The Story of Stress: Part 1

I was intermittently aware of experiencing stress back in my school days: talking in front of a class, waiting outside the principal’s office, working feverishly to finish a class project on time. In university I took a course in psychoneuroimmunology, which offered a more academic look at stress and its impacts on the body. In research papers we read about rats and other unfortunate captive creatures being shocked or otherwise stressed, with various adverse impacts on their physiology then measured.

However, it was not until I landed in the full-time working world that stress and stressors become more of a frequent and relevant topic of discussion. I worked in a medical/health library and our collection of stress management books, for both employees and researchers, seemed to grow by the year. There was also a burgeoning focus on employee well-being, and I remember many employees being handed a slim booklet titled: “Adapting to Stress: Start Taking Charge,” created in 1988 by the Hope Heart Institute (I still have it). It was fairly comprehensive document, with a focus on stress management strategies to reduce negative health impacts, including heart disease.

Since that time, I have read many books and papers on the topic. I think the topic continues to hold my interest because the experience of stress is universal, and has important—even life-saving—utility in some circumstances, although more so for our ancestors who dealt with greater physical demands and threats, like the proverbial sabre-toothed tiger. In the modern world, demands are now more likely to be psychological, but they create the same cascade of bodily responses. And, while the stress response is universal, what triggers a stress response in one person, may not for another. Fascinating stuff.

So, I thought I would delve into my stress library and choose two books that have made an impact in the field, albeit with slightly different takes on the topic. In this post I will focus on the book: When the Body Says No: The Cost of Hidden Stress, by Gabor Maté, a well-known Canadian physician.

Early in this book, Maté cites the work of Hans Selye, considered the founder of stress theory as well as the originator of the term. Selye states that stress consists of internal/physiological alterations--visible or not--when an organism perceives a threat to its existence or well-being. As well, this stress response is heightened when the demand made on an organism (which can be a positive or negative event) exceeds that organism’s capacity, or perceived capacity, to deal with that demand.

Maté draws on medical research, as well as his decades of clinical experience as a family physician, to advance the concept of a mind-body connection and its role in various conditions and diseases, including autoimmune disorders. In this context, he explores the link between stress and disease, examining how early emotional experiences (as well as current ones) impact the body’s immune system and ultimately lead to illness. Reflecting the book’s title, and through multiple case studies, Maté attempts to illustrate how disease can be a consequence (or a way of the body saying no/enough) when the mind cannot or will not acknowledge and or cope with certain emotional issues or traumatic content.

Despite my comments to follow, I think this is an important book to read. In western medicine, the mind-body link is still a relatively new idea, and not regularly reflected in medical practice in many sectors. As well, Maté worked for many years in a Downtown Eastside medical practice, which no doubt influenced and or solidified his trauma-informed perspective. Trauma at any stage in life, can have profound implications for physical and mental health, including the behavioural choices that influence these. Again, this is an idea that is just beginning to take hold in a variety of health fields, including those related to addiction and mental health treatment. In both these realms, Maté remains a crucial voice.

That said, the book is weighty with medical disorder cases that seem to be explained a little too conveniently (or dare I say simplistically) by Maté’s central theories. I think the cases he presents are real, and there may be an emotional/traumatic component to illness manifestation or continuation in a portion of these. But it feels like an over-assertion to say this is a factor in all cases: one that may be under-emphasizing or under-reporting other known or unknown factors. Related to this is the danger of blaming the victim. Maté insists this is not his intention, but that’s sometimes how it reads, and it doesn’t feel very helpful, particularly as the book is very light on practical ways forward for impacted patients. In the case where deep-seated trauma may be a legitimate factor in a current medical condition, many do not have access to specialized and typically costly trauma assessment/treatment. That just sounds like a recipe for more stress. 

In fact, it is not until the final (19th) chapter that Maté outlines how the reader might "heal" or mitigate some of the health threats he talks about in the previous 18 chapters. He outlines the seven “As”: acceptance, awareness, anger, autonomy, attachment, assertion, and affirmation. While he explains these in more detail, with examples, they still feel more conceptual than practical, and too little too late.

Again, When the Body Says No covers important ground, particularly in reminding us about the mind-body connection and the real impacts of unaddressed trauma (big and smaller) on well-being. I recommend reading it with an attitude of curiosity, and in full knowledge that Maté has a strong point of view to share. 

Enchanted April

It’s the time of year—at least in Westcoast BC—when spring is gaining some traction after months of grey skies, short windy days, and multiple layers of clothing. While it still feels too slow in coming, with many false starts and retreats, every sustained rise in temperature inspires hope. So, it seemed like the perfect time to introduce The Enchanted April, written by Elizabeth Von Arnim, first published in 1922.

As the book begins, two women are also struggling with the dregs of winter in post-World War 1 England. On a February afternoon, in a London woman’s club, they each separately come upon a newspaper advertisement that reads as follows:

 To Those Who Appreciate Wisteria and Sunshine. Small medieval Italian castle on the shores of the Mediterranean to be let furnished for the month of April. Necessary servants remain.

Mrs. Lottie Wilkins and Mrs. Rose Arbuthnot are middle-class housewives with predictable lives and strained marriages. They attend the same church, but differ in temperament and re the social circles they travel. Yet the advertisement stirs something in both of them, although they initially dismiss it as a pipe dream. But Mrs. Wilkins, “sees them there,” and thus begins the journey to San Salvatore.

To afford the rent, the women advertise for two more to accompany them. Applying are Mrs. Fisher: an older, curmudgeonly widow, and Lady Caroline Dester (the author later uses her family nickname Scrap), a young beautiful woman in need of rest from a full social calendar and a host of grabby suitors.

As the holiday begins under the warm and welcome Italian sun, tensions flare between these women of different backgrounds, characters, senses of entitlement, and expectations for the trip. For example, Lady Caroline’s single intention is to “lie comatose for four weeks in the sun.” It takes the others some time to understand this and just let her be. As they settle and begin to take in the magic of the place, they eventually bond over shared misfortunes and the pleasures of life in their tranquil surroundings.

Almost immediately Lottie “sees” her husband Mellersh there, despite the fact that the vacation seemed like an escape from her humdrum London life and her sometimes overbearing husband. She writes to him, and encourages Rose to invite her husband as well, which rocks the equilibrium of their little foursome. Mellersh arrives and surprisingly fits right in, happy his wife has made advantageous social connections. He finds new appreciation for Lottie and is heartened to offer help and advice to the others.

Joining them later at the castle is Mr. Briggs, owner of the property. He is initially drawn to the attractive and interesting Rose, but ultimately becomes distracted by Lady Caroline’s extraordinary beauty. Then Rose’s husband Frederick arrives: a philanderer and author of racy royal memoirs. He never received Rose’s invitation to visit, but instead coincidently came in search of Lady Caroline. He is startled by the appearance of Rose, as well as her enthusiasm, warmth, and ardour as she is overwhelmed by his unexpected arrival. In true San Salvatore style, they rekindle their romance and forgotten regard for one another.

As I describe the basic plot, it might seem like a gals get-away, which men then join to liven up the party. However, much of the novel is a languid homage to the deliciousness of slowing down, and to opening up our hearts and senses. From the moment she reads the advertisement, Lottie is drawn to the idea, then the reality, of San Salvatore. The warm sun and bursting garden, as well as her new-found initiative in supporting her own needs, infuse her almost immediately with a sense of agency and generosity towards others. That openness and warmth is contagious, and allows each woman to begin to trust each other and slowly reveal vulnerabilities. This ultimately extends to the men in their lives.

As the story closes, Lottie envisions her increasingly close relationship with Mrs. Fisher continuing back in England. Over the month, Mrs. Fisher’s initially crusty, demanding demeanour has softened into an almost motherly affection for all, with a willingness to accept affection in return. Lottie also sees a future match for Lady Caroline and Mr. Briggs, despite Lady Caroline’s early annoyance at his almost worshipful (and potentially grabby) attention.

But what happens when the magic of San Salvatore is but a memory, and ordinary life resumes? We’ve all had a restful, immersing vacation we’re sure will remain with us, yet the feeling inevitably fades as stressors re-accrue. But I’d like to think there are certain places and experiences that never leave us, and we can call them back in a heartbeat. I hope that magic continued for The Enchanted April characters.

NOTE: This book was made into a movie in 1991. A few plot points were changed, but the filmmakers did a laudable job of capturing the book’s characters and magic of San Salvatore. It has stayed with me. 

Clara Callan: A Canadian Favourite of Mine

Several decades ago (2001 or 2002), I went with a friend to a local literary festival. One of the authors, Richard B. Wright, read from his new book at the time: Clara Callan. The story is primarily told through an exchange of letters and Wright’s short reading intrigued me enough to buy the book.

My friend who attended with me has never warmed to the book, while I’m drawn back in every time I read it. What is it about this story that resonates strongly with me?

Clara Callan follows the lives of two small-town Canadian sisters, from the end of 1934 to the end of 1938. After their father’s death, thirtysomething Clara stays put in the family home, teaching school in their small Ontario hometown, as her father did before her. Her younger, more adventurous sister Nora is ready to spread her wings and moves to New York City, using connections to get work as an actor on radio.

Their letters back and forth chronical their lives during these four years; journal-type entries from Clara add further background detail. As Nora settles into her life in New York, her co-worker and free-spirited friend, writer Evelyn Dowling, also begins writing Clara. Clara’s letter topics range (and jump around) from the minutia of daily work and small-town life, such as keeping a coal furnace going in winter, to more weighty matters including her early-in-the-story rape and having to deal with the resulting pregnancy. Nora’s letters typically focus on her burgeoning career; her social life with friends, co-workers, and various men, as well as advice for Clara around expanding her seemingly little life.

But while Nora initially appears to be leading the bigger life, cautious dutiful Clara comes up from behind, experiencing significant life changes as the story unfolds. She distances herself from God and her church, while Norah continues to believe. She travels to New York, then Italy with Norah and her emotionally abusive boyfriend, offering Norah support throughout the journey. She also participates in an intellectually satisfying correspondence with Norah’s friend Evelyn. Later Clara begins seeing a man she met at a movie theatre, continuing even after she learns he’s married. Small-town rumours circulate and she is harassed. She finally breaks off her relationship with the married man, but finds herself once again pregnant. This time she decides to keep the baby, forcing her to resign from teaching and embark on a bold new life as a single mother as 1938 comes to a close.

Norah and Evelyn have dramas of their own, contributing to respective personal changes in both work and life; but their evolutions seem less surprising than Clara’s. In fact, their boldness and brashness seem subtly tempered over time by wisdom won through hard knocks.

Wright does a fine job of writing for these three strong, unique women. His ability to do so reminds me of the talents of Wally Lamb. In an era when women’s voices were essentially silenced or eclipsed, his focus on such voices is refreshing. That said, I would have liked to have seen more substantial, nuanced, and positive male characters. Other than a few mentions of Clara’s late father, and her teaching colleague, the only other men represented were a rapist, several cheating husbands, and a narcissistic abusive boyfriend. One would hope the men of the 1930s had much more to offer.

I also appreciated the Canadian context of this novel. The backdrop to a good portion of Clara’s year is the dark, bleak Canadian winter. Wright does a good job of capturing the claustrophobia and wearing nature of this season; and, admittedly, that atmosphere could be off-putting to some readers. Yet, this winter bleakness is counter-balanced by the hope and new energy of spring, the lushness of summer, and the crisp beauty of fall. For those of us who live in the land of Canadian seasons, it feels familiar and reassuring.

Also dark are some of the themes explored in the book: rape, illegal abortion, small-town intolerance, depression/mental illness, sexism, the limited options for women in that era, and politics (particularly in Europe) leading up to World War Two. Yet again, these are ably offset by the positives and small wins of everyday life, including the acceptance and support Clara, Nora, and Evelyn are able to offer and find in each other.

As my friend would attest to, Clara Callan is not for everyone. It is no beach-read romp, which is sometimes what we really need as winter drags on. But there’s also so much there to embrace and take comfort in: the bond of sisters (and siblings) who are different but mostly accepting of those differences; the power of reciprocal communication to ground us and help us feel known; the energy and promise of personal evolution, and the way life can surprise us and we can surprise ourselves.