A) Stress is harmful and should be avoided, reduced, and managed.
B) Stress is helpful and should be accepted, utilized, and embraced.
Five years ago, I would have chosen A without a moment’s hesitation. I’m a health psychologist, and through all my training in psychology and medicine, I got one message loud and clear: Stress is toxic.
For years, as I taught classes and workshops, conducted research, and wrote articles and books, I took that message and ran with it. I told people that stress makes you sick; that it increases your risk of everything from the common cold to heart disease, depression, and addiction; and that it kills brain cells, damages your DNA, and makes you age faster. In media outlets ranging from the Washington Post to Martha Stewart Weddings, I gave the kind of stress-reduction advice you’ve probably heard a thousand times. Practice deep breathing, get more sleep, manage your time. And, of course, do whatever you can to reduce the stress in your life.
But I’ve changed my mind about stress, and now I want to change yours.
Let me start by telling you about the shocking scientific finding that first made me rethink stress. In 1998, thirty thousand adults in the United States were asked how much stress they had experienced in the past year. They were also asked, Do you believe stress is harmful to your health?
The researchers concluded that it wasn’t stress alone that was killing people. It was the combination of stress and the belief that stress is harmful.
Eight years later, the researchers scoured public records to find out who among the thirty thousand participants had died. Let me deliver the bad news first. High levels of stress increased the risk of dying by 43 percent. But — and this is what got my attention — that increased risk applied only to people who also believed that stress was harming their health. People who reported high levels of stress but who did not view their stress as harmful were not more likely to die. In fact, they had the lowest risk of death of anyone in the study, even lower than those who reported experiencing very little stress.
That number stopped me in my tracks. We’re talking over twenty thousand deaths a year! According to statistics from the Centers for Disease Control and Prevention, that would make “believing stress is bad for you” the fifteenth-leading cause of death in the United States, killing more people than skin cancer, HIV/AIDS, and homicide.
As you can imagine, this finding unnerved me. Here I was, spending all this time and energy convincing people that stress was bad for their health. I had completely taken for granted that this message—and my work—was helping people. But what if it wasn’t? Even if the techniques I was teaching for stress reduction—such as physical exercise, meditation, and social connection—were truly helpful, was I undermining their benefit by delivering them alongside the message that stress is toxic? Was it possible that in the name of stress management, I had been doing more harm than good?
Stress can make you smarter, stronger, and more successful. It helps you learn and grow. It can even inspire courage and compassion.
I admit, I was tempted to pretend that I never saw that study. After all, it was just one study—and a correlational study at that! The researchers had looked at a wide range of factors that might explain the finding, including gender, race, ethnicity, age, education, income, work status, marital status, smoking, physical activity, chronic health condition, and health insurance. None of these things explained why stress beliefs interacted with stress levels to predict mortality. However, the researchers hadn’t actually manipulated people’s beliefs about stress, so they couldn’t be sure that it was people’s beliefs that were killing them. Was it possible that people who believe that their stress is harmful have a different kind of stress in their lives—one that is, somehow, more toxic? Or perhaps they have personalities that make them particularly vulnerable to the harmful effects of stress.
And yet, I couldn’t get the study out of my head. In the midst of my self-doubt, I also sensed an opportunity. I’d always told my psychology students at Stanford University that the most exciting kind of scientific finding is one that challenges how you think about yourself and the world. But then I found the tables were turned. Was I ready to have my own beliefs challenged?
The finding I had stumbled across — that stress is harmful only when you believe it I — offered me an opportunity to rethink what I was teaching. Even more, it was an invitation to rethink my own relationship to stress. Would I seize it? Or would I file away the paper and continue to crusade against stress?
TWO THINGS in my training as a health psychologist made me open to the idea that how you think about stress matters—and to the possibility that telling people “Stress will kill you!” could have unintended consequences.
First, I was already aware that some beliefs can influence longevity. For example, people with a positive attitude about aging live longer than those who hold negative stereotypes about getting older. One classic study by researchers at Yale University followed middle-aged adults for twenty years. Those who had a positive view of aging in midlife lived an average of 7.6 years longer than those who had a negative view. To put that number in perspective, consider this: Many things we regard as obvious and important protective factors, such as exercising regularly, not smoking, and maintaining healthy blood pressure and cholesterol levels, have been shown, on average, to add less than four years to one’s life span.
Another example of a belief with long-reaching impact has to do with trust. Those who believe that most people can be trusted tend to live longer. In a fifteen-year study by Duke University researchers, 60 percent of adults over the age of fifty-five who viewed others as trustworthy were still alive at the end of the study. In contrast, 60 percent of those with a more cynical view on human nature had died.
The images trigger fear, and what better way to calm down than to smoke a cigarette? The doctors assumed that the fear would inspire behavior change, but instead it just motivates a desire to escape feeling bad.
Findings like these had already convinced me that when it comes to health and longevity, some beliefs matter. But what I didn’t know yet was whether how you think about stress was one of them.
The second thing that made me willing to admit I might be wrong about stress was what I know about the history of health promotion. If telling people that stress is killing them is a bad strategy for public health, it wouldn’t be the first time a popular health promotion strategy backfired. Some of the most commonly used strategies to encourage healthy behavior have been found to do exactly the opposite of what health professionals hope.
For example, when I speak with physicians, I sometimes ask them to predict the effects of showing smokers graphic warnings on cigarette packs. In general, they believe that the images will decrease smokers’ desire for a cigarette and motivate them to quit. But studies show that the warnings often have the reverse effect. The most threatening images (say, a lung cancer patient dying in a hospital bed) actually increase smokers’ positive attitudes toward smoking. The reason? The images trigger fear, and what better way to calm down than to smoke a cigarette? The doctors assumed that the fear would inspire behavior change, but instead it just motivates a desire to escape feeling bad.
Another strategy that consistently backfires is shaming people for their unhealthy behaviors. In one study at the University of California, Santa Barbara, overweight women read a New York Times article about how employers are beginning to discriminate against overweight workers. Afterward, instead of vowing to lose weight, the women ate twice as many calories of junk food as overweight women who had read an article on a different workplace issue.
Fear, stigma, self-criticism, shame — all of these are believed, by many health professionals, to be powerfully motivating messages that help people improve their well-being. And yet, when put to the scientific test, these messages push people toward the very behaviors the health professionals hope to change. Over the years, I’ve seen the same dynamic play out: Well-intentioned doctors and psychologists convey a message they think will help; instead, the recipients end up overwhelmed, depressed, and driven to self-destructive coping behaviors.
After I first discovered the study linking beliefs about stress to mortality, I started to pay more attention to how people reacted when I talked about the harmful effects of stress. I noticed that my message was met with the same kind of overwhelming feeling I would expect from medical warnings intended to frighten or shame. When I told exhausted undergraduate students about the negative consequences of stress right before final exam period, the students left the lecture hall more depressed. When I shared scary statistics about stress with caregivers, sometimes there were tears. No matter the audience, nobody ever came up afterward to say, “Thank you so much for telling me how toxic my stressful life is. I know I can get rid of the stress, but I’d just never thought to do it before!”
I realized that as much as I believed talking about stress was important, how I was doing it might not be helping. Everything I had been taught about stress management started from the assumption that stress is dangerous and that people needed to know this. Once they understood how bad stress was, they would reduce their stress, and this would make them healthier and happier. But now, I wasn’t so sure.
MY CURIOUSITY about how your attitude toward stress influences its impact sent me on a search for more evidence. I wanted to know: Does how you think about stress really matter? And if believing that stress is bad is bad for you, what’s the alternative? Is there anything good about stress that’s worth embracing?
As I pored over scientific studies and surveys from the past three decades, I looked at the data with an open mind. I found evidence for some of the harmful effects we fear but also for benefits we rarely recognize. I investigated the history of stress, learning more about how psychology and medicine became convinced that it is toxic. I also talked to scientists who are part of a new generation of stress researchers, whose work is redefining our understanding of stress by illuminating its upside. What I learned from these studies, surveys, and conversations truly changed the way I think about stress. The latest science reveals that stress can make you smarter, stronger, and more successful. It helps you learn and grow. It can even inspire courage and compassion.
The new science also shows that changing your mind about stress can make you healthier and happier. How you think about stress affects everything from your cardiovascular health to your ability to find meaning in life. The best way to manage stress isn’t to reduce or avoid it, but rather to rethink and even embrace it.
So, my goal as a health psychologist has changed. I no longer want to help you get rid of your stress—I want to make you better at stress.