Over the years many models have been proposed to try to define and explain stress, but a common feature is a reliance on capacity. So-called life-event scales, for example, assume a capacity for coping which is exceeded when someone is exposed to a sufficient number of events. The approach was refined by adding ‘readjustment scores’ to the events, but to no avail: the life-event approach not only completely fails to explain stress, it also misleads people into thinking that events are somehow inherently stressful. Other models have relied on materials science, using concepts of strain and stress, but since coping is fundamentally influenced by emotion, inert materials are no model at all. Others again have spoken about coping resources being exceeded by demand, another mechanical view which explains very little.
Most of these models have been generated in the fields of psychology and psychiatry, and therein lies the problem. Owing to my original training in clinical psychology I’m usually thought of as a psychologist, and indeed, a by-line for the Challenge of Change programmes is ‘Psychology at Work’. Unfortunately, psychology is not a unified discipline. To some extent the same can be said about many academic disciplines, but at the extremes in psychology the differences are a gulf across which people hardly speak the same language. The time for a division between what is sometimes described as the ‘soft’ and ‘hard’ ends of psychology is long overdue, and would help to resolve a lot of confusion.
Hard and soft are not necessarily value judgements, but rather provide a way of describing the kinds of data people work with. The problem with soft data is that the findings are open to a wide range of interpretations. The conclusions are often influenced as much by intuitive speculation as concrete evidence, and hence the dangers of relying on them. The Challenge of Change Resilience programmes begin with a caution to not believe what psychologists tell you, and that caution is echoed from deep within the discipline itself: Tana Dineen’s book, Manufacturing Victims, she hoped would “challenge the authority, power and privilege of the purported psychological experts of this era, curb the damages being done by psychologists, diminish the influence of the psychology industry, and (help people) take back their own lives”. Robyn Dawes writes similarly in House of Cards: Psychology and Psychotherapy Built on Myth: “Instead of relying on research-based knowledge in their practice, too many mental health professionals rely on ‘trained clinical intuition’. But there is ample evidence that such intuition does not work well in the mental health professions. (In fact, it is often no different from the intuition of people who have had no training whatsoever)”
In other words, much of what people ordinarily understand psychology to be is based on little more than magical thinking. At the same time, human behaviour is a complex process that involves mind. We could argue endlessly about mind and brain, which is the same rather tired and pointless debate about distinguishing between body and mind. Easier by far to assume that the distinction is a false dichotomy, and to focus on brain/body. Mind is a minefield of speculation, and the more that research conclusions can be based on evidence from physiology instead of mind, the better understanding we will have. This is not to suggest that physiology provides final conclusions – the whole enterprise of science is predicated on the continuing question, ‘what’s wrong?’, but the evolution of scientific thinking is based on evidence, not myth.
Ideally, the label ‘psychology’ should be reserved for that branch of the discipline that relies more on the ‘psych’ part of the tile (which means mind or soul), while the branch that is concerned with explaining behaviour with reference to brain should be neuroscience. This difference is already established, but formally dividing the discipline into two would offer a clear and unambiguous way of describing these very different approaches. Our own work on stress and resilience provides a concrete example. We began by wanting to know what it was that seemed to protect some people from stress while others appeared more vulnerable. We developed scales to measure these aspects of behaviour, but rather than drawing on psychological models of stress for our items, we asked people instead to respond to scenarios by saying how they would think, act and feel in each one. The items were used verbatim, irrespective of the ‘correctness’ of the grammar, and the first two scales to emerge were rumination and emotional inhibition.
There was some evidence around for the role that emotional inhibition might play, but since this was the first published measure of rumination, we didn’t know how it might impact on stress. Rather than psychological speculation, we tested it by taking people who either habitually ruminated or not and exposed them to stress in our laboratory, while at the same time measuring physiological parameters like blood pressure and heart-rate. While everyone showed an increase in physiological arousal – fight-or-flight – it was the ruminators who took significantly longer to recover back to baseline afterwards. This was our ‘Eureka moment’, realising that the simplest (and indeed the only) way to define stress is as rumination. This is the behaviour that makes people self-evidently miserable and, by continuing inappropriately to prolong a perfectly adaptive physiological response, will impact on their health as well.
The initial finding has been reinforced in every study since: ruminators have an exaggerated and prolonged cortisol response, and chronic ruminators show compromised immune function. For me, the ‘Eureka moment’ didn’t come from speculating about what stress might be, but by finding a measure that had demonstrable physiological consequences. The Challenge of Change programme argues that the one constant is that everything changes, but some things, like the inappropriate blanket term ‘psychology’, unfortunately take longer to do so than they should.