Gives a very useful set of lenses for how to think about stress in all its forms and manifestations. The bulk of the book deals with stress in medical biology and human physiology, but there are applications beyond our bodies, to our lives, communities, even among civilizations. A very interesting work.
The chapter "When Scientists Disagree" by itself makes this entire book worth reading. It is an eloquent articulation of the nature of scientific debate (including the implications of when scientific debate turns insulting and hostile), and the author quite humbly provides the reader *all* of the professional disagreements and contentions with his model of stress. This part of the book really sings out with humility, sincerity and a scientific rigor we seems to have lost in the postmodern era.
Notes:
* General adaptation syndrome (G.A.S.): how we adapt to stressors: various shock therapies across history (fever treatments, electric shock, etc) provided improvement with no direct relationship between the treatment and the cause of the disease. Hormetic response instead.
* Hippocrates and the idea that disease is not only suffering (pathos) but also toil or "ponos", the idea that the body fights to restore itself toward normal. "Disease is not mere surrender to attack but also fight for health; unless there is fight there is no disease." p 12
* He decides to study "the syndrome of being sick"--what it is that happens to the body when made ill, what are the reactions of the body to a toxin, a pathogen, etc. Many of his mentors recommend against it, but he's encouraged significantly by Canadian Nobel laureate Frederick Banting, the discoverer of insulin.
* He "discovers" and names G.A.S., the general adaptation syndrome: a sort of model or theory of the biologic stress and the body's response to it, either in the form of death, or in the form of injury followed by resistance, and then recovery.
* Adds a word to the French language (as well as many others): Le stress
* Stress is an abstraction; it has no independent existence... What we actually see when something acts upon the living body is a combination of stress and the specific actions of the agent.
* Selye on being a little lax with scientific terminology sometimes: "To quote B.F. Skinner, "No one looks askance at the astronomer when he says that the sun rises or that the stars come out at night, for it would be ridiculous to insist that he should always say that the sun appears over the horizon as the earth turns or that the stars become visible as the atmosphere ceases to reflect sunlight. All we ask is that he can give a more precise translation if one is needed."
Book II: The Dissection of Stress (more technical)
* "In a nutshell, the response to stress has a tripartite mechanism, consisting of: (1) the direct effect of the stressor upon the body; (2) internal responses which stimulate tissue defense or help to destroy damaging substances; and (3) internal responses which cause tissue surrender by inhibiting unnecessary or excessive defense. Resistance and adaptation depend on a proper balance of these three factors."
* "Normally, stress applied to a limited part of the body causes inflammation, but the ability of parts to respond locally in this way is impaired when the whole body is under stress."
* "Stress is the common denominator of all adaptive reactions in the body." A simple but vague definition.
* "Stress is the state manifested by a specific syndrome which consists of all the nonspecifically induced changes within a biologic system." A more precise definition
* "Stress causes two types of changes: a primary change, which is nonspecific both in its form and in its causation, and a secondary change, which has the specific pattern of the G.A.S. The first acts as a common prompter which can elicit the second from any part of the body."
* Bringing us to a simpler definition: "stress is the nonspecific response of the body to any demand."
* Distress versus eustress
* Stress always manifests itself by a syndrome, a sum of changes, not by one change.
* "Adaptation energy": a term coined for that which is "used up" during adaptive work in the face of stress, a type of capacity to respond and recover from stress/stressors.
* Multi page tangent on vivisection and animal experimentation.
* Adaptability can be well trained to serve a special purpose, but eventually it runs out; its amount is finite. (Rats treated with cold, toxins, intense exercise, have better adaptation to cold temperatures but only for a finite period of time, then "exhaustion" sets in.) This led to the concept of "adaptation energy."
* Stress and inflammation, the purpose of inflammation, and the regulation of it.
* "Adaptability is probably the most distinctive characteristic of life. In maintaining the independence and individuality of natural units, none of the great forces of inanimate matter are as successful as that alertness and adaptability to change which we designate as life--and the loss of which is death. Indeed there is perhaps even a certain parallelism between the degree of aliveness and the extent of adaptability in every animal--in every man."
* "What matters is not so much what happens to us, but the way we take it."
* Self-observable danger signs of stress:
Pain in the neck or back
Hypermotility
Pounding of the heart
Irritable colon
* Inflammatory diseases: allergic inflammation as morbid hypersensitivity, where defensive inflammation is experienced as disease.
* Sodium chloride as a type of "sensitizer" of the animal/human to stress or to stress-related hormones, cf: the baby chicken studies Selye did.
* "Inflammatory pouch" experiments with rats, where you could experiment about the effects on the body based on a localized infection/irritation, and see what hormones could drive both a spread or a walling off of the irritant. Also how infections in one part of the body can produce an inflammatory response elsewhere.
* Using stress therapy on human patients with severe rheumatoid arthritis.
* Anti inflammatories vs increasing infection risk/reducing the body's defenses. Stress (at excess levels) doing the same, lowering defenses.
* Maladaption and its role in nervous and mental disorders: PMS, digestive diseases like IBS/ulcerative colitis or ulcers, gout, diabetes, etc.
* "Studying the mechanism through which the lining of the stomach defends itself against self-digestion. Meat is digested in the stomach; why does the gastric juice not digest the lining itself?"
* Liver function which drives the ability to metabolize corticoids: if liver function is impeded, many of the negative effects (or positive effects, depending) of hormones in the body can be amplified, which amplifies (or reduces) the body's reaction to stress/G.A.S. response.
* When Scientists Disagree: On scientific debate, debates about the stress concept. Really useful chapter: "Some of my friends have advised me not to mention dissident opinions in this book, because controversies among scientists would only confuse the general reader and could hardly hold much interest for him. I disagree. I think anyone sufficiently interested in medical research in general--or in stress in particular--to read this book would want to make up his own mind about the issues at stake. In any event, he will learn more about what is in doubt if the views of the opposition are not censored. I shall spare no effort to describe all major causes of contention in an understandable manner, because, to my mind, no one can really grasp the essence of research without trying to comprehend the reasons for disagreement among scientists."
* "We are constantly exposed to all kinds of germs which could make us sick, but often do not. Why not?...If a microbe is in or around us all the time and yet causes no disease until we are exposed to stress, what is the cause of our illness, the microbe the stress? I think both are--and equally so. In most instances disease is due neither to the germs as such nor to our adaptive reactions as such, but to be inadequacy of our reactions against the germ."
* "Most of the agents which can make us sick are, to a greater or lesser extent, conditionally acting pathogens: that is, they cause maladies only under special circumstances of sensitization."
* "As soon as man understands that, for him, the ladder of comprehension has no end, he can find comfort in the realization that consequently there is no limit to his possible progress; no matter how advanced his wisdom, he remains capable of yet another step forward."
* "Health and biologic normalcy are not synonymous."
* Cell theory, the first great truly unifying theory of biology and medicine--considering cells as the fundamental structural unit of life, versus "reacton theory": considering "the reacton" as the "functional unit" of life: for example, the neuron of the nervous system or the nephron of the kidney. "The smallest biologic target which can still respond selectively to stimulation."
* Interesting chapter on the nature of understanding: teleology, what does it really mean to understand something? Knowledge vs understanding. Considering teleologic motives (explaining something in terms of its end purpose/goal/function) in order to reach understanding.
Book V: this book covers real world applications of the ideas in this book.
* How to combat disease by strengthening the body's own defenses against stress. Psychosomatic implications: Bodily changes during stress act upon mentality and vice versa.
* Philosophic implications of stress research: how it plays a role in aging, the development of individuality, the need for self-expression, the formulation of man's ultimate aims.
"We come to the conclusion that the incitement, by our actions, of love, goodwill and gratitude in others is most likely to assure our safety within society. Why not seek this consciously as a long range aim in life?"
* Most stressors are emotional, and even somatic reactions affect us largely because of the nervous responses which they evoke. "As a rule a problem arises because we are conditioned or predisposed to react in a certain way when meeting the stressors of daily life."
* Medical implications: our bodily defense reactions can also fall into a groove when facing stress: we respond with a consistent, exaggerated hormonal response whether appropriate or not. Certain shock techniques can shake us out of this, for example insulin shock, electroshock therapy, etc. Also complete rest can give the body relief from stereotyped somatic reactions to stress. This can include prolonged sleep, transcendental meditation, etc.
* Psychosomatic implications: "the mere fact of knowing what hurts you has an inherent curative value." Knowing your body. Not knowing "what is wrong" makes us worry more. Having an explanation of what is wrong ("you have X") helps calm people.
* Three major elements of stress:
1) the stressor, the agent which started the trouble;
2) the defensive measures, the response of the body or mind to the stressor;
3) the mechanisms for surrender, either physically, such as not putting up barricades of inflamed tissue, or psychologically.
* "We can often eliminate the stressor ourselves, once we have recognized its nature, or we can adjust the proportion between active defensive attitudes and measures of surrender, in the best interest of maintaining our balance."
* Somatopsychic versus psychosomatic: How our behavior (smiling, frowning) can impact our mood state.
* On being keyed up: also checking one's conduct as carefully during stress as one would at a cocktail party. A person can be intoxicated with his own stress hormones--we are on guard against external toxins, but it takes more wisdom to recognize and overcome the foe which fights from within. We must consciously look for signs of being keyed up too much. To watch our critical stress level is just as important as to watch our quota of cocktails. (See pages 171 to 178)
* The stress quotient: local stress in any one part divided by total stress in the body. "If there is proportionally too much stress in any one part, you need a diversion. If there is too much stress in the body as a whole, you must rest."
* "Deviation" or turning something aside from its normal course: instead of experiencing worry it is better to involve the body in general stress--activate the entire body through some action, hard exercise, some diversion, etc to adjust the stress quotient. Activating the whole body, by general stress, makes worry less important in proportion. "You must find something to put in the place of the worrying thoughts to chase them away. This is deviation."
* Meditation, and transcendental meditation.
* How to sleep: "Keep in mind that the hormones produced during acute stress are meant to alarm you and key you up for peak accomplishments. They tend to combat sleep and to promote alertness during short periods of exertion.... stress keeps you awake while it lasts (even when it outlasts its cause) but it prepares you for sleep later when your reaction to it is finished."
* Living life at a pace that suits you, trying different "speeds" of life to find which works best.
* Selye's philosophy of "altruistic egoism" to deal with stress in his life. A form of gratitude. "No matter how acute the happiness they give, the pleasures of the flesh are ephemeral; they cannot be accumulated in the form of any kind of capital. They cannot give us the sense of a life mission well accomplished or of having earned some type of wealth which assures our security throughout life."
* However, note that at the same time pleasure can in some ways be "stocked up": the better we learn to enjoy beauty, greatness, nature, the more we profit from contemplating it. "Since it involves activity, it is in itself an outlet for self-expression. This can be learned, and it is well worth learning.... The capacity to contemplate, at least with some degree of understanding, the harmonious elegance in nature's manifestations, is one of the most satisfactory experiences of which man is capable."
* "Greatness or excellence in any field can become a very satisfactory aim in itself."
* Earning your neighbor's gratitude and love. "The decision of how to be useful to different people must remain a problem for your own ingenuity."
* "I intended to do, and could do, no more in these pages than to present the syntax and grammar of stress, illustrating its application to the philosophy of life by one example: my own."
For further reading:
The Way of An Investigator by W.B. Cannon
Stress Without Distress by Hans Selye