the world very relaxed.
BARLOW: Well, they may be, and then it's a question of how they're processing this particular event inside their minds, because you can put people in exactly the same situations, and they will have totally different responses to it. I always remember a story I saw on television once, about the mudslides that were taking place in Southern California, and a TV interviewer coming up to one man whose house had been destroyed. His reaction was what you would typically expect. He was very upset; his house had been destroyed; what was he going to do? The government should do something about this. He was crying. It was a very strong presentation for the evening news. Then the reporter went down the street to another man who had suffered the same fate, and his response was a little different. It was, "Well, my family got out all right. We can save a lot of this stuff. It's been buried in the mud, but we can dig out the pictures." And then his last comment, which was the telling one, was, "You know, I've always wanted a third bedroom." The same situation, and a very different response.
MISHLOVE: In other words, the attitude with which we approach life actually seems to affect the way our physiology reacts towards outside stress.
BARLOW: As long as it's a social stressor. When it's a physical stressor, then I'm not so sure that that's true. For example, if you put people in a sauna for three hours and the temperature is close to two hundred degrees, I don't know how many people could control their response to that. That's a physical stressor. But primarily today we're dealing with social stressors in any case, so the physical question is sort of moot.
MISHLOVE: One thing I've heard a lot about is the Holmes-Rahe Scale. This is a list, I understand, of social circumstances that people go through in their lives, and they're rank ordered according to how much stress they typically induce.
BARLOW: Right. For example, the death of a spouse was given one hundred points.
MISHLOVE: That would be about at the top of the scale.
BARLOW: That was the top of the scale, that's right. There's been a lot of question about that scale. It does not show a strong correlation. If you look at the research very carefully, it's very limited in its applicability. But there have been some interesting things done with it. There's a woman named Suzanne Kobasa who did her original research in the Midwest at the University of Chicago, and what she did was she took people who had a lot of points on this scale, which would indicate basically change.
MISHLOVE: A lot of points might be getting a divorce, going bankrupt, getting fired from your job, all at the same time.
BARLOW: And other things too -- Christmas vacation, getting a parking ticket. They were also given points, but a fewer number.
MISHLOVE: Don't positive experiences also cause stress?
BARLOW: That's right -- getting married.
MISHLOVE: Getting a promotion might cause as much stress as a negative experience.
BARLOW: What the Holmes-Rahe Scale was trying to look at was change. But when you look at the research pretty closely what you see is that the correlations on that research are not so strong. You know, that scale has been in every magazine article that anybody can read, and the research is just not as strong around that as you might think. What I was going to say was that Kobasa took this study and identified people with high numbers of scores, and then she said, I'm going to look at the ones who remain healthy. Who are the people who have a lot of change in their life who remain healthy? Basically what she said is that they have high self esteem. She said they were actors rather than vegetators; when they had a problem they tended to move towards action rather than sitting with it. And they had their life goals in order; they knew what their priorities were, so when something happened they could measure it against that. They also had what the psychologists call an internal locus of control; that is, when something happened to them, they saw that they were responsible for it, rather than they were a victim of their surroundings.
MISHLOVE: In other words, people who tend to blame would be those who are holding more stress in their bodies?
BARLOW: That's right. Well, you don't have much control if you're blaming.
MISHLOVE: Let me get back to that phrase I used -- holding stress in the body. Some people, if they have a stress response, they get upset, they can get angry, they get the various physiological concomitants of that response. I suppose the shoulders move up like this, stomach tightens, throat might get dry -- different things for different people. But they discharge it right away; they get it out of their system.
BARLOW: Do they?
MISHLOVE: Well, some people do.
BARLOW: Some people do.
MISHLOVE: I know some people do. They may go out and have a run.
MISHLOVE: Or they exercise, or they go out and hit a punching bag.
MISHLOVE: They get rid of that, and then they're back to normal.
BARLOW: Then they're back to normal, and then the body can endure some more. I think it's very important for people to understand that their bodies can endure enormous amounts of stress. What the body can't endure is enormous amounts of stress for prolonged periods of time; that is to say, no break from it.
MISHLOVE: So if you hold on to it, if you get stressed and you don't know how to discharge the stress, that could be a problem.
BARLOW: That's the problem. Or you don't even know that you've got it, and that's maybe one of the big problems.
MISHLOVE: I understand in your workshops typically people are carrying a lot of stress that they're not aware of.
BARLOW: Totally. They have no idea that their shoulders are up; they have no idea that their jaws are clenched. Frequently people in my seminars will tell me that they didn't learn that they had a problem with bruxism, which is the unconscious grinding of the teeth, or the holding of the jaw tight, until they went to see a dentist, and their dentist told them that they were grinding their molars flat; only then were they aware that they were doing this. You know, it takes quite a bit to grind your molars flat, and to be unaware of this is quite a state of denial.
MISHLOVE: So this is common.
BARLOW: Very common, extraordinarily common. In fact, one of the jokes that I make in my seminars, after people list all the things that they go through, all of the indicators that they have that they're under stress, is to say to them, "You know, you may think that you're the sickest group in the world, but you're not. If you went out in the street and asked people randomly as they went by, you'd see that they've got the same problems."
MISHLOVE: So many people must go through their lives thinking that a state of living with a clenched jaw or a tight stomach or tight shoulders is normal-natural.
MISHLOVE: "Everybody does this, don't they?" Sort of like that.
BARLOW: Right. And that's how you get people dropping dead of heart attacks, and their friends will say about them, "You know, he was never sick a day in his life. How did that happen?" Well, it doesn't happen like that. You really have to work hard to destroy your heart. You have to work hard to destroy your body. It's built for the long haul.
MISHLOVE: You yourself were at one time a person who was experiencing a high degree of stress.
BARLOW: That's for sure.
MISHLOVE: You became a stress management trainer by learning how to manage and control your own stress first.
BARLOW: It came out of my own personal experience. I had heart disease as a child, and I was hyperkinetic. What I did as a child was I got out of things by getting sick and breaking bones, and it's unfortunately something I have to watch even to this day. If I'm doing something that I don't want to do, I'm very likely to fall down, and I really have to be careful about this, because my natural tendency to withdraw, my flight mechanism, is to hurt myself, and I don't like that in myself, but I have to admit that it's a part of my personality.
MISHLOVE: At one time you also had a big coffee habit, I understand.
BARLOW: Oh, I grew up with the notion that people who couldn't do whatever they wanted to do were weak, and that if you needed to sleep more than two hours a night, that there was something wrong with you. Of course people need to sleep more than two hours a night, or at least most people do. And so I just drank enormous amounts of coffee, and I ate No-Doz pills straight. I was so hyper that there were times that I literally couldn't feed myself. The food would fall off the fork because I was keeping myself in such a state of heightened awareness. I say today that I'm extremely lucky that I was in college at a time when amphetamines weren't readily available as they are today on the campuses. I have enormous sympathy for these youngsters going through the enormous stress of getting their education, and having all of these drugs available to them to take them up, to take them down, to play with their moods. It's very hard to avoid that.
MISHLOVE: So one of the ways that we stress ourselves, sometimes deliberately, is through using coffee, sugar, tobacco, alcohol, things of this sort?
BARLOW: Oh yes, the coffee especially. You sit down and the waitress or waiter comes up to you, and it's assumed that you're going to have a cup of coffee. Most people have a hard time getting started in the day without that cup of coffee.
MISHLOVE: How does that cause stress?
BARLOW: Well, what it does inside the body is it's a central nervous system stimulator, so it affects the adrenal glands, and the adrenalin makes the heart beat faster, makes the muscles get tighter, makes you think clearer, at least initially. It's if you use too much of it that is the problem.
MISHLOVE: By stimulating the adrenal glands.
BARLOW: Yes. It's a total body system response. You don't just stimulate one part of it. Everything gets stimulated. And it can happen as a result of the pressures that people put on themselves towards achievement, and that's I think where a big part of the stress comes from. In my own case, it was probably an overachiever's attitude when I was eighteen, nineteen, twenty. I graduated from high school when I was eighteen. I had my first Master's degree before I was twenty-one, and I also had my first set of ulcers. I was in pretty bad shape. It was in 1972 that I finally made some decisions to change my life, and it was done because doctors told me that I wouldn't live to forty if I didn't do that, so I got motivated to change my life. And what I found, which has been the most interesting thing in the whole field of stress for me, is that you can learn how to manage your stress without having to reduce the amount of activity that you have in the world. You don't have to become a low achiever to manage your stress well.
MISHLOVE: Well, you're certainly an example of a high-achieving person who does, I presume, manage their stress.
BARLOW: I think I'm managing my stress well. I'm forty-four now, and I think that I'm in better shape than I've ever been before; at least it feels that way. But I can also feel, because I do a lot of traveling in my work, I can feel when it gets out of control for me, and if there's one advantage I have that maybe other people don't have, it's that, because I teach this subject, I'm constantly monitoring, constantly aware as to what my body's doing, so I don't let it get to a point where I'm out of control.
MISHLOVE: So your first rule, if you were to tell people how to handle their stress, would be just to be aware of it.
BARLOW: Exactly. There was a study done at Stanford Medical Center a number of years ago now. It was quite a telling one, in which they were interested in why so many people had lower back pains. It's the number-one cause of disability in the United States, lower back pains -- lower back injuries or pain to such a point that the person has to quit their job. So they were interested in this, and how they conducted the study was to put a belt around the participant's hips, and on one side of the belt was a sensitive biofeedback device which would measure muscular contractions. It had electrodes which came around and attached to the lower back. When the lower back got tight to a certain degree, the machine registered this, and then it emitted a high-pitched sound, something like this: "Eeeeeeee." At this point the participants were instructed: "Go to this side of your belt, take off the pad of paper and pencil and write down what you were doing." It was very clever. Then they could say if somebody walked by somebody's office, that person was the stressor; if it was the telephone -- it was a very good attempt. But the problem that the researchers ran into was that after three weeks they had to discontinue the study. Now, it's interesting to get people to guess why the study had to be discontinued.
MISHLOVE: I suppose it was because it was going off all the time.
BARLOW: That's what most people will say, or they ran out of paper and pencils because there were so many stressors. But the answer is that the beeper stopped going off; in other words, the participants stopped tightening their lower back.
MISHLOVE: In other words, because they were becoming aware, through this process of biofeedback, which is what you've set up here. Through awareness we can learn to relax.
BARLOW: That's right.
MISHLOVE: And I guess relaxation itself is the antidote to the stress response.
BARLOW: Letting go of it, yes. Relaxation doesn't have to mean sitting down with your eyes closed for twenty minutes, or taking a nap. It doesn't have to mean that. Once people learn how to do simple relaxation techniques, and if they are aware, so they don't let it get too bad -- because if it gets really bad, you need to take a vacation; sometimes people need to do this -- but if you have it just a little bit and then notice it and let go of it, and have a little bit more, notice it and let go of it, that's what the body's really built for.
MISHLOVE: Just as we can consciously tighten up, we can also consciously let go.
BARLOW: Right, but you need to know that you're tight. That's what people have a hard time with.
MISHLOVE: There's a lot of research lately, isn't there, that suggests that the immune response is related to the stress response.
BARLOW: But that's not just lately; that's been known for some time. Hans Selye, the father of the concept of stress, the Canadian who died a few years ago -- that was part of his original research. Definitely the immune system gets involved with it. I think maybe what you're referring to in terms of recent research is there's a lot of connection with this -- identifying, for example, somebody's in a bad marriage, and seeing if their immune system is affected by this, and yes, it is. One of the glands in the body, the thymus gland, which is partly responsible for the production of white blood cells, actually atrophies when a person is in a highly stressed state for a long period of time.
MISHLOVE: I suppose if a person, even if they're not in touch with what their body's doing, if they're chronically feeling depressed --
MISHLOVE: -- or tired, that would be indicative of a stress response.
BARLOW: Or their emotions are out of control; that would be another indicator. You know, it's probably safe to say, when people look at the question of does stress cause illness, because that's still a controversial question, it's probably safe to say -- well, let me put it this way: You can't say that stress causes illness; that would be an overstatement of what stress does. But in every case where you have illness, what you'll probably see is something, some piece of stress is involved with it.
MISHLOVE: Stress could certainly exacerbate that sort of thing.
BARLOW: That's right.
MISHLOVE: A concept that you use frequently is the notion of self talk, monitoring your self talk. How does this relate?
BARLOW: Well, our self talk affects what we think about a situation. A way to look at it is that when you're dealing with a social stressor you're not really looking at reality; what you're looking at is your interpretation of that reality, and your self talk is that interpretation of that reality. So you could have -- well, here's an example. There's a woman that I read about in the newspaper that caught my eye -- fifty-six, widowed for the first time, which is when the average woman in this country is widowed for the first time, incidentally. Her children were grown, and she decided she wanted to fulfill a long-term fantasy, which was to become a Roman Catholic nun. She agreed to do this on one condition, which was that the convent that she joined would allow her to work in a Mexican jail. Now, most people would say, "Do everything you can to avoid being in a Mexican jail." Well, this woman's self talk about being in that Mexican jail is obviously different from somebody's self talk who's trying to avoid being in that Mexican jail.
MISHLOVE: In other words, if you're constantly involved in situations, and your mind is always saying, "This is horrible. This is terrible. This is bad."
BARLOW: "This is a problem." A piece of research done on that, that was very simple -- they looked at people who used the word problem; they looked at people who used -- it could be any number of phrases, but something along the line of, "This is an opportunity." For example, people who said, "We've got a problem down in Marketing," or, "We've got a problem with that person over in the typing pool," versus the people who said, "You know, there's a situation down in Marketing that deserves our attention," or, "There's somebody over in the typing pool who needs a little more careful supervision now." Those people who used the latter phrases had a reduced stress response compared to the people who identified their situations as problems. A simple shifting of a word seemed to make a difference in a person's reaction to the same situations, and that's why self talk is important.
MISHLOVE: You know, one of the intriguing things I find in the field of stress management in general is that there are people like yourself who are now going into corporations and teaching corporate executives to do things that would have once been considered unthinkable, like meditation.
BARLOW: Right, yes.
MISHLOVE: Let's talk about the role of these kinds of practices. What do you recommend, beyond what we've discussed already?
BARLOW: Well, let me just talk about how unusual it is, for just a second. Ten years ago, or eleven years ago, when I first went into businesses, I think I may have been one of the first people to go in and do practical workshops. There may have been somebody else, but I'm not aware of them. Now everybody is getting on the bandwagon and offering stress management courses. It's not considered a weakness to go to a stress management course today.
MISHLOVE: No, it's standard management training.
BARLOW: That's right, and everybody wants to hear about it. Even if they've heard about it before, they want to hear about it, because they need to be reminded. And people are very receptive to a wide variety of strategies. What I do in my programs is I try to hit as many different people's needs as possible. Some people want to hear about exercise; we talk about that. Some people want to do relaxation exercises, and we do relaxation/meditation kinds of exercises. I put a heavy emphasis on what I call quick-and-dirty techniques, things that people can do without taking time -- things that you can do in a meeting, for example; teaching people how to breathe with their eyes open, to relax their diaphragm, to relax their muscles, simple kinds of things. Because people aren't going to do difficult things.
MISHLOVE: One of your techniques, which I think is quite remarkable, is just to put little reminders up in certain locations, near the telephone or the refrigerator, reminding people just to watch their level of stress, watch their breathing.
BARLOW: Right, because it's so easy to make yourself relaxed.
MISHLOVE: I suppose one or two deep breaths can really make a big difference.
BARLOW: Absolutely. It starts the cycle of moving towards the parasympathetic nervous system response, the relaxation response. Just as something can move you into the stress response, something can start to move you out of it.
MISHLOVE: What about people who come and tell you that they find that their religion or their spiritual approach is the way that they manage stress?
BARLOW: I have no problem with that. I think that's totally appropriate. If you look at certain countries -- Haiti, Dominican Republic, where there's tremendous poverty, a tremendous amount of environmental stressors that these people are facing -- they have very, very low cardiovascular problems, and it seems to be their religious attitude. That's self talk.
MISHLOVE: That's interesting.
BARLOW: It's their religious attitudes that seem to be keeping them from some of the degenerative diseases that we face in the United States, for example.
MISHLOVE: In other words, if they have an attitude of pride in what they do, and a feeling of connection, of harmony somehow with the universe, through their religion, that's a stress management tool.
BARLOW: That's right, because then they can endure. If you perceive your burdens, as some religious people do, as opportunities to bear a cross, well, then that problem is not a problem. Some people have handicapped children; they look upon the child as providing an opportunity for them to learn how to love. It's just different self talk about a situation that could destroy a family.
MISHLOVE: Well, stress seems to be something that's increasing in the environment. We hear more and more about toxic chemicals in the environment, about air pollution, about water pollution, in spite of twenty years of environmental efforts. It seems as if these kinds of skills, which have in the last ten years just been moving into the business community, are going to have to become more widespread in our culture, because the amounts of our stressors are not decreasing.
BARLOW: Right, but what you were just listing were a bunch of physical stressors, and ultimately I'm not so sure that these strategies will work against a preponderance of physical stressors. That in my mind is a totally different subject.
MISHLOVE: You can't breathe away toxins in the environment.
BARLOW: Maybe you can, but you'd have to do a lot of breathing.
MISHLOVE: At some point you have to try and attack the stressor directly.
BARLOW: That's right.
MISHLOVE: You have to make a decision as to what you can deal with internally, and what you want to deal with through political and social action.
BARLOW: Right. But for example, most of the social stressors are here to stay -- for example, economic instability, differences between races, differences between us socially, religion. Those things aren't going to go away. The crowdedness, that isn't going to go away. So we have to learn how to adjust to some of these things -- deadlines that people face in their businesses; the fact that American business today is getting leaner and leaner staffed; people's jobs are getting larger and larger, with fewer and fewer resources to do them.
MISHLOVE: Merger mania.
BARLOW: And we have to do it to stay competitive.
MISHLOVE: The pressure to be more efficient is a source of stress.
BARLOW: That sort of thing you really can't do anything about, so what you have to do then is to learn to accept it, and learn how to gauge your own response in relationship to it.
MISHLOVE: Dr. Janelle Barlow, it's been a pleasure having you with me. You've really exemplified, not only through your discussion, but in your life itself, what it means to manage stress.
BARLOW: Thank you.
MISHLOVE: Thank you very much for being with me.
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