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Column23 December 2002 Making everything hard work by Dr Michael Fitzpatrick Work Stress: The Making of a Modern Epidemic, David Wainwright and Michael Calnan, Open University Press, 2002. A recent bulletin from our local Primary Care Trust (PCT) reported a 'week of activities' under the banner 'Working on stress'. These included 'stress counselling', 'advice on coping with stress' and a range of complementary therapies (reflexology, aromatherapy and Shiatsu). While offering to check workers' blood pressures, managers also aimed to raise their 'self- awareness' of work-related stress. The bulletin reported that the week was 'a real success with overwhelming and positive feedback'. No doubt a relaxing massage with aromatic oils beats sitting at the computer, but in this excellent book David Wainwright and Michael Calnan warn of the danger of the emergence of a new identity: the work-stress victim. This trend is now encouraged by a wide range of influences, including the courts, health and safety legislation and policy initiatives, trade unions and employers' organisations, the media, the medical profession, and a substantial academic sector. The work-stress epidemic is believed to afflict around 'one in four' of all workers. Surveys conducted by the authors among a range of different workers - including GPs and other primary healthcare staff - confirm the extent to which the discourse of work stress has been assimilated in British society. As our PCT initiative confirms, the workplace has become the focus of psychotherapeutic intervention. The problem is that when workers adopt the identity of work-stress victim, and seek help from a counsellor or a doctor, they effectively relinquish sovereignty over their mental life. For some, it may be necessary to acknowledge that they cannot cope with a stressful job. But for many, the very process of raising awareness of stress and offering 'support' may facilitate the transition from being a coper to being a non-coper, from active worker to passive victim. Wainwright and Calnan are concerned that, while blurring the distinction between coper and non-coper may reduce the stigma of failure, it may also lower expectations of resilience. One of the strengths of Work Stress is its insistence on questioning many of the assumptions underlying the work-stress epidemic. For example, it is generally accepted that changes in working conditions and practices over the past 20 or 30 years have had a negative effect on workers. But there can be little doubt that working lives were much more arduous, dangerous and insecure in the first half of the twentieth century, when there was no epidemic of work stress. How has it come about that virtually any adverse experience at work has become redefined in terms of stress? The very fact that different workers respond differently to similar conditions confirms that the effect of workplace conditions is mediated through the consciousness of the individual worker. Whether or not adverse experiences at work lead 'to more serious psychological or physical health problems appears to depend upon a wide range of personal, social and cultural factors that determine an individual's resilience', argue Wainwright and Calnan. While most accounts of work-related stress tend to take it at face value as an epidemic disorder of the modern workplace, Wainwright and Calnan emphasise the central importance of the subjective factor, of the outlook of workers themselves, in the emergence of this phenomenon. Work Stress provides a fascinating survey of the 'history of stress', from the physiological and endocrinological studies of Walter Cannon and Hans Selye in the mid-twentieth century, to the more psychological and epidemiological studies of recent decades. Yet, despite a vast amount of research, much of it sponsored by employers concerned about their workers' productivity as much as their welfare, the nature of the stress response and its consequences remain poorly specified. The fact that high levels of stress have been invoked to explain the vulnerability to coronary heart disease of both thrusting entrepreneurs and low-status civil servants indicates the limitations of the concept. In response to the ahistorical approach of conventional accounts of stress, Wainwright and Calnan seek to incorporate the insights of epidemiology, psychology and physiology into a wider social, economic and cultural context. They emphasise 'the need to conceptualise the stressed worker as an emotionally expressive, embodied subject who is active in the context of power and social control'. They posit a 'triple helix self' from which subjectivity emerges: one strand is provided by the 'external environment' (nature, buildings, institutions); another is provided by 'discourse' (socially constructed understandings of our bodies' possibilities and limitations); the third is 'corporeality' (the physical reality of the body). The authors insist that these strands must be understood, not as abstractions, but in historically specific forms. At the tail of the helix lie biographical and historical influences (including genetics, which like the external environment and discourse, predates the birth of the individual). At its head emerges the self at any particular moment. This model allows the authors to explain the process through which phenomena become 'embedded' in the self - that is, acquire fixity and continuity over time - through all three strands of the helix. Embedded phenomena may be eroded by forces independent of human activity; they may also be changed consciously through individual activity on all three levels. The authors recognise that there may be effects through all three strands of which the individual is unconscious. Thus work stress may be experienced in the form of physical symptoms of which individual workers may have widely varying levels of awareness. Furthermore, bringing a bodily process (such as the palpitations or rapid respiration of a panic attack) into consciousness is not always sufficient to bring it under conscious control. Influences at the environmental and discursive levels have profound effects on self-identity - yet they may be simply taken for granted and regarded as immutable. The struggle to make bodily processes conscious and to master them is mirrored by the struggle to influence environmental and discursive phenomena. The key point is that the process by which physiological stress responses become embedded in the body is open to conscious restructuring. 'Has work become harder or have workers become less resilient?' The authors concede that this straightforward question is 'surprisingly difficult to answer'. They set about trying to answer it, not only by reviewing the familiar changes in the workplace and the labour market over the past 20 years, but by placing these changes in the wider political and ideological climate that has emerged following the collapse of socialism and the transformation of the trade unions. Perhaps the most telling indicator of the new times is the fact that the unions have abandoned collectivism in favour of providing personal services. They have played a central role in promoting the concept of work stress, together with issues of bullying and harassment in the workplace. As Wainwright and Calnan put it, 'work stress is the phenomenal form taken by antagonistic production relations in Western society at the current time'. In their conclusion, the authors champion 'resistance to the therapeutic imperative'. In place of the work-stress victim, they propose a 'mentally competent, emotionally resilient subject who has high expectations of human potential'. Their final sentence strikes a strangely familiar, but nonetheless inspiring, note: 'our aim has been to criticise work stress in theory; it can only be overthrown in practice.' Buy Work Stress: The Making of a Modern Epidemic by David Wainwright and Michael Calnan from Amazon (UK) or Amazon (USA) Dr Michael Fitzpatrick is the author of The Tyranny of Health: Doctors and the Regulation of Lifestyle, Routledge, 2000 (buy this book from Amazon (UK) or Amazon (USA)), and a contributor to Alternative Medicine: Should We Swallow It? Hodder & Stoughton, 2002 (buy this book from Amazon (UK). Reprinted from : http://www.spiked-online.com/Articles/00000006DBA2.htm spiked sections | central | culture | health | life | liberties | politics | science | IT spiked, Signet House, 49-51 Farringdon Road, London, EC1M 3JP Email: [EMAIL PROTECTED] © spiked 2000-2002 All rights reserved. spiked is not responsible for the content of any third-party websites. <A HREF="http://www.ctrl.org/";>www.ctrl.org</A> DECLARATION & DISCLAIMER ========== CTRL is a discussion & informational exchange list. Proselytizing propagandic screeds are unwelcomed. Substance—not soap-boxing—please! These are sordid matters and 'conspiracy theory'—with its many half-truths, mis- directions and outright frauds—is used politically by different groups with major and minor effects spread throughout the spectrum of time and thought. That being said, CTRLgives no endorsement to the validity of posts, and always suggests to readers; be wary of what you read. 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