Monday, August 25, 2014

Compassion versus competition: What does your body think?

For me, September brings many new experiences: new students, new apartment, new projects, new bosses and supervisors, new routines. New, new, new. What I know from my training and research is that new is almost always a source of stress for the mind and the body. Repeated physiological stress can have a significant negative impact on your health, but I won’t belabor the point, since I’ve discussed the impact that stress has on the body already here and here. This happens because the activation of the stress system distributes hormones throughout the body to help you overcome the present threat, but these same hormones damage tissues in the brain and the body when distributed frequently and in excess.

Unfortunately, novelty is not something we can avoid in life, nor would it be advisable, interesting or, dare-I-say, “healthy” to try to live that way. So, if our goal is to have a full and enriched life, while protecting our physiological resources, are there strategies we can use to strike that balance? If so, are they mental or physical?

Luckily, Dr. James Abelson and his colleagues at the University of Michigan (GO BLUE!) have dedicated their brilliant scientific minds to understanding what stress really is, what it does to the brain and body, and what causes it. Most recently, they asked the very specific question:

Can thinking of others during a stressful task help buffer the physiological stress response? 

To answer this question, they recruited 54 mentally and physically healthy adults (age 18-45) and had them complete a lab stress task. Before, during, and for 1 hour after, the research team collected blood samples (from which they extracted stress hormones) through an IV. Participants were asked to take 3 minutes to prepare a 5-minute speech about their qualifications for their ideal job, and then deliver this speech in front of a panel of male and female judges. During their speech, they were scrutinized by these judges, and when unable to fill the 5 minutes they were asked questions about their qualifications. Immediately following this speech task, the participants were asked to serially subtract 13 from 1022. If they made a mistake, they were asked to begin again. Oh, and I forgot to mention, all of this is done on videotape too. This is a pretty standard stress task in psychology, if not the most widely used.

So what’s the experiment? Before beginning the stress task, each participant was randomly assigned to 1 of 4 instructions conditions: standard, standard with control, coping, and compassionate goals.

The standard condition included the stress task instructions as they are typically delivered in other studies.

In the standard with control condition, participants were allowed to close a curtain to shield them from the judges and camera in order to reduce their distress during parts of the task.

In the coping condition, participants were provided with information on cognitive coping strategies to help reduce subjective experiences of stress. For example, participants were given information on how to “normalize negative thoughts and anxiety-related bodily sensations,” while also receiving reassurance that “physical and emotional sensations were normal” for this task. These strategies are consistently effective in stopping negative thoughts from perpetuating the cycle of anxiety.

Finally, and of most interest, the compassionate goal group was intended to shift their goal from self-promotion to helping others; from competition to compassion. To do this, the participants were advised that an alternate strategy to promoting your skills and abilities in a job interview could be to instead emphasize the good they could do for others if given the position.

Overall, Dr. Abelson’s team was interested in how the release of stress hormones in response to this task would differ between these groups, or whether these cognitive interventions would reduce the physiological burden of this stress task. They found that the participants in all of the 4 groups reported no differences in their experiences of stress throughout the task. They all found it pretty stressful, but their bodies told a different story. Participants in the coping group (given ideas of how to think about their stress experience as normal so as not to perpetuate anxiety), actually began to release stress hormones before the stress onset. This suggests that efforts to learn or employ this strategy actually caused them to worry in anticipation of the task. In addition, this group demonstrated higher stress hormone concentrations in response to the task.

In comparison, they found that participants in the compassionate goal group had substantially lower stress hormone release during and following the stress task compared with the other groups. This suggests that reducing the mind’s focus on the self and reaching competitive goals in comparison with others by focusing on helping others can reduce the physiological activation of the stress system.

As with any good study, there are limitations to these findings. To me, the most important to consider is that these interventions were not designed with a goal of improving job interview performance and performance was not measured as far as I can tell. So, while the compassionate goals intervention was “better” for the body, there is no way to know whether it would help achieve the goal of an interview, which is convince the judges to hire you. Related to this, participants in all 4 conditions reported their perception of stress during the task as exactly the same. In other words, even though participants in the compassionate goals intervention had lower stress responses and those in the coping group had higher stress responses, they all remember the stress task as being equally stressful. Thus, none of these interventions make the task seem any easier.

As a clinical psychologist, I find this last detail to be the most important. Cognitive skills, such as was used in the coping intervention are meant to be learned, practiced, and then implemented. They are the cornerstone of effective psychotherapy interventions for patients with anxiety. The first time a person uses a cognitive skill for managing anxiety, it will be difficult and will appear to “not work.” I can’t tell you how many times I have had patients returning to therapy with a “that didn’t help” experience. And I agree, nothing works automatically, it takes practice and repetition. What I would be interested to see, is whether the coping intervention resulted in reduced anxiety, both physiologically and psychologically, if that participants had time to practice or even master this intervention.

So what’s the point? You can reframe thoughts about a stressful experience to reduce the physiological experience of stress. These findings are surprising and encouraging to me while also thought-provoking as a clinical psychologist. Overall, taking a compassionate and others-focused approach to something generally stressful, such as a job interview, can reduce the physiological burden of the task at hand. This is fascinating to me, since there is a strong link between helping others and better physical health. This study suggests that the physiological stress response system may explain the link between them. While taking a compassionate, other-focused approach to your next stressful assignment may not change your life today, your body will thank you tomorrow.

Abelson, J. L., Erickson, T. M., Mayer, S. E., Crocker, J., Briggs, H., Lopez-Duran, N. L., & Liberzon, I. (2014). Brief cognitive intervention can modulate neuroendocrine stress responses to the Trier Social Stress Test: Buffering effects of a compassionate goal orientation. Psychoneuroendocrinology, 44, 60-70.


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