This is a book about confusion. Stress is a word we throw around like confetti, yet no one knows or cares much what it means. “It’s like defining sex, it’s pretty impossible,” says the managing director of a company selling stress tests.

Stress is everywhere these days – there are 11 million websites devoted to the condition, one per cent of the British population is said to be living with “post-traumatic stress disorder”, and any self-respecting celebrity boasts of having had at least one breakdown. Stress is now accepted as a part of modern life, Angela Patmore argues, “because a powerful ideology has convinced people of its existence”.

Fear of anxiety is not a new phenomenon and the author uncovers stress’s antecedents in amusing places, from the “flutterings” and “spasms” of Mrs Bennet in Pride and Prejudice to the pages of the Spectator in 1894, which reported that in an age of “luxurious indulgences” men were giving up hunting and polo because of “lost nerve”.

In the 1930s, an Austrian endocrinologist, Hans Selye, invented the modern, medical version. Selye defined stress as “the rate of wear and tear on the body”. He conducted experiments on animals, exposing them to extreme hardship, and found that they all manifested characteristic physiological changes. Stress for him was about how the body responds to injury or disease, but Patmore blames him for the inexact science that was spawned.

Today, “life events” are what make us stressed out. There is even a league table of “life change units”, with death of a spouse in number one place, earning you 100 points, followed by divorce on 73. Down at the bottom is Christmas, with an almost relaxing 12 points. And from Selye’s wear-and-tear concept, we now have an anything-goes approach, as evidenced by the Health and Safety Executive’s definition: “Stress is the natural reaction people have to excessive pressures or other types of demand placed on them.”

By the 1990s, the World Health Organisation was calling stress “a worldwide epidemic”. It is hard not to laugh at the absurdity of it all. Twenty-nine per cent of Americans admit to having “yelled” because of stress, while 26 per cent have been driven to eat chocolate. It is reassuring, then, to find that Britain leads the world in stress management, with firms offering “contentment audits” for office workers for a mere £280 plus VAT. Of course, if that fails, there are always dolphin click noises, aroma pillows and the ineffable “squeezy water knobbled key-rings”.

We not only have a National Stress Awareness Day but also a “stress bus tour” of central London. In August 2003, detectives in North Wales were issued with stress balls, while at the BBC harassed journalists have been reminded by occupational therapists to “ensure you sit on the cheeks of your bottom”.

All this is good knockabout stuff, until you read the casualty figures. Half of all sickness absence in Europe is now stress-related and, in December 2004, the Government published figures showing that more than a million people were unable to work due to emotional problems – a 45 per cent rise since 1997. The cost of this alone is estimated at £2.4 billion a year. Those who benefit from the growing diagnosis of stress are drug companies and the huge stress-management industry, which in America was estimated to be worth $11.3 billion in 1999.

Patmore, who scrupulously handles the term with inverted commas throughout, believes that we are medicalising people for perfectly normal emotional reactions. Her alternative is to separate stress into “arousal” and “resignation”, illustrating the difference between healthy stimulation and a powerless sense of vulnerability. She quotes the “hormesis” school of doctors, who argue that we must seek short bursts of stressful activity to be healthy and that too much relaxation can be bad for us.

Patmore’s analysis can be simplistic and pedantic. “Stress” is a useful word to describe the low-level panic that we have all experienced at some time. And there is no consideration of plausible modern theories such as “status anxiety”.

She can also seem glib about suffering. Her suspicious attitude to shellshock seems to deny the psychological torment that broke many brave young men in the trenches of Passchendaele and the Somme and, like many polemicists, she quotes selectively and overstates her case. Another annoyance is her clunky prose and banal generalisations, such as the assertion that Asian shopkeepers are “tirelessly polite and cheerful” and never suffer from stress.

But, on balance, her book is a welcome antidote. In an age where commentators talk of Sri Lankan children being “in denial” about the tsunami because they want to go back to school, it is time to accept that stress theory has gone too far. Come back stiff upper lip, all is forgiven.

The Truth About Stress by Angela Patmore, 440pp, Atlantic Books, £12.99

This piece appeared in the Daily Telegraph on 5 February 2006

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