The Center for Creative Leadership’s 2013 White Paper on “The Surprising Truth about What Drives Stress and How Leaders Build Resilience” lists stress and burnout as the top two issues leaders worldwide wrestle with. “Burnout” is a syndrome caused by excessive stress which can produce physical, emotional and mental exhaustion. Burnout is the end game of deepening stress.
The Devastation of Constant Stress
The effects of prolonged stress on our bodies and our minds are well documented. Rather than experiencing just a shot of cortisol, the fight or flight hormone that revs us up to deal with a problem, uncontrolled stress can put us into constant cortisol overload. Abdominal fat builds up, we become insulin resistant, our arteries stiffen and blood pressure rises, heart rate and blood flow increase, often damaging and eventually blocking vessel walls, all putting us at higher risk for coronary disease. We may speak more loudly or experience lapses in judgment or logic. Hands and feet grow cold as blood rushes to the body’s core. Research shows the heart often beats erratically, spiking again and again. White blood cell production and therefore immune functioning is impaired, making us more likely to succumb to all sorts of illness.
Just the avalanche of negative thoughts that stress can provoke can impact our health. In Mind Over Medicine, a book about the power of placebos, Dr. Lissa Rankin found that negative thoughts have physiologically damaging impacts while positive thoughts set off the release of powerful healing hormones and neurotransmitters, such as dopamine, nitric oxide, and endorphins into our blood stream. “Our bodies’ natural repair systems can’t work properly if we’re chronically stressed or pessimistic.”
A 2004 study conducted by Dr. Elissa Epel and Dr. Elizabeth Blackburn of the University of California at San Francisco found the first piece of biological evidence establishing a direct link between high stress levels and rates of aging– those suffering from long-term stress had shorter, more deteriorated telomeres (a piece of DNA that is found at the tip of chromosomes in each cell in the body). According to Denis Novack, Professor of Medicine and Associate Dean of Medical Education at Drexel University College of Medicine at Drexel University, “there is no such thing as a separation of mind and body — the very molecules in our bodies are responsive to our psychological environment.”
High stress unequivocally reduces our intellectual functioning. According to researcher Coutu in a 2008 study, “Stressed people don’t do math very well. They don’t process language very efficiently, and they have poorer memories, both short- and long-term.” Math and language abilities can drop as much as 50% because of excessive stress. As Rick Hanson PhD, a California-based neuropsychologist, explains, “stress is like fine sand being drizzled into the brain. It might keep working, but if you dump enough sand in there, it’ll freeze up at some point.”
Stress also exacts an emotional price, which in turn can be physically and intellectually debilitating. Researchers are finding that emotional pain produced by stress is felt and processed in the brain just as physical pain is and in the same area, the anterior cingulate cortex. To the same extent that physical pain is debilitating, so is the emotional pain associated with depression, substance abuse or disengagement that stress can cause.
Stress has an outsized impact on our organizations’ productivity and profitability, as well. According to an article in the HBR, a Gallup survey found disengagement and stress to be major inhibitors of productivity and retention. “The American Institute of Stress reports [in 2013] that stress is the main cause underlying 40% of workplace turnovers and 80% of work-related injuries, costing companies millions of dollars annually.”
The typically high stress in the American workplace has been exacerbated by the recession and high unemployment rates. According to a Forbes article, another Gallup poll “indicated that ‘U.S. Workers are Least Happy with Their Work Stress and Pay’ out of 13 aspects of work conditions. Well over a third of those surveyed said they were ‘totally dissatisfied’ with the amount of on-the-job-stress…” In a 2012 StressPulseSM survey by ComPsych Corp, which provides employee assistance programs, 63% of the employees polled said they had high levels of stress with extreme fatigue and feeling out of control. According to Dr. Richard A. Chaifetz, CEO of ComPsych, ‘people who currently have jobs – many of whom have taken on extra work – are starting to show signs of prolonged stress. This can result in burnout and reduced performance.’”
One study found that those who are depressed are particularly hampered in their ability to recognize and therefore manage their and others’ negative feelings, including the very feelings that are fueling their depression. An interesting NIH-funded study published in 2011 in Psychosomatic Medicine also found that in people with high blood pressure, “the emotion-recognizing ability [is] reduced… even after taking into account medication use and other factors.” Leading to “emotional dampening,” hypertension evidently “reduces the ability to recognize anger, fear, sadness, and other emotions in people’s faces.”
Whether caused by one’s own depression or high blood pressure, this emotional dampening can lead to further difficulties. According to the authors: “In complex social situations like work settings, people rely on facial expressions and verbal emotional cues to interact with others. If we have emotional dampening, we may distrust others because we cannot read emotional meaning in their face or their verbal communications. We may even take more risks because we cannot fully appraise threats in the environment.” The authors believe that emotional dampening may be implicated in clinical disorders of emotion regulation, such as bipolar disorders and depression.
A recent article in the WSJ points out that our stress can also have adverse consequences on those around us, as well. When under stress, subjects in an experiment were less likely to “feel another’s pain.” As one of the researchers note, “It’s rare to find individuals in whom stress brings out the best—fostering calm, rational thinking, deep humanity and the notion that strangers are just friends you’ve yet to meet. More typically, stress literally and metaphorically narrows our field of vision; it tends to makes us less generous and cooperative in economic games, more xenophobic, more likely to interpret ambiguous expressions as hostile ones, and more likely to displace frustration and aggression onto those around us. As this new study on the biology of stress found, it also makes us less likely to feel someone else’s pain.” Burnout’s emotional exhaustion has also been demonstrated to produce negative attitudes and lowered empathy, and to lead to depersonalizing clients and colleagues.
It is no surprise, then, that one of the tragedies of stress is that the debilitation it causes often robs people of their ability to be securely connected socially, which in turn produces further anxiety and depression and debilitation. “People who feel more connected to others have lower rates of anxiety and depression; studies show that they also have higher self-esteem, are more empathic to others, are more trusting and cooperative and, as a consequence, others are more open to trusting and cooperating with them. Social connectedness therefore generates a positive feedback loop of social, emotional, and physical well-being. Unfortunately, the opposite is true for those who lack social connectedness.” So, for example, “[d]ampening of positive emotions may rob one of the restorative benefits of close personal relations, vacations and hobbies.”
Sound familiar? Lawyers have higher rates of distress–in large part arising out of poorly managed stress– than any other profession. The debilitation that many lawyers experience because of their distress may further exasperate their professional and personal functioning, which then in turn fuels their distress.
Stress for Good
There is, however, a good side to stress. People experiencing beneficial or “adaptive” stress feel pumped. The blood vessels dilate, increasing blood flow to help the brain, muscles and limbs meet a challenge, similar to the effects of aerobic exercise, according to research by Wendy Mendes, an associate professor in the department of psychiatry at the University of California, San Francisco, and others.
Finding the right balance between the kind of stress that produces optimal performance and that which devastates is one of the better tricks for all professionals to learn.
There are a number of steps to take to try to rein in the negative effects of stress. Recognizing when one is highly stressed, and the triggers that produce it is a start. Being able to step back enough to decide how best to deal with a stressful situation or person is a good next step. Focusing on positive thoughts during the stressful event and then making sure that you recharge or rest afterwards help moderate the constancy of stress. Deep abdominal breathing and training in meditation and mindfulness, which help develop an ability to regulate one’s own mental and physical states, also help moderate stress.
Creating constructive emotional states, such as a sense of having control, has been demonstrated to be important in effectively dealing with stress. Hundreds of people participating in Harvard’s executive-education programs reported less stress and anxiety than did the general population and were also found to have cortisol levels comparable to the average levels of the general population. “Moreover, the higher their rank and the more subordinates they managed, the lower their cortisol level.” Why? “Most likely because the leaders had a heightened sense of control—a psychological factor known to have a powerful stress-buffering effect.… Such leaders face troubles without being troubled. Their behavior is not relaxed, but they are relaxed emotionally.”
Setting positive expectations of stress can also ameliorate the bad and promote the good impacts. One study coached college students to believe that feeling nervous or excited before a presentation could improve their performance, and in fact it did, and they also had increased dilation of the arteries and smaller rises in blood pressure compared to the control group. In a similar study, students who received the same coaching before taking graduate-school entrance exams posted higher scores on a mock test in the lab and also on the actual exam three months later. They also posted higher levels of salivary amylase, a protein marker for adrenaline that is linked to episodes of beneficial stress.
As one legal consultant has pointed out, stress is no doubt with us always but we can still watch and learn–and manage our attitudes about stress, sometimes even to hilarious effect.
Many workplace wellness programs have begun coaching people on how to hit an optimal performance zone with enough stress to stimulate success but not take a physical or psychological toll. Has your firm taken that important step?