It is known that these scores and the position on the scale of some of the incidents, vary in different cultures. Different belief systems place the stress of marriage higher in Europe, for example, than in Japan. It is also clear from the list that stress factors are not necessarily unpleasant episodes. A holiday for example is seen as a cause of stress. Change itself, pleasant or unpleasant, is therefore one potential for stress. But it can be argued that since even in high-scoring individuals, 20 per cent do not become ill soon afterwards, it is the response of the individual, his attitudes, beliefs and underlying health status, that is the real determining factor in the effects of stress. This list can be used as a guide, but it should be coupled with thoughts as to what are the most appropriate, least stressful, responses; these responses should then be cultivated.
There is another element in life, which can often produce even more stress than events and changes which actually take place. This is the highly charged area of anticipated problems or events. Whilst losing a job is indeed a high-scoring stress factor, the anticipation of such a loss presents potentially greater stresses by virtue of the time-scale involved. Once a job has been lost, the reality of the situation determines that the individual does something about the matter. Looking for a new job, making practical arrangements regarding finance etc. are all stressful but are, in fact, responses to the event. If, however, there are rumours of possible redundancy, and the anxiety and uncertainty continues for months or years, then the stress induced may be far greater. It is nevertheless worth remembering that, in such a case, there are practical steps which can be taken to minimize the effects of the stress once the individual realizes what is happening.
So, apart from actual changes in life being potentially stressful, it is also evident that anticipation of such changes (i.e. projecting from the present into possible future happenings) also creates stress. It is also, unfortunately, true that much stress relates to an inability to resolve events which are in the past. Guilt, self-pity, brooding over past events, real or imagined, therefore present another major area of stress production. Not only does such attention to the past produce stressful changes in the body, but it greatly diminishes the individual’s ability to function well in the present.
Those factors which have a potential for allowing stress may be seen as real physical events, such as intense noise, extreme heat or cold, or as real, anticipated or remembered unpleasant events, such as divorce; in addition, any change from the status quo, such as a visit, a holiday or promotion at work are likely to involve some stress. Such factors can be termed ‘stressors’, and the potential for harm of all of these will be tempered by attitudes, emotions and personality factors. Conflicts, real or imagined, between the individual and other people or groups is a further major stress factor. The strain, conflict and pressure, resulting from any variety of stressors, may produce an anxiety state which may be short-lived or long-term, depending upon underlying personality traits, acquired attitudes, beliefs and so on. Since it is not possible, in the main, to protect oneself against the major changes in life, it should be thought of as desirable and necessary that attitudes should be cultivated which will minimize the effects of the inevitable vicissitudes of life.
External stress factors, whilst easy to identify, are less easy to measure and control. These might include excessive noise (engineering workers); exposure to excessive heat (bakers), or cold (workers in cold-storage areas); intensely boring or repetitive occupations (assembly line workers), and such factors as commuting on an unreliable transport system, or having to drive in heavy traffic for hours every day. Other, more extreme, examples of constant external stress factors are those endured by people working in areas of potential danger (police,