Idiots are invincible. Dr Ro

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      a) Approach-Approach (as in caretta-caretta):17 When I have to choose between two similar and positive – or, at least, attractive – goals or choices. For example: “Shall I go on a date with Kate or Sue?” (“Both!” I hear my more dapper readers reply). “Shall I choose chocolate cake or apple pie?” (“Both!” answer my greedy and potentially chubby readers).

      b) Avoidance-Avoidance: when I must choose between two negative (unattractive and/or unpleasant) goals, I wonder: “Which is the least bad, therefore the better?” For example, “I must go the dentist, which is unpleasant and painful, or shall I leave it … for another time?”, “Should I remain unemployed or should I accept a demeaning job?”

      c) Approach-Avoidance: when there is one goal with both negative and positive aspects. For example, “I am going to ask Penelope out on a date, but what if she turns me down?”, “Double cheeseburgers are tasty, but what about the calories?”, “Shall I get a divorce or stay married?”.

      The difficulty of choosing between two alternatives was one of Bob’s main sources of stress.

      The second category is Pressure.

      There are three sub-sets in this category as well. Pressure to perform or produce more, time pressure (very little time for the realization of disproportionally numerous tasks), and pressure imposed by “social dictates” (these require that we behave in a certain way and, as such, compromise or obey the dictates of society; traditions, fashion trends, behaviour protocols all find their place here).

      The third category is Frustration.

      In our efforts to achieve targets that are important to us (professional, familial or social), we often come up against unforeseen obstacles that block us from achieving our goals. Although we may have tried very hard, external factors such as other people (e.g., our boss, colleagues, family), a marriage, a pregnancy, or an unavoidable house move, often intercept our planned course. Similarly, a loved one’s chronic health problem can literally put the brakes on our career or personal development.

      Another characteristic example is teenagers who often feel frustrated because their options are hindered by their age and related factors such as lack of money, parental control, differential treatment by other adults, etc.

      One can significantly reduce the intensity and effects of this type of stress by examining and modifying his/her irrational expectations.18

      The fourth category is Change.

      According to the definition of stress above, changes are capable of generating stress because they place demands on the individual to adapt. Consequently, any event, pleasant or unpleasant, that necessitates change, can cause stress (occasional or chronic). This category is open to a new demarcation of the sources of stress into Everyday Life Hassles and, Major Life Changes. It appears that the former can be more stressful than the latter.

      1) Everyday Life Hassles. Most of us believe that stress is an integral part of everyday life. “Minor” problems, that cause stress on a regular basis, can include: housework, health problems, time pressure, inner concerns (loneliness, insecurities), environmental problems, money worries, work issues, and others.

      According to a survey of middle-aged adults in America, the top 10 daily hassles (in order of priority) are:

      Concerns about weight, health of a family member, rising prices of common goods, home maintenance, too many things to do, misplacing or losing things, yard work or outside home maintenance, property/investments/taxes, crime, and physical appearance.

      Similarly, sources of joy, always in evaluative order and always according to the same study, are:

      Good relationship with spouse or lover, good relationships with friends, completion of a project, feeling healthy, satisfactory sleep, eating at a restaurant, fulfilment of one’s obligations, visits/phone calls/mail, spending enough time with one’s family, and pleasant living environment.

      2) Major Life Changes. Certain events have a decisive influence on the life of the individual and are accompanied by – or necessitate – important changes and adjustments. Such sources of stress include “shared” disasters such as earthquakes, fires, and war, but also deaths, family of financial problems, imprisonment, as well as positive changes, such as a wedding, a birth, sudden improvement in finances, holidays and travel, etc.

      Believing that the future will be just like the present (only … shinier and more comfortable, with less buttons) is absurd. In the words of Kelly Morgan, “Changes are inevitable and not always controllable. What can be controlled is how you manage, react to and work through the change.”

      Holmes and Rahe (1970) developed the Social Readjustment Scale,19 a questionnaire in which respondents record the changes that have occurred in their life over the last six months.

      The scale contains a points table ranging from 15 (Christmas holidays) to 100 (death of a relative) for every stress-inducing change. Marriage is positioned in the middle of the scale with 50 points! An overall score is produced by adding all points. The researchers found that 80 percent of individuals who scored over 300 points in their study went on to suffer from a serious health problem over the next six months. Only 33 percent of those with a total score below 150, that is with fewer changes in their lives, fell ill!

      Critics of this particular study have pointed out several deficiencies, including the fact that the scale does not take into account important parameters such as each individual’s perception of the event, personality, or differing responses to the same event. Moreover, the number of negative events included in the questionnaire is disproportionally larger than the number of positive events.

      Other researchers using this scale were able to demonstrate the correlation between psychological stress (positive or negative) and a significant number of physical symptoms and ailments. Yet, due to the nature of the studies (correlational data only) one cannot surmise any cause and effect.

      Before you become totally stressed out, we should note that even if an individual attains a high score on the scale, people with a tendency for illness are usually in poor physical and psychological condition anyway. These individuals do not have at their disposal the techniques for dealing with stress that you will acquire if you choose to carry on reading!

      Many will wonder: “Is it true that stress is cumulative?”

      Most certainly. For example, traffic problems and poor transport conditions steadily increase our arterial blood pressure. Small, everyday problems (e.g., it is raining, the bus is late, a flat tyre, a problem at work, an interpersonal conflict), can often accumulate and end up being more stressful than other apparently more significant events.

      Similarly, many positive events in a row can also … cause stress and make us ill! On the other hand, previous successful stress management experiences can help us deal more effectively with similar situations in the future.²⁰