Stress Care for Couples
THE CONCEPT OF STRESS
The phenomenon of “stress,” in very general terms, is a physiologic response to psychological and physical demands and threats (stressors). An individual’s unique characteristics (i.e., stressor appraisal, coping skills, disposition, etc.) and life circumstances (i.e., poverty, neighborhood environment, social support structures, etc.) also contribute to the individual’s experience. The negative health outcomes can result when the demands and threats substantially tax or overwhelm an individual’s capacity to respond. For example, obesity, insulin resistance, cardiovascular disease, and metabolic syndrome are all potential long-term consequences of an altered metabolism that accompanies chronic activation of the physiologic stress response.
Cohen et al, has provided a helpful definition of stress, as follows: “when environmental demands [internal or external; real or imagined] tax or exceed the adaptive capacity of an organism, resulting in psychological and biological changes that may place persons at risk for disease.” This definition represents a bio behavioral model of the stress process.
An individual’s adaptive resources, such as coping skills and social support, are important elements in a comprehensive picture of the stress process. A person with an adequate and supportive social network might appraise stressors in an optimistic light or use a problem-solving coping approach, with the knowledge that ready resources are available from friends and family members. Conversely, a person who is socially isolated or functioning within a violent or abusive environment may have a sense of hopelessness and negativity which can affect her appraisal of stressors.
Finally, behavioral and lifestyle factors also add to the complexity of the stress response. Many individuals adopt behavior and lifestyle changes as coping strategies that may or may not be effective, or may even be harmful. Many of these changes can be viewed as beneficial in reducing stress and are associated with improved health outcomes (i.e., adequate sleep, exercise, and stress reduction methods). However, many can be harmful and contribute to adverse health outcomes (smoking, alcohol/drug use/abuse, poor diet, and inadequate sleep).