From the notebook of Dr. HANS SELYE

This famous Canadian doctor, whose theories on stress inspired a new approach to medicine, looks at our ills, worries, hopes and failures and—from a great knowledge—offers some fascinating findings

October 13 1956

From the notebook of Dr. HANS SELYE

This famous Canadian doctor, whose theories on stress inspired a new approach to medicine, looks at our ills, worries, hopes and failures and—from a great knowledge—offers some fascinating findings

October 13 1956

From the notebook of Dr. HANS SELYE

This famous Canadian doctor, whose theories on stress inspired a new approach to medicine, looks at our ills, worries, hopes and failures and—from a great knowledge—offers some fascinating findings

a Starting new insight into the life, health and arms of men

THE FEEL OF LIFE

After a pilot has left the ground in a plane—unless he wants to kill himself—he cannot stop his motor before he gets back to earth. Yet there is much he can do to get as far as possible with a given airplane and fuel supply, under given climatic conditions. The two great limiting factors over which he has no control are: the fuel supply and the wear and tear that the weakest part of his plane can tolerate.

When a human being is born—unless he wants to kill himself—he cannot stop before he has completed his mission on earth. Yet he too can do much to get as tar as possible with a given bodily structure and supply of adaptation energy, under given social conditions. 1 he two great limiting factors—which are set when a man is born -—are: his supply of adaptation energy and the constant wear and tear the weakest vital part of his body can tolerate.

The real fuel of life is not the food we take, but adaptability, because the living machine can make repairs and adjustments en route, as long as it has adaptation energy. With this it can assimilate caloric energy from its surroundings. Consequently, resting an overworked part in the body helps not only by "cooling it down” but also by permitting it to make major repairs and even improvements. The object of man is not to keep going as long as possible. This is charmingly expressed by the statement on the masthead of the Journal of Gerontology, a medical journal devoted to the study of old age: “To add life to years, not just years to life.”

Man certainly does not get the feeling of happiness, of having completed his mission, just by staying alive. A long life without the feeling of fulfillment is tedious. And yet. when they analyze their lives, most people get the feeling of merely muddling through from one day to the other. Just staying alive is no adequate outlet for man's vital adaptation energy. Comfort and security make it easier for us to enjoy the great things of life, but they are not in themselves great and enjoyable aims.

WHAT MAKES YOU DIF

Our reserve of adaptation energy is an inherited finite amount, which cannot be regenerated. On the other hand, we could enormously lengthen the average life span by living in better harmony with natural laws.

Among all my autopsies (and 1 have performed quite a few) I have never seen a man who died of old age. I don't think anyone has-ever died of old age yet. To die of old age would mean that all the organs of the body are worn out proportionately, by having been used too long. In practice, this is never the case. We invariably die because one vital part wore out too early.

the

“There is a difference between work that puts you to sleep and the work that keeps you awake”

An old man may die because one wornout hardened artery breaks in his brain, or because his kidneys can no longer wash out the metabolic wastes from his blood, or because his heart muscle is damaged by excessive work. But there is always one part that wears out first and wrecks the whole human machinery.

What makes you grow old?

Aging is not determined by the time elapsed since birth, but the total amount of wear and tear to which the body has been exposed. There is a great difference between physiologic and chronologic age. One man may be much more senile in body and mind—and much closer to the grave—at forty than another person at sixty. True age depends largely on the rate of wear and tear, on the speed of self-consumption; for life is essentially a process that gradually spends the fixed amount of adaptation energy we inherited from our parents.

Vitality is like a bank account that you can use up by withdrawals but never increase by deposits. Your only control over this precious fortune is the rate at which you make your withdrawals. The solution is not to stop withdrawing, for this would be death. Nor is it to withdraw just enough for survival, for this would permit only a vegetative life, worse than death. The intelligent thing is to withdraw generously, but never squander.

Many people believe that, after stressful activities, a rest can restore them. This is false. Experiments on animals have show-n that each exposure leaves an indelible scar; it uses up reserves of adaptability that cannot be replaced. Since we constantly go through periods of stress and rest during life, just a little deficit of adaptation energy every day adds up to what we call aging.

The great art is to express our vitality through the particular channels and at the particular speed nature foresaw for us.

Will stress conquer cancer?

A fascinating field for research is the study of stress in relation to cancer. It is well known that a large variety of cancers do not grow well in animals or people subjected to severe stress. In fact, sonic types of cancer have undergone considerable (though incomplete) regression under the influence of ACTH, cortisone and other hormones. To what extent could we, by learning more about the mechanism of such regressions, help in the fight against this, the most terrible among human ailments?

Can you beat insomnia?

The stress of a hard-working day can make you sleep like a log or it can keep you awake all night. There is a difference between the work that helps you to sleep and the work that keeps you awake. A stressful activity that has come to a definite stop prepares you for rest and sleep; but one that sets up self-maintaining tensions keeps you awake. The fatigue of work well accomplished gets you ready for sleep but, during the night, you must protect yourself against being awakened by stress.

Everybody knows the value of protection against noise, light, variations in temperature, or the difficulties of digesting a heavy meal taken before retiring. But what can you do to regulate psychologic stress so it will not keep you awake?

If you suffer from insomnia, there is no point in telling yourself: "Forget

everything and relax; sleep will come by itself." It doesn’t.

Sheep-counting, warm milk, hot baths are of little value, since they help only those who have faith in them. By the time you retire it is too late for anything except the sleeping pill. It is during the whole clay that you must prepare your dreams;

• Do not let yourself get keyed up more than is necessary to acquire the momentum for the best performance of what you want to do. If you get keyed up too much, especially during the later hours of the day, it may carry over into the night.

• Keep in mind that hormones produced during acute stress tire meant to key you up for peak accomplishments. They tend to combat sleep and to promote alertness during periods of exertion; they are not meant to be used all day long. II too many of these hormones are circulating in your blood they will keep you awake just as a tablet of ephedrine (a derivative of adrenaline) would. Your insomnia has a chemical basis that cannot easily he talked away after it has developed.

• Try not to overwork any one part of your body or mind by repeating the same actions to exhaustion. Be careful to avoid repeating the same task when you are already exhausted.

• Nature likes variety. Remember this, not only in planning your day, but in planning your life. If you use the same parts of your body or mind over and over again the only means Nature has to force you out of the groove is stress.

• If a sleepless night follows a day of overexertion, next day your work will have to be done while you are sleepy. The stress of it may mean another sleepless night and the development of a vicious circle difficult to break. The best way out is to sleep during the day or to take a mild sleeping powder at night.

Don’t overload your memory

There is a limit to how much you can burden your memory. Trying to remember too many things is one of the major sources of psychologic stress. I make a conscious effort to forget all that is unimportant and to jot down data of possible value (even at the price of having to prepare complex files). Thus I keep my memory free for facts truly essential to me. This technique can help anyone to accomplish the greatest simplicity compatible with the degree of complexity of liis intellectual life.

Are your goals worthwhile?

Let me present a little motto 1 developed while analyzing stress in my experimental animals, my colleagues, friends and myself. It is based on solid biologic laws and—at least in my case—it works. Whatever happens during the day that threatens my equanimity 1 just think of this little jingle:

Fight always for the highest attainable

aim

But never put up resistance in vain.

Everyone should fight for whatever seems worthwhile to him. On the other hand, he should aim only for things attainable; otherwise he will merely become frustrated. Finally, resistance should be put up whenever there is reasonable expectation of its succeeding, but never it we know it would be in vain.

Any time when I begin to teel keyed up, 1 stop to analyze the situation. 1 ask myself: Is this really the best thing I could do now, and is it worth the trouble of putting up resistances against arguments. boredom or fatigue? If the answer is no. 1 just stop.

Can you stop worrying?

Everyone knows how much harm can be caused by worry. Medical textbooks arc full of cases of gastric ulcers, hypertension. arthritis and other diseases caused by chronic worrying. Nothing is accomplished by telling such people not to worry. I hey can't help it. I he best remedy is deviation or general stress. By highlighting some other problem or by activating the whole body the source of our worries automatically becomes less important.

For a person who is to undergo a dangerous operation, or finds himself on the verge of economic disaster, it is impossible to stop worrying just by deciding not to. You must find something to put in the place of the worrying thoughts. I his is deviation. If such a person undertakes some strenuous task that needs all his attention, he may still not forget his worries, but they will fade. Nothing erases unpleasant thoughts more effectively than concentrating on pleasant ones.

How tension makes you drunk

Everybody is familiar with the feeling of being keyed up from nervous tension. Our muscles limber up during exercise and we are thrilled by emotional experiences. On the other hand, jitteriness from being too keyed up impairs our work and even prevents us from getting rest. Being keyed up is a real sensation. It has not yet been fully analyzed, but we know that at times of tension our adrenals produce an excess both of adrenalines and of corticoids. We also know that taking adrenalines or corticoids can produce a sensation of being keyed up and excitable. We know too that stress stimulating our glands to make hormones can induce a kind of drunkenness. Without knowing this, no one would think of checking his conduct as carefully during stress as he does at a cocktail party. Yet he should. The fact is that a man can be intoxicated with his own stress hormones. 1 venture to say that this sort of drunkenness has caused much more harm to society than the other kind.

In all our actions throughout the day we must look for signs of being keyed up too much—anti we must learn to stop in time. To watch our critical stress level is just as important as to watch our critical quota of cocktails. More so. Intoxication by stress is sometimes unavoidable and usually insidious. You can lay off alcohol: even if you do take some, at least you can count the glasses. It is impossible to avoid stress as long as you live and your conscious thoughts cannot gauge its alarm signals accurately.

Many more people are the helpless slaves of their own stressful activities than of alcohol. Simple rest is no cure. Activity and rest must be judiciously balanced.

How much rest you need

Every person has his own requirements for rest and activity. To lie motionless in bed all day is no relaxation for an active man. With advancing years most people require increasingly more rest, but the process of aging does not progress at the same speed in everybody. Many a valuable man who could still have given years of useful work to society has been made physically ill, and prematurely senile, by retirement at an age when his requirements and abilities for activity were still high. This psychosomatic illness is so common that it has even been given a name: “retirement disease.”

All work and no play is harmful for anyone at any age: but then, what is work and what is play? Fishing is relaxing play for the business executive, but it is hard work for the fisherman who fishes for his living.

Complete rest is not good, either for the body as a whole, or even for any organ within the body. Stress, applied in moderation, is necessary for life. I have always been against the advice of physicians who would send an extremely active business executive to a long exile in some health resort to relieve him from stress. Ambitious and active men often become much more tense when they feel frustrated by not being allowed to pursue their usual activities.

When you need rest

It seems to he one of the most fundamental laws regulating human activities that no one part of the body must be disproportionately overworked for a long time.

To carry a heavy suitcase for a long time without fatigue, you have to shift it from one hand to the other occasionally.

If there is too much stress in any one part of the body, you need diversion. If there is too much stress in the body as a whole, you must rest.

The curative value of knowing thy body

Most of our tensions and frustrations stem from compulsive needs to act the role of someone we are not. Only he who knows himself can profit by the advice of Matthew Arnold:

Resolve to he thyself: and know, that

Who finds himself, loses his misery.

The mere fact of knowing what hurts you has an inherent curative value. Psychoanalysis has demonstrated this better than any other branch of medicine. The psychoanalyst helps you to understand how previous experiences—which may have led to subconscious conflicts, sometimes early in childhood—can continue almost indefinitely to cause mental or even physical disease. But once you realize the mechanism of your mental conflicts, they cease to bother you.

To know “thyself" includes the body. Most people fail to realize that “to know thy body” also has an inherent curative value. Take a familiar example. Many people have joints that tend to crack at almost every movement; by concentrating upon this unexplained condition, a person can talk himself into a crippling arthritis. If, on the other hand, some understanding physician explains to him that his cracking sensations are due to slight inconsequential irregularities in joint surfaces that have no tendency to become worse, the disease is practically cured—just by the knowledge of its trilling nature.

Almost everybody has had some insignificant allergic condition of the skin, cardiac palpitations or intestinal upsets; any of these can cause serious illness through psychosomatic reactions merely because not knowing what is wrong makes us worry.

Gratitude as our ultimate aim

Gratitude and revenge are the most important factors governing our actions in everyday life. Upon them also depend our peace of mind, our feelings of security or insecurity, of fulfillment or frustration—in short, the extent to which we can make a success of life.

Gratitude is the awakening in another person of the wish that 1 should prosper. It is perhaps the most characteristically human way of assuring security. By inspiring the feeling of gratitude, I induce another person to share with me my wish for my own well-being.

Revenge is the awakening in another person of the wish that I should not prosper. It is the most important threat to security. Still, it also has its roots in a natural defense-reaction. It is a savage distortion of the natural wish to teach others not to hurt us. When we punish a child for doing something bad. our action comes very close to revenge, even if it is guided by parental love. Punishment is an object lesson that teaches proper future conduct by retaliation. Unfortunately, in practice, it is very difficult to draw the line between teaching by punishment for a constructive purpose, and senseless, purely vindictive retaliation as an aim in itself, a morbid satisfaction of the urge for self-expression.

Both gratitude and revenge are feelings concerned with reward: they are, in a sense, remunerations: the former for

good, the latter for bad actions. But the important point is that both have common fundamental qualities that might fit hem to act as ultimate aims.

We need not give much thought to revenge; it is nothing but a grotesque malformation of our urge to teach; a kind of “disease of the teaching instinct." It has no virtue, and can only hurt both the giver and the receiver of its fruits. The seeds of any fruit can only reproduce the tree they came from. Revenge generates more revenge, while gratitude tends to incite still more gratitude.

To me, the most striking feature of inspiring gratitude is that it possesses— more than any other value—all those characteristics we seek in some ultimate aim based on the laws of Nature:

• It can act as a common denominator for the most diverse ways of selfexpression; each person can strive to inspire gratitude in others, according to his own talents.

• The effects of gratitude are lasting; they can be accumulated.

• Neither wealth, nor force, nor any other instrument of power can ever hope to be more reliable in assuring our security and peace of mind than the knowledge of having inspired a great deal of gratitude in a great many people.

Can a conscious striving for gratitude become a way of life? When 1 first thought of it, 1 did not think so. Working for any kind of reward seems unworthy of becoming the ultimate aim of existence. Most people would not like to admit—-even to themselves—that they do v/hat they do just to make other people grateful.

When you ask an artist why he paints, an author why he writes, a soldier why he risks his life in battle, they may give you all kinds of answers—some idealistic, some mercenary—but they would laugh at the idea that they want gratitude.

The scientist who sacrifices his private life in laboratory work may admit that he does it only “for fun" or out of a wish “to be of service.” But he would be surprised — and indeed ashamed — if you succeeded in convincing him that he actually works to earn the gratitude of fellow men. Most scientists would consider this selfish, if not naïve. Yet, what is more selfish and more naïve, working “for fun" or for gratitude?

My suggestion seems even more preposterous when you think of people who do things that could not be of any material or spiritual help to anybody. Do they also work for gratitude? Take the gunman whose life is a chain of robberies and murders? And what of the man who gives anonymously to the poor, precisely because—by not asking for gratitude— he wants to please God?

Yet, if you look a little closer, are not these forms of self-expression subconsciously planned to earn gratitude? There is the gratitude of those who are inspired by a great painting or a great idea, the thankfulness of men who have been saved by the valor of soldiers or the genius of scientists. And does not even the most debased thug commit his crimes because his earlier attempts to express himself in a manner that would earn gratitude have failed? And does not the saintly giver remain anonymous because he prefers grateful approval by a divine being to the gratitude of men?

Why is everybody so anxious to deny that he works for recognition? 1 have met a great many scientists, but 1 doubt if any would have thought that public recognition of his achievements—by a title, a medal, a prize or an honorary degree— motivated his enthusiasm for research. When a prize brings both honor and cash, scientists would be more inclined to admit being pleased about the money (“one must live") than about the public recognition (“I am not sensitive to flattery"). Why do even the greatest minds stoop to such falsehoods? Most talented scientists ;ve not at all money-minded. On the other hand, all the scientists 1 know sufficiently well to judge are extremely anxious to have their work recognized and approved by others. Is it not below the dignity of scientific mind to permit such a distortion of his true motives?

To give meaning and direction to life we must have some ultimate aim. That is why a natural ultimate aim must have two great characteristics: it must be something we can work for (otherwise it would give no outlet to self-expression), and its fruits must be sufficiently permanent to accumulate as life goes by (otherwise it could not be an ultimate aim). To please God. to live for the country or the family, or any other worthwhile and permanent institution, have long served mankind in its search for long-range aims.

As much as we thirst for approval, we dread censure. I do not know of a single person who "doesn’t care what anybody says.” Those who are honest with themselves know that they would prefer to be approved rather than criticized — even when they arc quite certain to be right in cither case.

Among all human attributes the one most harshly and justly criticized is egotism. And yet selfishness is the most fundamental characteristic of living matter. We cannot avoid being egotists. To incite gratitude in others is perhaps the most natural basis for the ultimate aim of man. It can be hoarded throughout life and accumulated into a tremendous wealth that, more reliably than any other, assures our security and peace of mind in this world. It is an egotistic aim: that is why it is so fundamentally natural. It can be pursued through whatever talents you may have; that is why it permits selfexpression to anyone. It can be accumulated as long as you like and even your offspring will benefit by it; that is why it can act as a proper long-range aim. And —best of all—this is one type of selfishness for which you certainly need not dread censure: no one will blame you for hoarding the gratitude of your fellow men.

Gratitude, whether you receive it or give it. is in itself enjoyable. But there arc many pleasing things that do not seem logically related to the incitement of gratitude. The passive receipt of rewards, for instance. The enjoyment of food and drink, of a beautiful sunny day, of a magnificent painting, or the purely sensual pleasures of sex, are not sought to inspire gratitude in others. But let us not forget that the actual receipt of rewards—no matter how great the delight it can give us—is also quite unsuitable to act as an ultimate aim in life. Why? Simply because it is too ephemeral. It can be ardently sought to enrich a moment; but we cannot accumulate these sensations into a treasure assuring our security and peace of mind in the future. Still, striving toward gratitude is so deeply rooted in man’s nature that we feel the instinctive urge somehow to connect even these values with thankfulness: to say grace before dinner, to ennoble sex with grateful love, to feel indebted to the maker of every enjoyable thing—be it a poem, a health-restoring drug or a sunny day—has its roots in this feeling.

These passive pleasures are disqualified from being ultimate aims; but they still can be important aims. The passive enjoyment of great art, or of the wonders of Nature, help us to achieve a degree of equanimity and while they give no means for self-expression, they help to provide self-sufficiency. The better we learn to enjoy greatness—be it in art or in Nature —the more we profit from contemplating it. To learn how to enjoy this kind of greatness can be a very exacting task and—since it involves activity—it is an outlet for self-expression in itself. This can be learned, and it is well worth learning.

Can selfishness be good?

In a sense, selfishness is the original sin, not only of man, but of all living beings. Why pretend that we can do without it? We cannot, and trying just leads to frustration and self-incrimination. But if we follow the philosophy of gratitude, we make all our selfish impulses also altruistic. From a scientific point of view, this strikes me as the most highly ethical among all possible natural guides to conduct. No one will blame us for hoarding avariciously the gratitude of our fellow men. it

Dr. Selye’s observations will be included in a book. The Stress of Life, to be published later by McGraw-Hill Book Co.