DOCTOR IS IN: The Stress Sandwich

BY CHARLES RAISON, MD

Assistant professor of psychiatry, clinical director of the Mind-Body Program, and director of the Behavioral Immunology Program in the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine.

Stress is everywhere today, both in our private and public lives, but also relentlessly in print, with discussion after discussion regarding what it is and what can be done to ease it. At the risk of adding to the din let me touch upon one aspect of stress here that has implications for ways we can reduce its bad effects in our lives.

Think of stress like a sandwich. There’s a piece of bread on the top, a piece of bread on the bottom and usually something tastier in the middle (except for a poor college student friend of mine who put two pieces of white bread together and called it a wish sandwich!). Think of bad stress as the bread on the top and bottom and let’s call the good stuff in the middle something like “optimal challenge.” What this analogy gets at is that bad stress is a matter of degree. The bottom piece of bread is the bad stress that comes from living too dull and routine a life. Believe it or not, studies show that being bored is itself a powerful stressor. The top piece of bread we might call “being overwhelmed”—this is the stress that comes from feeling like life is asking more from us than our emotions can handle. Being overwhelmed comes in lots of flavors from being just too darn busy to being terribly traumatized by war.

One trick for dealing with stress is to try to stay in the middle of the stress sandwich in the meat of life, what I’m calling “optimal challenge.” If you are interested in this idea let me recommend the classic view on the topic “Flow” by Mihaly Csikszentmihalyi. The basic idea is that you see what’s in front of you as a challenge, neither boring or threatening, difficult enough to keep you fully engaged, easy enough for you to accomplish your goals.

Some people find it much easier than others to live in this state of optimal challenge, and research suggests they have especially long and fulfilling lives, other things being equal. But all of us can do simple things to increase the amount of time we are in life’s sweet challenge spot. Basically it boils down to this. If you are stuck in a boring routine, actively look for things you can do to introduce novelty into your life. This doesn’t usually require massive life changes. Start by trying to do one thing you really like doing for its own sake once a week. If you are living with feelings of being threatened or overwhelmed by the world try this: Instead of focusing on the large problems facing you, attempt to break the problems down into the smallest pieces possible and focus on the little pieces. All large problems have many smaller pieces that can be addressed and solved individually. Because they are smaller, these little sub-problems are more likely to feel challenging and less threatening.

More about Dr. Raison

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