Risk Factor: Psychological Stress - A healthy living risk factor e-article
and stress self-test
Truth for Healthy Living - Tests with
their answers that overcome and prevent probably the most serious threats
to healthy living: psychological stress with inaccurate self-esteem, smoking
Breast Cancer Risk Factor: Chronic Psychological Stress
can print a copy to make the quiz easier to score.
I asked the woman I love if she
thought psychological stress* is one of a small number of risk factors
that cause women to have breast cancer. Judy isa good person
to ask. You see . . . she is a clinical nurse specializing in cancer research
for a university medical center and has worked there for 30-plus years.
She is also a two-time survivor.
* Refers here to that biochemical
response/strain not caused by "sympathomimetics" such as caffeine.
Judy responded with what I guessed
was the usual answer to that question. She said, "There is no clear-cut
evidence that stress is one of the risk factors for breast cancer."
Then she explained that a few studies report that it does contribute. Most
suggest the opposite . . . it doesn't.
What I thought about her response hurt my feelings. You would think that
from reading what I've written she would pay little attention to some of
that research. She wouldn't believe that the evidence is uncertain. I'm
convinced thatstress does combine with a few other important risk
factors to produce this cancer!You see, I research and help people
What scared me was the thought she might be at greater risk for having
cancer again because of her understandable misconception. It wasn't my
fear but my affection for her that encouraged me to tell Judy what I believe
that follows. If you have had breast cancer or you are at risk for it,
please pay attention!
Higher levels of ongoing or chronic
stress (primarily the hidden kind) do cause breast cancer and as much as
any other risk factor. Meaning no criticism . . . any study, book or article
that says or implies otherwise is mistaken.
How do I know? Every piece of research
that I can find that uses a better measure of stress says so. At least
one study, that used the less accurate way of calculating stress, also
suggested that it is one of the important risks for breast cancer.
The popular "life events"
way of measuring stress doesn't work well enough. The more recent version
of that less accurate means of measuring stress asks you which life events
(serious illness, divorce, fired from a job, a move to another home, marriage,
etc.) you've experienced during the past year. The test assigns points
- ranging from 18 to 123 - to those you've experienced. If when you add
your numbers you get between 250 and 500, then you are supposed to have
a "moderate level" of stress.
To me, that's like trying to find
out if someone is cold by asking her questions such as, "How
many snows did you get last year?" or "Did you sleep with a blanket
on your bed last winter?"
The studies that alleged that stress
wasn't a risk factor for this cancer used the "life events" test.
Little wonder they found what they did!
The better way to gauge stress
ask people how much they believe
find out if they have symptoms
of chronic stress and
see if they use "home remedies"
(hurtful eating, etc.) to try to get some relief.
Using the "someone is cold"
analogy again . . . if you want to find out if someone feels cold, simply
ask her, "Do you feel cold?" In case she has been chilled so
long that she somehow doesn't recognize it (like with hidden stress), you
can ask her if she has symptoms, "Do you have 'goose bumps?'"
Note: There is an example of a better
way to measure stress further along in this article. Feel free to take
and score it.
"Life events" measures
discourage a sense of competence . . . while fostering guilt in women at
risk. Neither of those outcomes will be useful. One liability in saying
or implying that life events cause stress is that people can easily hear
the message, "There is nothing much you can do to avoid stress. After
all, there is little you can (or would want to) do to sidestep many life
events." Another negative is that the "life events stress tests"
at least imply that women deserve blame. For example, "You made yourself
stressed and sick by getting married and moving into a new home."
Our ancestors got to be our ancestors
by surviving. When a dangerous animal, for instance, attacked they didn't
stand around that long scratching whatever and trying to decide what to
do. Anyone who did got "chomped" and didn't get to be a progenitor.
What those who survived did have were thoughts that happened so quickly
they didn't know they were there. Those "fast thoughts" caused
thestress(the biochemical response to subconscious perceptions/thoughts
of threat) that created the uncomfortable emotions that fueled their defensive
behaviors. They fought, ran away or hid from what their super-quick thoughts
identified as dangerous.
We have inherited that "fast
thinking" ability. Those subconscious thoughts, NOT life events, cause
our stress. Since we don't know the thoughts are present when they happen,
they are not our fault. Tell a traffic court judge you didn't know what
you did was against the "rules of the road," and she will tell
you, "Ignorance of the law is no excuse." In what I call the
"court of life," not knowing is one of the best defenses we have.
If it doesn't work, we all get "sent up the river."
We need to sense the presence and
question those unknown-to-us (at the time) stress-making thoughts. Then
we can learn to counter them to avoid most stress. We do that by telling
ourselves what's more likely going on and true. Just as it is important
to discover which germ is causing a disease, it's crucial to acknowledge
and answer those honest, but mistaken, thoughts causing our stress. Note:
FeelingGood, a book written by Dr. David Burns, is a reasonable
introduction to this. Also see Stress
and Moods Mastery. It is the first chapters
and drafts of the latest edition of my health promotion program, StressMastery. Access is free and will remain so.
Here is an example of a more accurate
measure of stress I promised to share. If you find out or confirm that
you have too much stress, I very much hope you will begin to get real and
safe relief . . . right away.
Lovelace Stress Scale
Please read each of the ten statements
As you go ... gauge how well each
statement describes you in recent times. (The last six months or so.)
Respond to each statement with
a number from one to seven. The more you believe the statement describes
you, the higher the number you give.
Not at all like me ......................................................
Just like me
I have a fear that interferes or
holds me back. You might relate the fear to activities such as asserting
yourself, calling or meeting with friends or relatives, being rejected,
dealing with criticism, driving or maybe flying.
I believe that one or more of my
relationships at work or elsewhere suffers because of my irritability or
I doubt that I'm as successful
in my work or at home as I should be.
The way I eat and drink is nutritionally
poor or I eat too much fattening food.
I have a physical problem that
I suspect, or someone tells me, comes from pressures in my life. The problem
could be headaches, stomach upsets, back or neck pain, difficulty sleeping,
teeth grinding, bitten finger nails, excessive sweating, too much body
fat, decreased romantic interest, skin problems or cold hands. Please note
that factors other than stress can cause some of these physical concerns.
If you haven't already, check with your physician.
Most days, there are too many tasks
that I should complete.
I use something to calm or relax
me. Or I use something to pep me up or to give me energy/excitement. You
might, for example, use nicotine, caffeine, a medicine, a dietary supplement,
alcohol, a forbidden drug, gambling, risky relationships or maybe too much
I exercise - not activity done
at work, yard or house work - too little, or the exercise I do doesn't
Please add your numbers.
Put that initial score here: __
If your "initial score"
(above) was 59 or higher, check to see how often you gave a response of
seven. (The total presence of something so infrequently happens that it's
reasonable to consider such a response to be a subconscious attempt to
overstate it.) Deduct two points from your "initial score" for
each response of seven. If, for example, your "initial score"
was 61, and you gave seven responses of seven, then subtract 14 points
from your "initial score" for an "adjusted score" of
If you got an "initial score"
of 39 or less, you still might have some "hidden stress." Three
key items can tell you if you have this concealed, and particularly menacing,
Worry (inventory item # two)
hurtful eating (# six) and
using "home remedy" or
"painkillers" (# nine) are common ways to unwittingly
avoid an awareness of stress.
If you scored 39 or less and still
rated yourself with a fiveormore on statement two,
six or nine, then add seven points for each statement to your initial score.
That means, for example, if your score totaled 37 and you rated yourself
as five (or higher) on statement number two and statement nine then add
14 (two statements time seven) to your 37 for a new total of 51.
Did you respond to any of the 10
items by rating yourself with a number one? If so, add three points to
your score for each. (It infrequently happens that there is a total absence
of something. It's appropriate to consider such a response to be a subconscious
attempt to ignore stress.) For instance, if you answered two of the statements
with a number one, you would add another six points to the 51 for a final
adjusted total of 57. The difference between the 37 you started with and
57 represents Hidden Stress.
Type your adjusted score here: ___
number (initial or adjusted) suggests:
If you got an "initial score"
of 33 or less, that suggests that you are using subconscious denial of
how much stress you have. Don't take this as criticism. Instead, see it
as a possibility you need to consider. Also with an "initial score"
that low (33 or less), you may have misunderstood how to respond to this
inventory. (The more you believe a statement describes you, the higher
the number you give.)
If your "initial score"
was 34 to 39, that implies that you have a low level of stress.
If you scored (initial or adjusted)
40 to 45, chances are you have a moderate level of stress. Your score clearly
points to a need to reduce your stress.
Scores (initial or adjusted) of
46 and higher suggest a high level of stress. Doing something soon that
safely works to significantly lower your stress is, I believe, easily justified.
Obvious stress is harmful enough.
Hidden stress is worse. It can be difficult to get yourself to work on
what, understandably, you don't realize is there.
Please note: The author and publisher
offer this inventory for educational purposes. No lifestyle health risk
appraisal tells absolute facts. Such assessments suggest possibilities
to consider. When the results make sense, then please use them to your
benefit. Avoid making significant changes based on the results. Instead,
use what you learn combined with appropriate professional support.
Richard Terry Lovelace, Ph.D., MSW, ACSW,
LCSW is in clinical practice with Winston
Clinical Associates - Winston-Salem, North Carolina USA
Note: Dr. Lovelace is mostly retired
from clinical work and doesn't see new patients needing more than one or
Copyright Richard T. Lovelace. All Rights
Reserved. You have permission to reproduce materials available on this
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to lawyer, Laurel O. Boyles, P.A.