I picked up Kelly McGonigal’s The Upside of Stress assuming I would skim it for a few interesting ideas, but probably not finish it. This was based on having seen her TEDx talk, which I watched as a participant in a TEDx Circle. The idea of framing stress as a healthy part of the human experience, rather than the emotional version of the seemingly useless and sometimes deadly appendix, caught my attention. Plus, I liked SuperBetter, a book on a resilience written by her sister. To my surprise, I ended up reading the whole thing.
The power of mindset is a concept that has become the mantra of those eager to improve the world while upholding the status quo. We’re told the issue isn’t systematic inequality, it’s just your mindset! McGonigal deftly acknowledges social determinants of health and the limited options available to many people, placating one camp without upsetting the other. Sure, maybe life is unfair, but if mindset helps people living in refugee camps and victims of cruel fate, it can help you, too! Which is true, but dodges acknowledging that some of those sources of stress that are out of our control are in someone else’s control.

One of my pet peeves is authors slipping into the language of intelligent design while pretending to maintain scientific objectivity. Our stress response didn’t evolve “for” anything. While anomalies that turn out to be handy and heritable are more likely to stick around, our lives are more complex than some moths living during the industrial revolution. Our emotions and behavior are not so easily boiled down to soundbites or explained by what someone imagines the cavemen did.

McGonigal’s premise is that, surprise surprise, the stress response that once saved us from being eaten by lions is probably not knocking us down like a cavalry under machine gun fire by causing heart attacks, cancer, and dementia. Our repertoire of responses to stress is far more nuanced than fight or flight. And contrary to the popular notion that we’re responding to harmless stimuli as if every strongly worded email is a tiger rustling in the bush, most people are responding to actual threats with stress responses that help them cope with the situation at hand.

While I did once spend a day hiking with a woman who had survived the jaws of a jaguar and I have a friend who was bitten by a shark, most of us are not dealing with those sorts of threats. However, only someone with a very specifically limited set of life circumstances (aka an immense amount of privilege) can pretend that a strongly worded email isn’t potentially a serious threat to your life and safety. We’ve all heard that teenagers believe they are invincible, but this false sense of security seems more common among the wealthy.

You know what an automated notification from your bank, a form letter from your insurance company, or a meeting request from HR can do to your life. You know how easy it is to get distracted for a second and have the consequences of that second ripple throughout the rest of your life. You know you can do your best to play the game, work hard, be responsible, and still be forced to face the reality that nothing is guaranteed but death.

During my lifetime, the media has heralded the arrival of cloning, the moonshot to cure cancer, and the quest to end death. We weren’t prepared for the flu, though.

I was intrigued to learn that the original studies demonstrating the deadly impact of stress included things like putting lab rats into water and having them swim until they were physically unable to prevent themselves from drowning or subjecting them to arbitrary and unavoidable electric shocks. Even when the rats were rescued from the torture, they’d die anyway.

Taking the idea that the stress of experiencing senseless and unavoidable torture can lead to your death and extrapolating that to the idea that the stress of missing your train can increase your risk of developing cancer is…a leap, to say the least. But McGonigal tells us that’s basically what happened.

McGonigal reassures us that missing your train will only increase your risk of developing cancer if you think it does.

Her argument is less absurd than that sounds, since obviously reducing it to a sentence simplifies things quite a bit. Given how powerful the placebo and nocebo effects are, it makes sense.

The difference between being a lab rat who has been consigned to a torturous death and a lab rat who can’t figure out the pattern to when pushing the lever gets it a treat is something that would be helpful for researchers exploring caregiver burnout to consider.

For every study on caregiver stress that demonstrates that care work leads to burnout and an early death, there is another showing that care work is deeply meaningful and protective against illness [I didn’t count them up, although feel free to send me the actual numbers on this]. It’s very easy to imagine this discrepancy being explained away by paying attention to the actual experience of care work, something few studies bother to do. It’s hard enough to recruit participants, why sully things by dividing them into smaller groups? Plus, what we’re talking about here isn’t an easy box to check, like “eldercare” or “the sandwich generation.”

Is your experience of care work stressful because it is difficult to see someone you love struggling? Because it forces you to confront your values and whether your current life is in alignment? Because contemplating someone else’s frailty makes you acknowledge your own potential for frailty and the extent of our interdependence?

Or is your experience of care work stressful because you are ethically and legally required to provide around the clock care to someone while also somehow working to pay the bills? Because dealing with insurance and the programs designed to help you are straight out of a Kafka novel? Because care work is tedious and exhausting and the person you are supporting is not only not grateful but actively hateful, resentful, and abusive?

Some experiences foster post traumatic growth, as we learned in SuperBetter, while others are akin to throwing a rat in a bucket and letting it swim until it can’t stay above water anymore.

McGonigal encourages us to ask ourselves: “How hard is this going to be? Do I have the skills, the strength, and the courage? Is there anyone who could help me?”

If you are struggling with the idea that you should reduce the stress in your life or are worried about the toll stress is having on you, The Upside of Stress is a great book to help you set aside those fears. McGonigal provides simple guidelines to help you let go of the fear and shift your mindset to focus on finding meaning and trusting your inner wisdom.

This is a great book for people who are not sure if what they are doing counts as caregiving. If you are a caregiver who can really relate to that drowning rat, use your precious free time another way.

For all the articles urging us to reduce the stress in our life, most of the things that give our life meaning are quite stressful. If we could remove the non-meaningful stress from our lives, we would have already. It’s refreshing to have a stress expert acknowledge this reality. A good life doesn’t require low stress, nor would a stress-free life be something any of us actually wants.

There’s the idea that being anxious harms your ability to function; that the key to success is learning to suppress the stress response entirely. McGonigal reassures us that being anxious isn’t going to ruin our lives and that true health involves feeling the full range of human emotions.

The exercises at the end of the book aim to teach readers to turn distress into eustress. Distress is the suffering and anxiety that comes to mind when most of us think of stress. Eustress is the positive kind of stress, the stuff that gets us excited and gives us the motivation to do whatever it takes. Eustress pushes us into a flow state.

But aren’t there limits to how much stress people can take, even with the best attitude? Care work might not be as glamorous as lifting a car with sheer force of will, but it’s probably harder. So many care workers are lifting that car day after day after day.

The most important takeaway from the book is that it’s okay to be stressed out. It’s not a sign that you’re a mess in desperate need of psychiatric help or that you’re failing at life — a view that’s become pervasive. Maybe you’re not worried about lions, but that doesn’t mean you aren’t being stalked by a predator. Chances are, you’re under a lot of pressure and facing the messaging that there will be big consequences if you slip up.

So much of the messaging — from the media and our doctors — is that we’re to blame for not managing our stress. If we get sick, it’s our own fault. We should have put our own oxygen mask on first. We should have taken up meditation and jogging. Never mind that jogging as a person of color might get you murdered. Or that leaving someone with dementia unattended in the other room for a twenty minute meditation session is laughable. We can’t even get to the store to buy groceries, but we’re lazy and wasteful if we get things delivered. Assuming there’s enough money for that to be an option.

Our health insurance plans deny us preventive care; our cities can’t find the money to provide clean drinking water; we’re lucky if we can take unpaid time off to care for a dying spouse without getting fired. They give us an app to teach us how to be resilient and blame us if that’s not enough.

After all, studies show that former child soldiers turned out to be especially happy and resilient people. It’s “proof” to justify blaming us for not thriving in impossible situations. If what doesn’t kill us makes us stronger, I guess we should be grateful for injustice?

Maybe I’m just not enlightened enough to agree, but I’m not prepared to be grateful for injustice. I can embrace gratitude for love lost and the eternal challenge of embracing change, but that’s a step too far.

If refugees decide to be grateful for the things that drove them out of their homes I hope they end up with their own TED talk. But I, as someone with much more in common with McGonigal than a refugee, am not going to tell them to be grateful for the source of their suffering.

This is a mass-market book, so most of its audience is stressed out about office politics or dealing with test anxiety, not living in refugee camps. While her examples are dramatic, I’m inclined to assume they are there to demonstrate the veracity of her thesis more than to suggest that people in POW camps should be grateful for the opportunity to change their lives for the better. Still, each story we hear contributes to a toxic narrative reinforcing the bootstraps mentality that suggests that the people denied the fruits of capitalism are simply doing things wrong, rather than the reality that the whole system relies on their exploitation.

Other critics have suggested that what McGonigal is highlighting is not the upside of stress, but rather cognitive appraisal — our ability to assess a situation and determine what is stress and what is a challenge. There is no evidence to suggest that you can transmute the biological experience of stress into something else through mindset.

The physical toll of stress can be independent of the pleasure we get from the experience, such as having a heart attack while running a marathon or having sex. I’m not sure how applicable it is to make the comparison of physical stress with a physical cause to physical stress with an emotional cause.

There does seem to be widespread consensus that stress pushes us into action.

That push becomes problematic in situations where we have very little ability to act, as well as in situations where prolonged stress turns this temporary super-power into symptoms of a disorder.

McGonigal seems to forget that experiments in the lab are not real life. In one experiment, a loved one was given an electric shock while the participant either held their hand or held a squeeze ball. From the findings, she tells us that “By relieving our own stress [instead of supporting our loved one] we stay stuck in fear.”

Let’s not pretend that the way people behave for 15 minutes in a carefully controlled, completely safe scenario (while wired up to neurological monitors) tells us how to respond when a loved one is diagnosed with cancer or nearly killed in a car accident. It tells us very little about how to respond in that first life changing moment and it tells us nothing about how to respond when we’re ten years into our role of caregiver.

For all it’s resistance to anecdotal evidence, science loves to take small results in small studies as compelling evidence for some much larger theory.
She tells us how the tend and befriend and response unlocks the biology of courage and how withdrawing to meet our own needs is not only futile but triggers “compassion collapse” [I don’t have a PhD, but this seems to be a misapplication of the concept].

And yet researchers cannot seem to figure out why so many people struggle with self care.

I’ve got a hunch and I bet you do, too.