Combating Stress Before It Strikes

They say that knowing is half of the battle, but with stress it often seems like it doesn’t matter whether or not you know the stress is coming; there isn’t a lot you can do about it before it arrives to try to mitigate its effects. Or is there?

Stress.  We all live with it to one degree or another, and the amount we are feeling at any one time changes with the situation we are facing.  After the loss of a loved one, for example, stress levels go through the roof.  In our house, we recently lost one of our beloved dachshunds after she suffered Intervetebral Disc Disease, suffered a total paralysis of her back legs with loss of nerve function and quit eating and drinking not long afterwards.  We call our dogs furbabies for a reason; they are like children to us, and it was devastating to see Tasha go through that and eventually make the decision to put her down.  During the last few weeks of her life, and even now several weeks after her passing, our stress levels are higher than normal as we grieve her loss.

But stress doesn’t always have to be so dramatic.  Sometimes it’s the knowledge that you have to give a big presentation to the C-Suite.  Sometimes it’s an upcoming performance review.  Sometimes it’s and upcoming trip.  Around this time of year, it may simply be the approach of the holiday season, and gatherings with family that may send your stress levels rising.  They say that knowing is half of the battle, but with stress it often seems like it doesn’t matter whether or not you know the stress is coming; there isn’t a lot you can do about it before it arrives to try to mitigate its effects.  Or is there?

Neuroscientist Daniel Levitin spoke at TEDGlobal>London in September about employing a strategy called Prospective Hindsight, or a Pre-Mortem, before a stressful event in order to mitigate the damage that a stressful event can cause.  The term Pre-Mortem is a spin on the more commonly known Post-Mortem, where you take the investigations and research that takes place after a disaster, but move it instead to before the disaster strikes.  You try to look at everything that could go wrong in an upcoming event and think of ways to either prevent them from happening or to arrange it so the damage will be minimized if they cannot be avoided.

Some of the tips for mitigating disasters during stressful situations seem rather silly…for example he recommends designating a place in your house for easily lost items.  But part of the reason this is important he argues is that when you are under stress your brain releases cortisol, a hormone that clouds your ability to think.  You won’t recognize this at the time it occurs, because your thinking is clouded.  But by having all of the items you commonly need in a designated location, when you are under stress your hippocampus (an area of the brain which evolved to help remember the locations of important things like where the closest water source is) can guide you right to the item despite your cloudy thinking.  This is the essence of the Pre-Mortem; you are recognizing that under stress you won’t be performing at your best, so you put systems in place to allow you to continue to function through a stressful situation without having to be at your best.

As an example, Levitin proposes the following thought experiment:  You visit the doctor and your cholesterol is high.  The doctor recommends a statin drug to help lower it.  But he points out that at this point you should be asking your doctor for information, including the Number of People who need to be treated before a single heart attack or stroke is prevented (300 for statin drugs, a ratio of 300:1) and how many people experience side effects (5% or 15 out of 300).  This makes you as an individual 15 times more likely to be hurt by the drug than helped by it according to solid statistical evidence; and this is precisely the kind of thing you often don’t think about when you are stressed out after having just been told your cholesterol is too high and you are at risk for stroke or cardiac issues.  So should you take the drug?  Levitin isn’t saying, because that’s up to each individual and their doctors.  But he is arguing that you can put systems in place to help you think clearly in these situations, and that is where the Pre-Mortem can be applied to great effect.

This can be quite a humbling experience, because it means admitting that we are flawed and that we will fail.  That is hard to do in today’s society, because it is often seen as a sign of weakness.  But it is not weakness…it is an acceptance of nature.  Learning to work with that nature and prepare for times of stress simply makes sense, rather than trying to deny its existence.  I know that I will be putting some of this ideas into practice.

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