Academic journal article Journal of Social and Psychological Sciences

Stress: Sham Epidemic or Pathway to Ill Health? A Sociological Analysis of a Contested Concept

Academic journal article Journal of Social and Psychological Sciences

Stress: Sham Epidemic or Pathway to Ill Health? A Sociological Analysis of a Contested Concept

Article excerpt

Introduction

Stress is 'one of the most pervasive metaphors for personal and collective suffering', according to Helman (2000:202). His insight is illuminating, given the lack of a comprehensive and widely agreed definition of stress (Willemsen and Lloyd 2001:245). Antonovsky usefully reserves the term for 'the strain that remains when the tension [incurred through the experience of stressors] is not successfully overcome' (Antonovsky 1979:3). Helman links Selye's physiological account of stress from the 1930s with earlier medical, lay and religious models of misfortune, and the cultural notion of 'nerves' (Helman 2000:215-216). Finkler has studied the concept of nerves in both Mexico and the USA, and argues that it is a universal experience (1989 cited in Freund 1990:463).

But the 'sociobiologic translation' of stress into illness is not fully understood (Tarlov 1996 cited in Blaxter 2003:74) and is indeed contested. Some sociologists believe the current dominance of the stress discourse merely indicates a very modern-day lack of resilience (Wainwright and Calnan 2002). Others believe stress is simply a normal, even desirable human experience, and that it has no place in investigations of health and illness (Guardian, 21/01/06).

In studying stress, we should recall Durkheim's dictum on 'the non-reducibility of social facts to biological or psychological levels of explanation' (Williams et. al 1998:134) The problem with locating stress only in an individual's biology or psyche is that attention is directed away from broader social, political and economic issues. If 'deep-rooted ecological and socio-economic processes at work in generating new orders of ill health and human distress remain unaddressed' (Benton 2003:296), then it is at least partly because they have not been brought fully to light. Uncovering the power relations underlying stress, another 'lost link between objective affliction and subjective experience' (Bauman 2000:211), is an appropriate task for sociologists of health and illness.

Beck believes that the effects of what he terms the risk society are 'incalculable both in terms of individual lives and at the level of the state' (Beck 2000:3). On the understanding that these effects include high levels of stress, I will attempt to calculate some of those costs in this paper.

Wainwright and Calnan (2002) dispute claims of a stress epidemic. Indeed, such language is sensationalist and has been too freely used. But there is evidence that stress reflects real suffering, with real consequences for health and society. In examining the evidence for both sides of this argument, I will draw on sociological analysis of emotions, the body and political economy to explore the interaction of biomedical, social and political factors in creating the stress experience, and set them in a theoretical context.

The medicalisation of stress

In analysing the medicalisation of social problems, Lyon notes the 'expansion of the categories of socio-psychological disorders associated with contemporary life' (Lyon 1996:72). To a degree this has happened with stress. Doctors play a defining role in validating stress-related absence from work, through sick notes or long term sick leave, when workers receive incapacity benefit (Wainwright and Calnan 2002:190). There are now 2.7 million recipients of incapacity benefit, a threefold increase since the late 1970s (BBC News website 20/01/06). (1) Of that total, one million report that they are suffering from mental health problems. In addition, according to the mental health charity Mind, with 45 million days per year lost to stress and anxiety, mental health problems have taken over from back pain as the main cause of inability to work. 'Excessive' stress and depression at work cost firms about 100 billion [pounds sterling] a year in lost output (Mind 2005 cited in Guardian 16/05/05). The cost and the rate of increase in stress-related sick leave are of striking, if not epidemic, proportions. …

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