Workplace stress – medical epidemic or all in the mind?
A Battle in Print by Ken McLaughlin, senior lecturer in social work, Manchester Metropolitan University
Whether it is the public or private sphere, the world of work is increasingly presented as a source of stress. According to the Health and Safety Executive (HSE), one in five of us is stressed, whilst 79 per cent of us reported ourselves to be stressed in the past year.The impact on industry in monetary terms alone due to staff sickness and reduced productivity is said to be huge. Add to this the psychological torment of those suffering from stress-related disorders, and there would certainly appear to be a serious social problem.
Given the apparent ubiquity of ‘stress’, it is important to interrogate the stress phenomenon. This means that we need not only to understand what ‘stress’ is, or rather what it represents, but also to understand why it has become such a dominant part of modern culture, and what the implications are for us, both as individuals and as a society.
What is stress?
Biological accounts of stress maintain that it is a residue of the ‘fight or flight’ response necessary for the survival of our early ancestors, which maximises the body’s readiness to respond to life-threatening incidents with split-second decisions and optimum efficiency. While modern societies may have reduced physical dangers, according to one guide on combating workplace stress, the psychological demands and threats we face are no less severe, and ‘our interactions and relationships with family, friends, work colleagues and strangers have now become the “fangs of the sabre-tooth tiger”’ (Gregson and Looker 2004: 5).
The ‘stress response’ results in complex biochemical changes and physical sensations, and how it is experienced is said to be little different to how it was experienced by our forefathers. However, when workers complain that they are suffering from stress, do they mean that they are experiencing the fight or flight response? Or is it more likely that ‘stress’ has become a shorthand way of expressing a general dissatisfaction with their work? Could stress be a mimetic disorder, a form of hysteria whereby people mimic socially acceptable ways of exhibiting distress? If so, the current interest in, and expression of, stress in the workplace may lie more in societal and subjective changes than with purely biomedical explanations.
Of course, the fact that ‘stress’ is not a simple phenomenon does not necessarily mean that it is not a useful concept. Stress management experts would contend that by giving a name to unhappiness, the causes of stress and related physical problems can help in our understanding of how to combat unhappiness, and to treat it when it does arise. Even staunch critics of the work stress phenomenon acknowledge that stress is ‘real’ insofar as it has real consequences for those who face problems at work (Wainwright and Calnan 2004).
Whilst there have been numerous attempts to define stress, arguably the most common definition is that espoused by the HSE, one which is reproduced in many organisations’ stress policy documents. According to the HSE, stress is ‘The adverse reaction people have to excessive pressures or other types of demands placed upon them’.Like many proponents of the reality of work stress, the HSE does not deny that in life we will face demands and burdens which can be motivational and rewarding. They refer to such demands as ‘strain’ or ‘pressure’. It is only when ‘the level of pressure becomes harmful, counterproductive or in any way negative, [that] the term “stress” becomes applicable’ (Thompson et al. 1994: 2). Rather than a mere biological entity, stress is here held to be both an objective and subjective phenomenon, hinging as it does on both the objective dimension (the level of pressure) and the subjective dimension of the individual’s response to such pressure.
Does stress cause ill-health?
It is claimed that during the 1980s work stress was ten times more costly for employers than industrial relations disputes (Earnshaw and Cooper 1996), whilst in 1999 the Trades Union Congress estimated the cost of stress to industry at £5 billion a year (Paige 1999). Stress is said to lead to, or influence, the onset of a variety of physical health problems, such as coronary heart disease, alcohol-related diseases, asthma, high blood pressure and stomach ulcers, to name but a few. It is also said to lead to numerous psychological problems, including depression, paranoia, low self-esteem, and, in extreme cases, suicide or self-harm (See amongst numerous examples Earnshaw and Cooper 1996; Anderson 2006: 6).
With such wide-ranging physical and psychological symptoms that can be attributed to stress, is there a danger of making the very term meaningless? It would appear to be common sense that high stress levels will be detrimental to our health. However, some argue that the evidence base for such assertions is either weak or exaggerated, and even unclear or unproven (Briner and Reynolds 1999). One critic suggests that with five decades of research failing to validate the ‘stress leads to ill-health’ hypothesis, its proponents are adopting a position based on faith rather than evidence (albeit simultaneously clinging to the hope that future research will finally validate their belief) (Newton 1999a).
Whilst all agree that there has been an exponential rise in professional, governmental and academic interest in the subject of stress, there is disagreement as to what such a proliferation represents.
For some, it has not suddenly become a problem, on the contrary it has always been a problem, it was just unrecognised or hidden. From this perspective it is increased awareness and improved diagnostic expertise that has uncovered this hitherto hidden epidemic. In addition, social change and the increased pace of life, and the demands and uncertainty it brings, make us more susceptible to stress. This view is summarised well by one stress management consultant:
Our lifestyle has also made us far more susceptible to stress and stress is therefore on the increase in our society. We have more pressure put onto us in day to day living. We may live far away from the support of our immediate family, we may have very little family support and have no one to talk to…we have less job security and fear redundancy…the pace of life is much, much faster. We are inundated with e-mails, mobile phones ring constantly. We can never switch off or escape. All these factors together with many more make for a more stressed out society (Anderson 2006).
Few would argue that we face different pressures today than previously. However, is it the case that work and life are so much more difficult than in the recent or distant past? In relation to job insecurity, one British study found that average job tenure had changed little between 1975 and 1998 (Gregg and Wadsworth 1999). Whilst there is evidence of a slight rise in working hours in the 1990s, in a historical context it is hard to maintain that our working hours and conditions are worse than those faced by our parents and grandparents – conditions that were not only long and arduous but often dangerous and life threatening (Wainwright and Calnan 2004).
The focus on work stress and its management has also been criticised for individualising work-based conflict. The ‘stress fit’ employee is also the productive worker. This labour process theory of work stress is critical of the way in which employee grievances can be defined away as being the intrinsic weakness of an individual worker. In such a way, issues that could have been seen as potentially requiring a collective response by workers are reinterpreted as the responsibility of the individual worker – the grievance becoming a form of sickness to be cured by therapeutic intervention (
No doubt such critiques have a point, but whether they can be so readily applied to today’s context is a matter of debate. For example, from being viewed as a convenient tool which management could use to exercise control over the workforce, increasingly workers are using the issue of stress against their employer by way of litigation. In addition, policy advice maintains that employers ‘have a legal duty to ensure that health is not placed at risk through excessive and sustained levels of stress arising from the way work is organised’ (Health and Safety Executive 1995: 8). Far from choosing a therapeutic management style with which to control the workforce, employers are now obliged to implement stress management schemes designed to identify stress-inducing factors and to develop staff awareness of causes and symptoms of stress. Trade unions, far from being critical of such therapeutic practices, have in fact played a key role in their rise and implementation (Wainwright and Calnan 2004).
In other words, today it is not only the worker but also the organisation itself that becomes the primary target of stress-management intervention.
Few would disagree with proposals that make the workplace safer and more comfortable to work in. However, why are these demands framed in terms of the sick and vulnerable worker, rather than in terms of the strong collective worker of the not too distant past? Why have our colleagues and friends, once seen as people with whom we could unite, been transformed into threats to our mental health? By placing these demands in terms of the vulnerability of staff, do improvements come at a price, as workers are encouraged to adopt the sick role and defer to the therapeutic professional? Instead of raising their self-esteem, are we in danger of undermining workers’ resilience? Is it the discourse of stress rather than stress itself that stands in the way of the healthy worker?
Anderson, R. (2006). Understanding Stress: Myths and Realities.
Briner, R. and S. Reynolds (1999). ’The Costs, Benefits and Limitations of Organizational Level Stress Interventions’. Journal of Organisational Behaviour 20: 647-664.
Earnshaw, J. and C. Cooper (1996). Stress and Employer Liability.
Gregg, P. and J. Wadsworth (1999). ‘Job Tenure 1975 – 1978’ in P. Gregg and J. Wadsworth (eds) The State of Working Britain.
Gregson, O. and T. Looker (2004). MMU Guide to Managing Stress.
Health and Safety Executive (1995). Stress at Work: A Guide for Employers.
Paige, G. (1999). Work Stress: A Suitable Case for a Code.
Thompson, N., M. Murphy and S. Stradling (1994). Dealing With Stress. Hampshire, Macmillan.
Wainwright, D. and M. Calnan (2004). Work Stress: The Making of a Modern Epidemic. Buckingham, Open University Press.
date created:27/6/2006 17:35:38
last updated:27/9/2006 17:22:57