Sunday, April 5, 2009

Stress, profound psychological and emotional trauma

The term "stress" had none of its current general senses before the 1950s. As a semi-psychological term referring to hardship or coercion, it dated from the 14th century. It is a form of the Middle English destresse, derived via Old French from the Latin stringere – to draw tight.
It had long been in use in physics to refer to the internal distribution of a force exerted on a material body, resulting in strain. In the 1920s and 1930s, the term was occasionally being used in psychological circles to refer to a mental strain or unwelcome happening, and by advocates of holistic medicine to refer to a harmful environmental agent that could cause illness. Walter Cannon used it in 1934 to refer to external factors that disrupted what he called "homeostasis".
A new scientific usage developed out of Hans Seyle's reports of his laboratory experiments in the 1930s. Selye started to use the term to refer not just to the agent but to the state of the organism as it responded and adapted to the environment. His theories of a universal non-specific stress response attracted great interest and contention in academic physiology and he undertook extensive research programmes and publication efforts.

However, while the work attracted continued support from advocates of psychosomatic medicine, many in experimental physiology concluded that his concepts were too vague and unmeasurable. During the 1950s Selye turned away from the laboratory to promote his concept through popular books and lectures tours.
The US military became a key center of stress research, attempting to understand and reduce combat neurosis and psychiatric casualties. Seyle wrote for both non-academic physicians and, in an international bestseller titled "Stress of Life", for the general public.
A broad biopsychosocial concept of stress and adaptation offered the promise of helping everyone achieve health and happiness by successfully responding to changing global challenges and the problems of modern civilization. He coined the term "eustress" for positive stress, by contrast to distress.
He argued that all people have a natural urge and need to work for their own benefit, a message that found favor with industrialists and governments.[18] He also coined the term "stressor" to refer to the causative event or stimulus, as opposed to the resulting state of stress.
From the late 1960s, Selye's concept started to be taken up by academic psychologists, who sought to quantify "life stress" by scoring "significant life events", and a large amount of research was undertaken to examine links between stress and disease of all kinds. By the late 1970s stress had become the medical area of greatest concern to the general population, and more basic research was called for to better address the issue.
There was renewed laboratory research into the neuroendocrine, molecular and immunological bases of stress, conceived as a useful heuristic not necessarily tied to Selye's original hypotheses. By the 1990s, "stress" had become an integral part of modern scientific understanding in all areas of physiology and human functioning, and one of the great metaphors of Western life. Focus grew on stress in certain settings, such as workplace stress. Stress management techniques were developed.
Its psychological uses are frequently metaphorical rather than literal, used as a catch-all for perceived difficulties in life. It also became a euphemism, a way of referring to problems and eliciting sympathy without being explicitly confessional, just "stressed out".
It covers a huge range of phenomena from mild irritation to the kind of severe problems that might result in a real breakdown of health. In popular usage almost any event or situation between these extremes could be described as stressful.
The most extreme events and reactions may elicit the diagnosis of Posttraumatic stress disorder (PTSD), an anxiety disorder that can develop after exposure to one or more terrifying events that threatened or caused grave physical harm. PTSD is a severe and ongoing emotional reaction to an extreme psychological trauma; as such, it is often associated with soldiers, police officers, and other emergency personnel.
This stressor may involve viewing someone's actual death, a threat to the patient's or someone else's life, serious physical injury, or threat to physical or psychological integrity, overwhelming usual psychological defenses coping. In some cases it can also be from profound psychological and emotional trauma, apart from any actual physical harm. Often, however, the two are combined.
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