Disturbances in the interplay between man and man's environment is called stress. We meet such challenges by trying to produce more - or by withdrawing ("fight or run"). Stress reactions will be released in the body by these reactions. The whole human being is influenced by these reactions,- we change behavior and physiological reactions can be observed.
Man's adaption to today's environment must be seen from an evolutionary point of view. The adaption is poor. It took us millions of years of development to become the species we are to-day, and in most of this time lapse the conditions for survival have been quite different than the conditions we meet to-day. The basic requisitions for the survival of our ancestors were mostly of physical nature. To-day's challenges are mostly of psychological nature. The physiological stress reactions - being influenced by the stress-hormones adrenaline, noradrenaline and cortisol - enabled our ancestors to be ready for physical efforts : Fight or flee! The psychological challenges of to-day will release the same stress-reactions, but we do not start the reactions which are designed to rid us of the stress-hormones : Physical action.
VibroAcoustic therapy can help us to reduce the effects of these "un-necessary" physical reactions in the same way as f. ex jogging is contributing to prevent the negative effects of stress. This "silent jogging" is also suitable for persons who, by any reason, are unable to use physical exercise as a stress-reducing procedure.
Health danger?
How are we influenced by stress-hormones? Do they help us to cope with the challenges we meet ? Are they threatening our health?
There is no simple answer to these questions, but we can say that stress-hormones are facilitating our adaption to the demands we meet, and that they are necessary for maintaining our capacity to cope with stress. But - in the long run the effects may be dangerous. An increasing number of research reports point out that frequent or long-lasting increase of the content of stress-hormones in the blood may lead to structural changes in the blood vessels. This may, in turn , contribute to increase the risk for coronary diseases.
We are marked by our work.
Most of us are spending a large part of our adult life at our working place, and the work we do is influencing us in various ways. Rigid and supervised job situations give the greatest risk for high values of stress-hormones in our blood - caused by helplessness, reluctance and a feeling of being deserted. A job which permits control and possibility to influence the working process will, on the other side, be recognized as a positive challenge. People in such jobs usually ave a good health. They can exert influence on their own working situation in such a way that they achieve harmony between their own abilities and the demands they meet in their job. People who have no possibility to take initiative in their jobs often risk to be passive also in their free time.
A MODEL DESCRIBING STRESS
The demands of the environment is received by the brain from our senses. The brain evaluates if we can meet the demands, and what level of alertness our body needs to cope with the task. Our body is more adapted to the life situation of our cave-dwelling ancestors than it is adapted to the modern society. Therefore we find that our stress-reactions often are more harmful than useful. Our brain is tuned in to reactions which are not socially acceptable in our civilized society.
THE BRAIN WANTS THE "JUST RIGHT" STIMULI
The brain needs a certain amount of impressions from the environment in order to function well. Too little or too much input will disturb the brain centres which are responsible for our being awake. the "just right"-zone is varying from person to person. Unfortunately, many persons are forced to spend a large part of their lives outside of the zone, in which they might develop their potential to the optimal extent.
AM I ABLE TO COPE WITH THE DEMANDS FROM THE ENVIRONMENT?
A person who reaches equilibrium between the demands from the environment and own abilities will not be hurt by stress. On the contrary - one will feel "glad stress" and satisfaction with one's work. If, however, the demands exceed the abilities , the equilibrium will be disturbed, and the stress will be felt as something unpleasant. One way to re-establish equilibrium may be to give the person education which will increase his professional qualifications. Another way is to give the person stimuli which enables the body to get rid of the waste products from the stressful situation. VibroAcoustic therapy is one method of giving such stimuli. -A combination of the two approaches will probably give the best results.
THE "BUFFERS" WHICH PROTECT US
Control and influence over the job situation are key words concerning coping with high demands without exposing the body for too much wear and tear. Another important "buffer" is human support. Togetherness and support from other people can protect us against the harmful effects from stress.
VibroAcoustic therapy can give stimuli which both gives the body the possibility to rid itself of waste products and - through the conversation before and after each treatment - give human support to each client.
Individual treatment, using the equipment in connection with the health service at the working place, combined with discussion groups may also contribute to obtaining a good result.
OUR REACTIONS ARE DIFFERENT
We are all different, partly due to our genetic heritage and partly because of all our life-long experiences which influence us in various ways. There is, f. ex. a difference between the reactions of men and women to stress.
WHAT IS THE LONG-TERM EFFECT
Mental exhaustion may increase the risks for catching a somatic disease, but we still do not know exactly which biological mechanisms which lie behind this phenomenon. The scientists agree, however, that there is a connection between stress and diseases such as myocardial infarction, hypertension, gastric ulcers, asthma and migraine. Our mental well-being and effectivity will be influenced. Understimulation makes us passive and we feel aversion and fatigue - which also may have effects on our free-time activities. An interesting job is often accompanied by a rich and active free-time life.
VibroAcoustic therapy - in combination with correct counselling - can contribute to dissolve problem-filled situations which, for the client in question, may appear to be locked.
THE STRESS-SITUATIONS OF THE PAST..
The stone-age man has slowly evolved to be the man we find to-day through an environment which has been fairly constant through millions of years. It was important to be able to fight or to escape by fleeing when a danger was threatening. The body was prepared for a physical effort.
..AND OF TO-DAY
Man has, during the last centuries, changed our environment with an incredible speed by the help of technical development. The demands of to-day are more of mental than physical nature, but our body still reacts in the "stone-age way" when it interprets a situation as being dangerous,- but the body does not react accordingly.
THIS IS HOW THE PRODUCTION OF HORMONES START..
The demands of our environment is processed in the cerebral cortex which sends signals to hypothalamus in the mid-brain.
Hypothalamus regulates many important functions, f.ex. temperature, liquid balance in the body and the intake of nutrition. From here the message is passed on to the glandulae suprarenales via two ways,- via the hypophysis cerebri to the suprarenal cortex and via the sympatic nervous system to the suprarenal medulla.
The hypophysis cerebri is a gland in the brain which regulates many other hormone-producing glands.
The sympatic nervous system is activated when one perceives a situation as being dangerous, and prepares the body for fight or escape.
The hypophysis cerebri emits hormones which stimulate the suprarenal cortex which is stimulated to excrete the stress.hormone cortisol which is carried out to the body via the blood-stream.
The suprarenal medulla consists of transformed nerve cells of the sympatic nervous system. Here adrenaline and noradrenaline are produced, which are spread to body tissue in order to prepare the body for fight. Noradrenaline is also excreted at the ends of the sympatic nerves.
..WHICH INFLUENCE US IN VARIOUS WAYS
Cortisol influences and stimulates the immune defense system and counteracts inflammations. Noradrenaline constricts the blood vessels and makes the blood pressure rise. Cortisol has an effect on the metabolism of carbohydrates, lipids and proteins in all body tissue.
Adrenaline decreases the supply of blood to the inner organs, f. ex. the digestive organs, and conducts blood to the muscles. Adrenaline increases the pulse and the performance capacity of the heart.
THE STRESS-SQUARE
HEAVY STRESS - AND GLAD STRESS
The capacity to choose between alternative ways of action is specific for the human being. We are able to plan in advance and to foresee the consequences of our actions and hold advantages and disadvantages up against each other. When we are using this ability manage to cope with stress, it may be that it is the "glad stress" which is prevailing.
The heavy stress comes when we are unable to choose by ourselves, but are passively forced to accept situations full of strain.
The main components in the feeling of stress are tension and discomfort. In our everyday life we often find the two simultaneously. There are situations in which tension can fill us with joy and satisfaction. In other situations the feeling of discomfort and failure get the upper hand, and we may just surrender.
The content of stress-hormones in the blood is influenced by these experiences. When we feel discomfort and helplessness, the contents of cortisol and adrenaline in the blood increase. When we feel positive tension, the level of adrenaline is increasing, while the level of cortisol is kept low. When we feel mental well-being we have a better chance to cope with strain without harming our health. This may be because the production of cortisol is resting. Cortisol is supposed so increase the sensitivity of the blood vessels for the harmful effects of adrenaline and noradrenaline.
THE HUMAN FACTOR
In industry we find that much of such stress which comes from heavy and dirty tasks has disappeared after we began to use the new technology. But, when the work was made automatic and the human functions mainly consist of surveillance and control, different, but just as difficult, moments of stress may appear. The person who controls a process needs very seldom to take any action during normal circumstances, and the level of alertness decreases. At the same time, the operator must be alert and ready for immediate action. When a disturbance appears, the operator must change from passive surveillance routines to concrete actions. Both the understimulation and the overstimulation the operator is subject to in such situations increase the risk for incorrect actions. When incorrect actions lead to accidents, we call this "the human factor".
HUMANE JOBS
There is no simple recipe for obtaining satisfaction over one's work, but we know that control over one's own situation counteracts discomfort and increases the positive tension. When one is able to exert influence on one's own situation, we can define the best way of creating meaningful jobs.
The employee must have possibility to have influence over his work,- to feel his activity as a meaningful link in a greater context,- to feel togetherness with others in his work - and - to be able to develop his own ability and professional skill.
ACTIVE DISCOMFORT (cfr. stress-square)
This is typical for the grey every-day stress which many persons feel in their jobs. It is accompanied by high levels of adrenaline and cortisol in the blood. We find this type of stress in situations in which the persons are tied up and pressed to high productivity without capability to influence their own situation. This is typical for work at the production line or for monotonous supply of informations into computers - a "mental production line".
Very monotonous work has a tendency to "adhere" and not release its hold on the person after working hours. The work is also throwing its shadows over the free-time. Stress-hormones and blood pressure keep lying on an elevated level. Now it is time to kill the presumption that a monotonous working situation can be compensated by rich free-time activities. A job which restrains own initiative and denies the workers' insight and influence. makes them passive also in the free-time,- a kind of acquired helplessness. Stress may, besides being a burden in itself, create passivity and make it more difficult for the individual to change the conditions which create the stress - a vicious circle.
Stress-hormone reaction: Adrenaline increases much
Cortisol increases to some extent.
PASSIVE DISCOMFORT (Cfr. stress-square)
The cortisol and adrenaline levels increase. Here we find the heavy stress which is recognized by passivity and resignation. The wear and tear on the body may be greater during passivity than during the performance of drab and slow work. The unemployed are in the risk zone.
When one during a long period of time has had no possibility to change or influence one's situation, we may see a situation which we in psychological terms call "acquired helplessness". It is no use trying, and one becomes passive - even if the possibility for change is present. When one has learned this helplessness, it is very difficult to de-condition. It usually has a transfer-effect to other situations.
Stresshormone reaction: Adrenaline level increases somewhat
Cortisol level increases much
COMFORTABLE PASSIVITY (Cfr. stress-square)
The content of stress-hormones is low, and we feel very much at ease. Periods with comfortable passivity enable us to collect new resources in front of the coming tasks. When one is rested and in good form, one has a more effective resistance against stress. It is f. ex. easier to relieve oneself from the strains of work after a vacation than it is just before the vacation.
Stresshormone-reaction: Adrenaline level decreases
Cortisol level decreases
COMFORTABLE ACTIVITY (Cfr. stress-square)
Adrenaline level increases while the cortisol level is kept low. This makes the danger of increased adrenaline level less dangerous. Maybe it is the low level of cortisol during situations with high control one of the reasons why the risk for coronary infarction decreases when one has good control and influence over a very demanding job.
An especially interesting group of professionals in this context are conductors of symphony orchestras. They have an unusually tough and straining job and have high control of the result of their activity. Conductors usually live longer and have better health than other professional groups. Even among top level executives we can find this connection between glad stress and good health. They do not only succeed in keeping the stress within reasonable levels,- challenges make their creativity flourish, and the stress becomes a stimulus to new initiatives.
Stresshormone-reaction: Adrenaline level increases considerably
Cortisol level decreases considerably
WOMEN'S ROLES, MEN'S ROLES, JOB'S ROLES
The well-known definitions of which roles we are playing in the game of life are dissolving. In which way is this influencing our health in the long run ? Will the role of the all-purpose androgynous man be better prepared to cope with stress?
When a man meets a challenge, he usually reacts with elevated adrenaline levels and increased blood pressure. His reaction may, as time goes by, imply a health risk.
The picture of the women is more diverse. Here we do not find the same connection between action and high adrenaline levels. A woman will usually manage to cope with the same mental activity as the man, without generating extra resources in the body. She is able to economize her resources better, while the old flight-or-flee-reaction is triggered in the male. The fact that women are coping with stress in a more economical way may be a contributive reason for the longer average life-span in women - averaging about 7 years.
THE ANDROGYNOUS MAN
The male role is strongly connected with the necessity to perform,- to show off for others. The female role is aimed towards relations between human beings and care for others. When the pattern of these roles is dissolved, more and more of us are becoming androgynous,- that is mentally bi-gendered. The androgynous man unifies "male" traits such as decisiveness and self-confidence with "female" traits such as care and empathy. In this broad spectrum, a new and versatile human role will be developed.
The androgynous human being ought to be well prepared to manage different kinds of demands. In to-day's society we can see tendencies pointing towards this androgynous role. Women conquer new professional areas which formerly have been dominated by men, while the men, in a somewhat slower tempo, move over to jobs which are considered to be female in character.
THE REALITY OF MEN AND WOMEN - HOW IS THIS REFLECTED IN THE STRESS-REACTIONS ?
SHARING THE HOUSEHOLD WORK - WHO HAS GOT THE MAIN RESPONSIBILITY ?
In a Swedish questionnaire on total work-load the participants reported how the division of responsibility for the various tasks in the household were divided. The result show that the division of responsibility mainly follow the traditional pattern of division between men and women. The women have the main responsibility for washing, ironing, shopping food, cooking, sewing and mending. The man takes responsibility for the main economy and the car.
MEN GET STRESSED AT WORK..
There is a connection between the degree of stress at work and physiological reactions. In men the physiological reactions coincide with the degree of experienced stress.- the stronger feeling of stress, the higher blood pressure etc.
In women we do not fin this connection between the physical and the psychological situation,- their blood pressure does not rise when the feeling of stress increases.
..AND WOMEN GET STRESSED AFTER WORK
There is connection between women's stress at work and the reactions in the evening after working hours. The reactions of women show a positive coincidence,. i.e. - their reactions at work have a transfer effect to their reactions in the evening. For the men this connection is low - or negative. In the men the stress-machinery goes in low gear (blood pressure and stress-hormones) even when they report that they have felt stress at work. The women bring their pressure at work with them to their homes. Maybe the stress-reactions of the body are reflecting the conflict between incompatible demands ?
Women often feel that the demands they meet at work are higher than the demands men meet. They have to achieve more in order to be accepted as equals. They feel lack of communication in the working situation and feel they have too little influence on the job they are doing. In addition to this come the demands from theirafter work duties, and this is the extra weight that makes the system go out of balance.
SUPPORT AT WORK REDUCES STRESS AND THE PSYCHOSOMATIC PROBLEMS
By giving support in different ways, the stress of the job can be reduced, thus giving both the worker and the employer possibility to cope with the demands in an active and effective way. Common for all supportive measurements is, however, that they are dependent on active measures - needing both time and/or money.
Workers who feel strong social support report far less feeling of stress than those with low social support.
It is special for women that social support reduces the feeling of stress.
Groups with weak social support show increased incidence of psychosomatic problems,- back pains and similar problems of movement, headache, mental problems, problems with heart, stomach and intestines.
Groups with strong social support report fewer of these psychosomatic difficulties.
Women over 40 years of age have markedly more psychosomatic problems than other groups of workers. Older women have more than twice as many symptoms as men and younger women. (Symptoms connected with menopause are not included in this comparison)
SUPPORT BY VIBROACOUSTIC THERAPY
A possible way of showing support is to give the workers possibility to treat and/or prevent certain stress-reactions by offering possibility to receive VibroAcoustic therapy during working hours, or in the free-time - with support from the employer. The therapy can be given either by using equipment which is bought for the benefit of the workers by the employer, or by giving economical contributions for treatment at a physiotherapist or other registered therapist using this kind of equipment in their therapy.
The employer can, in this way give positive signals to the workers that the employer cares for the welfare and life quality of the employees, and that he is willing to invest in initiatives which may reduce the stress-reactions which will be accumulated during the day at work.
THE HEALTH CARE OF THE COMPANY - AN INVESTMENT IN STAFF QUALITY
We are usually very conscious about questions concerning the physical and chemical environment around our jobs. We also know what can be done to fight noise, odours and heavy lifting operations. However, when it comes to our psycho-social environment, we meet big holes in our knowledge. The stress-factors are often invisible and difficult to define. We cannot quantify them, and therefore they are easily overlooked and underestimated. To begin building up buffers against stress is one way to start fighting this pollution factor in our working environment. We have started to recognize dynamic stress-buffers, such as social support and individual control. Such measures usually take a long time to carry out in effect, because we first have to analyze the various factors of the environment. This analysis must end in a plan for action, in which the workers also have to get involved in some way or other.
One measure which may have almost immediate effect, will be the acquisition of VibroAcoustic stress-fighting equipment, or that the employees (and leaders !) will be admitted to take part in active stress-prevention or stress-therapy during paid working hours - or paid stress-therapy in their own free-time. A combination of VibroAcoustic therapy and psychosocial stress-buffers is supposed to have the best effect.
This supposition is based on the KANSA-project, carried out in the insurance company KANSA in Helsinki, Finland by Petri Lehikoinen et al.
In 4 out of 5 stress-parameters it is found that VibroAcoustic therapy is more effective than internal support groups in the company. Both stress-reduction methods are effective, however.
This study shows that we, when the circumstances are favourable, may expect VibroAcoustic therapy to be a very effective method of fighting stress. One can expect a yearly reduction in absence from work around 1 - 2 % if we succeed in fighting the stress problems.
WE ALL NEED KNOWLEDGE ABOUT STRESS - HEALTH - JOY OF WORK
The psycho-social working environment and the health of the staff is something concerning us all, and ought to be the responsibility of every one of us. In order to get the best possible effect out of improvements in the psycho-social environment, everyone on the organisation; leaders on all levels, workers and trade union officials must have the necessary knowledge of stress-factors in order to participate in the work towards change.
It is important that all learn to understand the complex interplay between conditions at work, the total life situation and the individual capacity of each person.
It is necessary to give broad information and education on all levels in order to learn how to interpret early warning signals, and on this early level start preventive action in order to avoid harmful stress.
BIBLIOGRAPHY
Arbetsmiljöfonden (Sweden) : Stress, hälsa, arbetsglädje.
Sammanfattning av forskningsprojekt om stress
och psykosocial arbetsmiljö ledda av Marianne
Frankenhaeuser.
Lehikoinen, Petri : The KANSA project.
Manuscript, Helsinki 1988.
Skille, Olav : VibroAcoustic research and treatment
procedures.
Manuscript, Steinkjer 1988.
Skille, Olav : Manual of VibroAcoustics.
Steinkjer 1986.