By Dr. Bob Kamath
This is an excerpt from "Is Your Balloon About To Pop?
This chapter gives a general outline of stress and
various stress-related issues. In the subsequent chapters, each of these issues will be explained in greater detail, with
examples. I recommend that readers, especially those with stress
disorders such as depression and anxiety, review this chapter
thoroughly several times and understand the model of the mind before
proceeding to the next chapter.
1. Stress is contagious.
Yes, stress is contagious. There is much truth in the following
story: An irate woman verbally abuses her timid husband, a
schoolteacher. Humiliated, the teacher takes his anger out on his
student by paddling him. Outraged over the unjust punishment, the
student kicks his hapless dog. The resentful dog bites the lazily
snoozing cat. The incensed cat works out its frustration by mauling
an unlucky rat. Running scared for its life, the wounded rat topples
an oil lamp, shattering it into a thousand pieces on the floor. The
burning oil from the broken lamp sets the house on fire. Carried by
the blowing wind the raging fire jumps from house to house and
spreads rapidly across the doomed town. The whole town goes up in
smoke—all because of the wrath of one woman.
Not only does stress adversely affect the health of people Suffering from it, but it also negatively affects everyone around
them. A stressed-out boss can upset all his underlings and create an
intolerably tense atmosphere at work. These upset workers might take
out their anger, helplessness and frustration on their family
members. Sometimes I see many workers from the same company, all
seeking psychiatric help immediately after a new boss has come on
board. Sometimes I see several siblings at the same time for the
treatment of depression or anxiety; their histories reveal that,
several decades earlier, they were all traumatized by an alcoholic
father who routinely brutalized the whole family. Or a stressed
father of a four-year-old boy suddenly wants to abandon his family;
his history reveals that his parents split up when he was four years
old. A grown man sexually abuses an innocent child; he reveals that
he was sexually abused by an adult when he was a child. A woman
gives up her child for adoption soon after giving birth, because her
own mother gave her up for adoption soon after she was born. An
African American man abandons his wife and his newborn baby, because
that is what his father, grandfather and great-grandfather did to
their families. Thus, the ripple effect of stressful events can be
felt not only by the people in the immediate circle of those events,
but also by several generations to come. Arguably, stress has a far
greater direct or indirect negative impact on humanity than any
other single factor.
2. Stress means getting upset about something.
Since stress means different things to different people, we need
to get a firm handle on this slick term before we can make sense
throughout the rest of this book. Effective communication of a
concept requires that the particular terms used in the book mean the
same to the reader as to the author.
Simply put, stress means getting upset about something. One’s
peace and tranquility of mind are gone.
A stressed person is an upset person. He experiences one or more
painful emotions, such as fear, hurt, sadness, anger, guilt, etc. in
his conscious mind, in response to whatever has upset him. He is
fully aware of these emotions. Because of their effect on his brain
chemicals, he might experience some transient stress symptoms:
irritability, sleeplessness, headache, poor concentration and the
like. Once he has coped with the situation that has upset him, the
painful emotions will disappear, he will calm down and his stress
symptoms will go away. For example, one might become upset over
losing his job. He might feel sad, hurt, fearful, guilty, ashamed
and angry. He might experience many stress symptoms, such as
sleeplessness, anxiety, tension, headaches and the like. After a
while, he accepts the reality that people find jobs and lose them,
lose jobs and find new ones. He calms down, gets another job and
moves on with his life. The opposite of being stressed or upset is
We can compare the conscious mind to a balloon: when the mind is
"inflated" with painful emotions, one experiences stress symptoms.
When these painful emotions disappear from the conscious
mind/balloon, it "deflates," or shrinks, and the stress symptoms
disappear (see picture 1).
Picture 1: When painful emotions "inflate" the
conscious mind, stress symptoms appear.
Rule #1: When painful emotions appear in the conscious
mind/balloon, we experience stress symptoms. Conversely, whenever
stress symptoms are present, the conscious mind/balloon is filled
with painful emotions.
We can illustrate this point with following example: If there is
sufficient smoke in the room, the fire alarm will go off.
Conversely, if the fire alarm goes off, there must be significant
amount of smoke in the room.
The conscious mind inflates and deflates with painful emotions
day in and day out in response to numerous upsetting events and life
problems. Even our dreams can upset us, inflating the sleeping mind
with painful emotions and causing stress symptoms to appear. For
example, if I dreamed of being chased by a ferocious bear I would be
scared, my mind/balloon would inflate with fear and terror, and I
would have several stress symptoms: fast heartbeat, shortness of
breath, sweating, etc. Upon waking up, I would realize that it was
only a bad dream. My fear would disappear, my balloon would deflate
and I would calm down. The more upset we are, the more painful
emotions we experience in the conscious mind; the more painful
emotions we experience, the bigger the balloon becomes and the more
we are troubled by stress symptoms.
Learning to keep the balloon shrunk is fundamental to coping with
stress. Those who are unable to rid the conscious mind/balloon of
painful emotions will experience more and more stress symptoms until
the balloon pops and they come down with a stress disorder, such as
depression or anxiety disorder. Then they will need a shrink to do
the shrinking for them. Now you know why psychiatrists are called
3. Stress symptoms are caused by painful emotions in the brain.
As we evolved into modern human beings over millions of years, we
developed the ability to experience and express hundreds of painful
emotions in response to upsetting situations. Thirty-six of them are
responsible for bringing on many stress symptoms and disorders, and
we will deal with those in some detail:
Fear, hurt, anger, sadness, guilt, shame, disappointment,
frustration, helplessness, hopelessness, humiliation, hate,
bitterness, resentment, envy, jealousy, terror, horror, disgust,
embarrassment, rage, exasperation, insecurity, despair, dejection,
remorse, regret, worthlessness, hostility, vengefulness, dread,
sorrow, sinfulness, despondency, uselessness and powerlessness.
The presence of these potentially toxic, painful emotions in the
conscious mind and brain causes the brain chemicals to change,
resulting in the appearance of stress symptoms. In other words, pain
in the brain is the basis of stress symptoms. The brain is connected
to the body organs via circulating hormones and a vast network of
nerves. Changes in brain chemicals are felt as changes in the
functions of the body organs, such as the heart, lungs, stomach and
skin. Stress symptoms are the brain’s way of warning us: "I am
sensing many painful emotions in your mind. Get rid of them as soon
as possible or do something to stop them from coming in." This is no
different from a fire alarm going off when it detects more than the
usual amount of smoke in the room.
The brain is hardwired to produce different groups of stress
symptoms in response to different painful emotions. For example,
fear and its cohorts in the brain produce a "fight or flight"
response; sadness and related emotions produce stress symptoms
related to "grief"; anger and allied emotions produce an "attack"
type of stress response; and guilt and related emotions produce
"guilty" behavioral responses. Readers interested in mastering the
art of coping with stress must thoroughly learn about the nature of
painful emotions, how they produce different stress symptoms and how
to handle them. In other words, one must become emotionally savvy.
In coping with stress, one’s Emotional Quotient (EQ) is more
important than one’s Intelligence Quotient (IQ). We will study more
about the nature of painful emotions in Chapter Four.
4. Stressors pump painful emotions into the conscious mind.
A. Sensory input. The conscious mind is constantly bombarded with
information from the world around us. The five senses—seeing,
hearing, touch, smell and taste—are conveyor belts that bring
thousands of bits of information into the conscious mind/balloon on
a daily basis. This continuous inflow of information is known as
sensory input. The nature of most of the incoming information is neutral; that is, we feel neither good nor bad about it. For
example, if you look at a chair, you feel neither good nor bad about
the chair. Some of the incoming information is perceived by the mind
as good, and we feel happy about it. For example, if you get a phone
call from your boss telling you that he is pleased with your
performance and is giving you a big raise, you will feel happy. Some
other information is perceived by the mind as bad for us. For
example, if you are told that your performance at work is not good
and you could be fired from your job at any time, you will feel very
upset. The upsetting situations are known as stressors.
B. There are two types of stressors:
1. Bad events—such as the death of a loved one, the breakup of a
relationship, betrayal or infidelity, an accident, robbery, assault,
rape, the loss of a job, etc.—are extremely upsetting. They are
one-shot painful events. When bad events occur, we experience many
painful emotions in our conscious minds all at once, such as fear,
terror, hurt, anger, sadness, guilt, shame and disappointment. The
mind/balloon inflates suddenly with these painful emotions, and we
experience severe stress symptoms.
2. Bad problems of life—such as problems with one’s job, money,
health, relationships, etc.—are ongoing life problems. They upset us
a little bit at a time, day after day, week after week and month
after month. Often, we feel trapped in these bad problems. In this
case, the mind/balloon inflates gradually, over a period of time,
with painful emotions such as anger, fear, bitterness, resentment,
insecurity, frustration or helplessness, and the stress symptoms are
not as dramatic as when they are caused by a single bad event. If
unsolved, most bad problems lead to the balloon popping because of
the relentless buildup of painful emotions in the mind. When the
balloon pops, one is brought down with a serious stress disorder,
such as major depression or panic disorder.
C. The bicycle pump as a model for stressors. Since bad events
and life problems pump painful emotions into the conscious
mind/balloon, let us represent them as a simple bicycle pump. Bad
events and bad life problems have something else in common with the
pump: they both suck! We will read more about stressors in Chapter
Picture 2: Stressors pump painful emotions into
5. The hidden mind is like a soda bottle with fizzy soda inside
How does the conscious mind decide what is bad for it? The mind
has a hidden compartment, like the basement of a house or the hard
drive of a computer, where it stores a large amount of information
that is gathered over a lifetime. The information pertains to
whether an object or situation is good or bad for the mind: if it is
bad, how bad, as well as how to react to it. As the powerful hard
drive of a computer saves millions of bits of information in its
numerous folders and files, this hidden compartment of the mind
holds its own millions of bits of information. Every time the
conscious mind receives some input from one or more of the five
senses, it checks with the hidden mind by asking, "What is this? Is
it good or bad for me? If it is bad, how do I react to it?" For
example, if a stranger offered you a cookie, your conscious mind
would ask your hidden mind, "Is this safe to eat?" Your hidden mind
might say something such as, "You don’t know this person. The cookie
he’s offered could be dangerous. Don’t eat it." This type of
interaction takes place between the conscious mind and the hidden
mind thousands of times a day. If your hidden mind does not know
whether something is good or bad for you, your conscious mind will feel baffled or confused. A
person whose hidden mind does not have the information needed to
make the right decision in response to a piece of sensory input is
said to be naïve, or innocent. We warn our naïve children about the
dangers of the world by saying such things as, "Don’t talk to
strangers! Don’t accept cookies from strangers! Don’t get into the
car with strangers!"
The soda bottle is an ideal model for the hidden mind. We can
compare the hidden mind to a full bottle of soda. Just as the
dissolved gas in the soda is invisible until the bottle is shaken,
all the information in the hidden mind is out of our immediate
awareness until some sensory input activates it and brings it to our
awareness. For example, right now, you are not thinking of President
Bush—until you read his name. Immediately after reading it, your
conscious mind might see his image on the screen of your mind, and
you might experience neutral, good or bad emotions related to him.
After a while, his image will disappear from the screen and go back
into the "Memory" folder of your hidden mind. We will read more
about the hidden mind in Chapter Seven.
Picture 3: The hidden mind holds millions of bits
of information in its folders.
6. Coping means shrinking the balloon.
Coping means getting rid of the toxic, painful emotions in the
mind. This allows the brain chemicals to go back to their original
position. Then the stress symptoms disappear. In effect, coping with
stress simply means being able to shrink the balloon by appropriate
methods. Coping requires us to become aware of the painful emotions
in the conscious mind; get rid of them by expressing them; cancel
them out by means of various mental skills; and skillfully turn off
the pump by solving the problems that are hounding us. Then we calm
down, and peace and tranquility return to the mind. It’s as simple
as that—except that stressed-out people are not able to do any of
these things. That is why they need a shrink to do the shrinking for
them. Unfortunately, most psychiatrists these days attempt to
control the symptoms of depression and anxiety by coating the
balloon with drugs, rather than by shrinking it or teaching people
how to shrink it themselves. Therefore, this book will focus on
guiding the reader to shrink his balloon. We will read more about
how to shrink the balloon in Chapter Thirteen.
Let us represent coping by a tube coming out of the right side of
the balloon (see picture 4). Now the model of the mind is complete.
Picture 4: The model of the mind.
7. The model of the mind.
Let us briefly review the completed model of the mind. The
bicycle pump in the picture above represents stressors. As soon as
the conscious mind/balloon receives sensory input from the pump, it
asks the hidden mind (soda bottle) about the nature of this input.
When told, "This is bad," the conscious mind becomes upset. The
balloon inflates with painful emotions, the brain chemicals change
and stress symptoms appear. The side tube represents those actions
that shrink the balloon. For example, if someone we love has died,
the balloon will immediately inflate with painful emotions related
to grief: sadness, hurt and sorrow. Inflation of the balloon will
cause the appearance of severe stress symptoms: fullness in the
chest, swelling of the face, intensely sad feelings. By grieving,
crying, sobbing and expressing our emotions (using the side tube),
we shrink the balloon and get rid of stress symptoms. Those who are
able to keep the balloon shrunk all the time stay well.
The main idea of coping is that the output of painful emotions
should equal the input. The reader must thoroughly understand this
model of the mind and the interaction between its four components,
to make sense of the various stress-related phenomena we will
discuss in the chapters ahead.
8. Managing stress means leading a wisdom-based lifestyle.
Managing stress means living a lifestyle that minimizes the
occurrence of bad events and problems. This boils down to making
wise choices in all aspects of life. To accomplish this, we have to
wisely manage our relationships, money, time, health, job and other
aspects of daily life. The bottom line in stress management is that
one should live a simple life, guided by wisdom. Whereas coping has
to do with ridding the conscious mind of painful emotions after one
has become upset, managing stress has to do with preventing
upsetting events and problems from happening.
A wise person always does the right thing. For example, to avoid
money problems, he lives within his means, saves money regularly,
refrains from incurring nonessential debts, does not get into
businesses about which he knows nothing, etc. To avoid health
problems, he resists bad habits, gets adequate exercise, and takes
good care of his body. To avoid conflicts with others, he holds back
from imposing his views on people or taking advantage of their
friendships; he engages others in adult to adult interactions, and
so on. In effect, stress management means gaining a good deal of
control over all aspects of one’s life (the pump).
Stress management also requires that we avoid making wrong
choices and doing wrong things. Both these mistakes are always based
on deep-rooted personality weaknesses, such as greed, insecurity,
possessiveness, arrogance, lust, hate and jealousy. Every serious
life problem, whether it is connected to one’s job, money, health or
relationships, is fueled by a personality weakness. We will study
how one could put leash on these weaknesses and more about stress
management in Chapter Fourteen.
9. How stress leads to stress disorders.
To most depressed or anxious patients, why they suffer from these
maladies is a great mystery. They go to their doctors with symptoms
such as sleeplessness, anxiety, tension, crying spells, tiredness
and poor concentration. After thoroughly examining and testing them,
the doctors tell them that no medical reason can be found for their
seemingly serious symptoms. To make sense of the symptoms, the
doctors then say that the disorder is a result of a chemical
imbalance. However, the truth is that the chemical imbalance is the
end result of an extraordinary amount of stress combined with poor
Reading this, almost all people in such a situation might wonder,
"How could this be when I handled my stress so well by being
strong?" Therein lies the problem. People who readily fall apart
when upset never become sick with stress disorders. And curiously,
by the time a person is down with a stress disorder, he has blocked
off from his awareness almost all his painful emotions, as well as
the memory of stressful events and the problems that caused them.
A. History of serious traumas. The symptoms of the stressed-out person are just the tip of the iceberg (see picture
5). Every person suffering from stress disorder has been through
many bad events and problems in his life, and he has experienced
numerous painful, toxic emotions related to these problems. His
balloon has inflated many times because of death of loved ones,
abandonment, betrayal of trust, conflict, disappointment, assault,
accident, physical, emotion and sexual abuse, breakups, serious
illness and other tragedies. Bad memories of these events and
problems, stored in his hidden mind, have become the submerged part
of the iceberg.
Picture 5: Stress symptoms are just the tip of the
B. A stressed-out person has had an overdose of painful emotions.
In response to these serious bad events and problems of life, the
stressed-out person has repeatedly experienced large doses of toxic,
painful emotions in his mind. We noted thirty-six of them above. The
majority of stressed-out people admit to skilled therapists having
experienced most, if not all, of these painful emotions in large
doses, over several years prior to becoming sick.
C. Coping by burying. As painful emotions flood the conscious
mind, the stressed person gets rid of them, shrinks his balloon and
calms himself down by making one simple mistake: instead of
shrinking his balloon by means of appropriate coping methods, he
says to himself, "This is too upsetting for me. I will be strong. I
will not think about it, I will not talk about it. I will just
forget it." He simply puts the painful emotions out of his awareness
by burying them in his hidden mind/soda bottle. In other words, he
bottles up his emotions. The balloon shrinks, the brain chemicals go
back to their normal state and the stress symptoms disappear. The
prompt relief from stress symptoms gives the person reason to
believe that he has handled his stress well, producing a false sense
of security. Since this method of burying (hiding or bottling up)
painful emotions in the hidden mind seems to work well, it becomes a
habit. However, all the person is doing is transferring his painful
emotions from the conscious mind/balloon to the hidden mind/soda
bottle (see picture 6).
Picture 6: Burying causes the balloon to shrink,
making a person feel calm.
D. The saturation point of the hidden mind. The problem is that
the hidden mind does not have a limitless capacity to store painful
emotions. As the person’s hidden mind keeps filling up with painful
emotions, he finds it harder and harder to calm himself down by
burying them. When the hidden mind finally reaches its saturation
point, he can no longer bury his painful emotions. Now, when painful
emotions related to new bad events and problems appear in the
conscious mind/balloon, they stay there. The re-inflated balloon
responds by obeying Rule #1: When the balloon inflates, stress
symptoms appear. We will read more about saturation point in Chapter
Picture 7: After the saturation point the balloon
starts to re-inflate.
As the balloon gets bigger and bigger, stress symptoms begin to
reappear one by one, become persistent and get worse over time. As
more painful emotions enter the balloon, it inflates even more and
stress symptoms steadily worsen, such as poor concentration,
anxiety, tension, depression, aches and pains, sleeplessness,
irritability and impatience. If one asks this person, "How long have
you had these symptoms?" he will say something like, "Oh, well,
probably about three years." What this means is that his hidden mind
reached its saturation point about three years earlier, and his
balloon started re-inflating from then onwards. Unfortunately, most
people do not seek psychiatric help until the balloon is about to
pop, or until it has already popped.
E. Low stress tolerance syndrome. As stress symptoms reappear one
by one, the person is at a loss as to why he has them. He also
notices that when he is upset about something, he stays upset. No
matter what he does, he cannot calm himself down. Why? Because he
can no longer bury emotions in his hidden mind and shrink his
balloon. This person is known as stressed-out. His symptoms have
been warning signals sent by his brain chemicals to his conscious
mind, saying, "Your soda bottle became saturated some time ago. Now
your balloon is filling up with toxic, painful emotions. Get rid of
them properly as soon as possible, damn it!" However, his focus now
is on his increasingly uncomfortable stress symptoms, not his
accumulating painful emotions. He’s like a person who has not
noticed the gradual build-up of smoke in the house, and whose main
focus is on how to switch off the screaming fire alarm.
Some of these symptoms, such as chest pain, are very frightening.
The person thinks they are caused by a real physical disorder,
perhaps heart disease. Stress is the last thing on his mind, since
he has thought all along that he was coping well with whatever was
upsetting him. To get quick relief from his dreadful symptoms, he abuses alcohol or drugs or goes to see his
doctor. His doctor diagnoses him as having a minor anxiety disorder
or depressive disorder, and puts him on a tranquilizer or
antidepressant medication. This takes care of his symptoms and gives
him some temporary relief.
Over time, as more emotions accumulate in the conscious
mind/balloon because of the inevitable stresses of daily life, the
stress symptoms become worse. In addition, the painful emotions such
as frustration and helplessness experienced in response to the
unremitting symptoms themselves further inflate the balloon. The
severity of persistent symptoms depends upon the size of the
balloon. The bigger the balloon, the more stress symptoms there are.
A person in this unfortunate predicament is said to be having low
stress tolerance syndrome (see picture 8). Depending upon the size
of one’s balloon and the type of painful emotions in his balloon, he
suffers from many stress symptoms: irritability, angry outbursts,
sleeplessness, excessive sleeping, anxiety, tension, poor
concentration, inability to shut the brain down, a hundred different
thoughts and emotions swirling in the mind, near-panic attacks,
depression and many more. Depending upon the predominance of
symptoms, people at this stage of stress are often diagnosed with
minor stress disorders such as generalized anxiety disorder (GAD),
Dysthymic disorder or chronic depression, Cyclothymic disorder
(minor mood swings), attention deficit disorder (ADD), Fibromyalgia
and the like. Their balloon could pop at any time. To prevent this
from happening, they avoid all sensory stimulation, including
people, commotion, traveling to distant places, watching television
or anything that might upset them. They become increasingly
withdrawn from social activities. We will read more about low stress
tolerance syndrome in Chapter Eight.
Picture 8: Low stress tolerance syndrome: the
balloon is inflating again.
F. The breaking point of the balloon: the slow progression of
symptoms finally results in stress disorder. While all this has been
going on, the brain chemicals have kept changing in order to deal
with the accumulating toxic, painful emotions in the brain or the
conscious mind/balloon. Finally, goaded by a precipitating or
triggering bad event—the straw that breaks the camel’s back—the
emotional pressure in the conscious mind/balloon reaches its
breaking point, and the balloon pops. The changes in the brain
chemicals have finally resulted in a chemical imbalance. At this critical
moment, the mind continually feels, "I just can’t take it any more!"
The stress symptoms have finally crystallized into a relatively
well-defined stress disorder, such as major depression, panic
disorder, etc. (see picture 9). Unable to tolerate emotional pain,
many people in this predicament experience suicidal ideas. We will
read more about various stress disorders in Chapter Twelve.
Picture 9: The breaking point: a stress disorder
G. The double whammy—a blast from the past. Some people’s
balloons pop suddenly and quite unexpectedly, and they are struck
down with a major stress disorder like a bolt from the blue. In
these people, a current painful event—say, the breakup of a
relationship—brings into the conscious mind/balloon some painful
emotions related to an old trauma buried deep in the hidden mind,
such as being abandoned by one’s mother or father in childhood. The
fury of the painful emotions spewing from the hidden mind is so
great that it pops the balloon (see picture 10). It is as if the
soda bottle has been so vigorously shaken that fizz bursts into the
balloon attached to the bottle’s mouth. These people’s soda bottles
may not have been saturated at all, but they did hold, under
pressure, painful memories of a very traumatic event in their past.
Double whammy is a blast from the past. Sometimes, however, double
whammy is milder in severity and causes only a few symptoms. We will
read more about double whammy phenomenon in Chapter Nine.
Picture 10: The double whammy: buried emotions
fizz up and pop the balloon.
H. Rule #2: The more severe the persistent stress symptoms, the
less one is aware of the painful emotions in his mind and the
stressors that caused them.
As the balloon begins to re-inflate, stress symptoms become
worse, and a curious thing begins to happen: the stressed-out person
becomes more and more focused on his symptoms—sleeplessness,
anxiety, poor concentration, panic attacks, depression, mind
racing—and less and less aware of his inner, painful emotions and
the stressors that caused them. People in this condition often make
statements such as, "I don’t know why I feel so miserable," "I don’t
know why I cry all the time," "I can’t sleep a wink, and I don’t
know why," or "I have panic attacks, and nothing has happened to
bring them on." If you ask the stressed-out person directly, "Is
something bothering you?" he will answer, "Nothing at all, except my
panic attacks!" If you ask, "What painful emotions are you having in
your mind?" he will reply, "I have no painful emotions in my mind at
all. The only pain I have is in my chest." If you ask, "Did
something happen recently to upset you?" he will say, "I don’t know
what it could be. The only thing that happened to upset me was my
People whose balloons have popped and who are suffering from
serious stress disorders, such as panic disorder or major
depression, have almost no awareness at all about their blocked off
emotional pain or the stressors that caused it. Their total focus is
now on the symptoms of the stress disorder. This is no different
from one’s focusing on the screaming fire alarm, rather than on the
smoke in the room.
How do we know that the stressed person’s mind/balloon is full of
painful emotions, and that he has been through many seriously bad
events and problems? Well, as soon as he starts talking with a
professional who is sensitive, empathic, non-critical and
non-judgmental, he will break down and express his emotions—much to
his own surprise. He will also reveal numerous horrendous events and
problems that have traumatized him over the years. He will say, "I
didn’t know I had all these emotions in me and that I have been
affected by all these bad events and problems." Raising one’s
awareness of the blocked off painful emotions in his conscious
mind/balloon is the first and the most important step in learning to
cope with stress.
Since these people do not know why they have their seemingly
serious stress symptoms, they begin to run to doctors in a futile
attempt to find an answer. They are now on a medical wild goose
chase, in a perpetual state of bewilderment. We will study this
unfortunate phenomenon in greater detail in Chapter Eleven.
10. A case study in shrinking the balloon.
An eighteen-year-old woman, a university student, was brought to
the emergency room of the local hospital by her friends because she
had suddenly gone blind in both eyes. The woman made it clear that
she was there only because her friends had forced her to come. She
admitted to suffering from numerous other symptoms over the past
several months: sadness, crying spells, headaches, sleeplessness,
irritability and inability to concentrate. Obviously, her balloon
had been inflating for a while. (Rule #1 above.)
When I saw her on the psychiatric ward, her face showed no
emotion at all. When asked directly, she denied that she was upset
about anything. (See Rule #2 above: No awareness of inner pain.)
During the course of an empathic interview, she broke down and
revealed that she had been extremely upset about her father, a
retired policeman who lived about two hundred miles away and who had
recently gone blind from diabetes. He was also seriously ill with
heart disease, and he coughed all night long, almost choking on his
own secretions. The woman worried a great deal over the fact that he
was getting progressively sicker and his doctors were not doing
anything to help him. When she had gone home during the Christmas
holidays, six weeks earlier, she had found him in really bad shape.
She was crushed when he told her that he could not see her, even
when she stood six inches from his face. She had just made up with
him after many years of estrangement, and was determined to make him
proud of her. But alas, this was not to be.
Upon returning to school, the woman continued to experience
painful emotions such as sadness, helplessness, hopelessness and
frustration, because of this heartbreaking episode and the ongoing
bad news about her father’s health. Week after week, her balloon kept getting bigger and bigger. But, because she believed
that grieving was a sign of weakness, she tried to put these
emotions out of her awareness and pretended to be strong. She could
not bury her emotions because her hidden mind/soda bottle was
already saturated due to past issues. She worried constantly that
her father might die at any time. To cope with her agony, she drank
alcohol to excess.
In the course of our interview, the woman became aware of her
sadness, helplessness, hopelessness and other painful emotions. She
expressed them through crying, sobbing, sighing, moaning and
groaning. Her emotions began to show on her face. As she continued
to grieve and express her pain, her eyesight began to return. Her
pupils, which had been as tiny as pinpoints, dilated suddenly, as if
her brain chemicals had abruptly switched back to their original
state. At this point, her eyesight improved dramatically.
As the woman continued to express her painful emotions, her
balloon shrank and she felt a whole lot better. She developed the
insight that her blindness was her way of countering, as well as
expressing, her extreme feelings of helplessness. Since she could
not do anything to help her father, she was "doing something" by
going blind. She revealed that all her life she had been taught to
believe that expressing painful emotions was a sign of weakness, so
she held her emotions in. In the interview, I told her to keep
expressing her emotions and not to deny them, and she was discharged
immediately afterwards. When I saw her briefly three days later, she
said that she felt even better, having convinced her mother to
appoint new doctors to treat her father. This made her feel less
helpless and more hopeful.
In this particular case, the patient was an open-minded person;
her stress symptoms had been present for a relatively short time;
she responded well to empathy; she was eager to learn new ways of
coping; and she was willing to change. At this stage, I decided not
to deal with the issues buried in her hidden mind (the reasons for
her estrangement with her father and other buried issues), and
focused only on the current issues that had caused her balloon to
inflate. She could deal with the past issues later.
The majority of the patients I see do not fall in this category.
By the time they show up in my office, they have been too sick for
too long and are too closed-minded, negative and distrustful to
reverse the chemical changes as dramatically as this woman could do.
However, all is not lost for them. Human beings are endowed with a
wonderful ability to change and adapt. No one is really beyond hope
if he is willing to learn new ways to cope.
11. Five reasons why people become stressed-out.
The misery of stress and stress disorders, which millions of
people in America suffer from, is preventable. It is based on the
following five factors.
A. The lack of knowledge that the mind, brain and body are, in
fact, one single unit, and that painful emotions affect our body
organs, bringing on frightening physical symptoms and serious
disorders. Ignorance of this single bit of information causes
stressed-out people to ask such questions as, "How could my mind
cause chest pain?" "How could stress cause my headache attacks?"
"How could stress cause my heart to beat fast?" and to insist, "I am
not imagining it! I am certain this is physical, not mental." They
pursue repeated medical consultations with specialists to prove the
point, and in the end, all they have to show for this medical wild
goose chase is huge medical bills and three big Ds: disgust,
disillusionment and demoralization.
Picture 11: The mind-brain-body is one indivisible
What we think and how we feel affects every single organ in the
body. Painful emotions in the brain can cause frightening physical
symptoms without anything being physically wrong. Because of the
intimate and intricate connections between the mind, brain and body,
prolonged stress can bring on physical disorders, such as irritable
bowel syndrome, arthritis, Fibromyalgia, high blood pressure, heart
disease, chronic fatigue syndrome, psoriasis and many more. People
who are unwilling to accept this reality are doomed to be on a
medical merry-go-round for the rest of their lives.
B. The erroneous focus on physical activity as a solution for
stress. Every single stressed-out person, regardless of his level of
education, intelligence, profession or social status, labors under
the erroneous opinion that coping with and managing stress consist
of doing something physical, such as jogging, exercising, taking hot
tub baths or lifting weights. This focus on physical activities as a
solution for stress symptoms is due to the fact that some of the
most distressing stress symptoms are, indeed, physical, such as
muscle tension and spasms, feelings of being "wound up," pain
somewhere in the body, inability to relax, etc. However, this
emphasis on mindless physical activity completely disregards the
fact that stress is an emotional phenomenon. Physical stress
symptoms are caused by blocked off painful emotions in the mind.
Anyone interested in coping with stress must shift his focus from
physical activity to learning to identify and deal with his blocked
off painful emotions.
C. The use of inappropriate coping methods to calm down. Almost
all stressed-out people harbor the erroneous belief that it is a
sign of weakness to express their emotions, so they try to "be
strong" when faced with stressful events and problems. When they are
upset about something, they hide, bury or bottle up their painful
emotions to calm themselves down. ("I don’t want to think or talk
about it. I just want to forget it!") When they can no longer hide
their painful emotions, they indulge in denial ("I’m not upset. I
have no problems."). They become experts in blocking their emotions
off from their awareness. The unexpressed painful emotions get
buried in the hidden mind and they disappear from their awareness.
Both these inappropriate ways of coping go utterly against
nature. Their roots go back five thousand years, to when primitive
man was being transformed into civilized man, and civilized society
curbed the free expression of emotions as a way of taming primitive
behavior. People who want to cope with stress must give up their
hang-ups about expressing emotions, and reject burying and denial as
D. The habit of indulging in distractions to cope with pain
1. The most common distractions are pleasurable activities that
millions of people indulge in: drinking alcohol to excess, abusing
dangerous street drugs, smoking cigarettes, overeating, having
promiscuous sex, gambling and overspending. These activities become
bad habits that can lead to serious health, financial, family and
legal problems. They block off painful emotions and promote the
burying of those painful emotions in the hidden mind. The hidden
mind of just about every alcoholic and drug addict is saturated and
his balloon is full.
2. When recreational activities, such as vacationing, hiking,
trekking, skiing, cruising and the like, are used to escape from
having to deal with emotional pain, they also facilitate the burying
process. These avoidance activities are, basically, an inappropriate
response to stress.
E. The preference for the short-term benefit of drug treatment to
the long-term benefit of learning better coping methods. More and
more people are resorting to exclusive drug treatment of their
stress disorders due to the erroneous belief that their disorders
are just the result of a chemical imbalance. They do not realize
that unless they learn better coping methods, their stress disorders
will keep getting worse over the years. Drugs merely coat the
surface of the mind/balloon and temporarily reduce the tension
inside it; they don’t shrink the balloon. In fact, psychiatric drugs
facilitate the burying process no different than alcohol and street
drugs do. As more emotions build up in the balloon, it pops again,
and now one has a "breakthrough" episode of his stress disorder. He
will then need two, three or even four drugs to coat the balloon and to
control his stress symptoms. Most doctors prescribing antidepressant
medication base their decision on a list of symptoms provided them
by drug companies rather than on adequate understanding of the stage
of stress the patient is at. Nowadays, doctors prescribe medications
even to people who are merely grieving over the death of loved ones.
In fact, the inappropriate and reckless use of antidepressant drugs
by uninformed doctors is now so widespread that many patients are
immune to drugs by the time they see a competent psychiatrist.
Instead of learning to cope with stress, these patients are
perpetually in search of new drugs to control their stress
disorders. We will study more about this unfortunate and
increasingly common problem in the next chapter.
12. Summary: The five stages of stress.
Now that the reader has a fair idea of what stress is here is a
glimpse of the stages of stress or emotional health that people
experience. We will study these stages in greater detail as we go
along. At any given time, everyone in the world is in one of the
following five stages of stress (see picture 12).
Stage One: Stage of robust health. The person in this stage is in
good emotional and physical health. He has no maladies. He enjoys
life to the fullest. He is a wise person who always does the right
thing. He is a highly aware person. He is good at getting rid of
painful emotions from his mind and solving his life-problems. He has
found balance in everything he does in life. His balloon is always
shrunk. His soda bottle does not have many buried emotions. He does
not abuse alcohol, drugs or indulge in other pleasurable things to
cope with his everyday stress. Let me tell you, anymore it is harder
and harder to find such people!
Stage Two: Stage of distress. In this stage, an emotionally
well-adjusted person is temporarily upset due to a particular event
or problem. He is now called a stressed person. He has many stress
symptoms. However, he is fully aware of why he is upset. If you ask
him, he will readily tell you something like "I am upset because I
lost my job," or "My mother died," or some such thing. He does not
have any hang-ups about expressing emotions. His balloon is full of
emotions, but his soda bottle does not have any painful emotions
related to the current upsetting event. He can calm himself down
relatively quickly by ridding his mind of painful emotions and
solving the problem. If his current life situation is a little too
overwhelming, he might benefit from one or two visits with a trained
counselor. For example, a middle-aged man is unable to grieve over
his mother’s death because he has harbored some anger towards her.
Once he talks out his anger, he grieves over the loss and can go
back to being his normal self. It is best to avoid medication
treatment at this stage.
Stage Three: Stage of low stress tolerance. In this stage, the
person is said to be stressed-out. His soda bottle is saturated, and
he can no longer cope by burying his emotions. His balloon is
inflated to varying degrees. He is unable to calm himself down. He
is irritable, impatient, snappy and crabby. He is not aware of why
he has these symptoms. His total focus is on his symptoms. If he
sees a doctor, he will be diagnosed as having one or more minor
stress disorders. At this stage, he may be helped by therapy alone
in the hands of a very competent therapist if his stress symptoms
are not too severe. However, most people seeking medical help at
this stage end up taking one or more psychotropic medications. Most
people at this stage respond well to medications. However, sooner or
later they reach the breaking point and come down with a major
stress disorder, unless they learn to shrink their balloon.
Stage Four: Stage of stress disorder. The balloon has finally
reached its breaking point either due to gradual inflating of the
balloon or double whammy. Because of a precipitating event, it has
popped. Chemical changes in the brain have resulted in a chemical
imbalance, and the diverse stress symptoms have crystallized into a
relatively well-defined stress disorder, such as major depression or
panic disorder. At this critical moment, the patient continually
feels, "I just can’t take it any more!" Counseling at this stage is
generally useless, as the patient’s suffering is so great that he
has no awareness of his blocked off painful emotions. All he is
looking for is quick relief from his numerous symptoms. Such
patients need one or more drugs to control their symptoms. Even
after they are treated with drugs, many of them just go back to the low stress tolerance
stage (stage three). This explains why 30-50% of patients do not
become completely symptom-free even with aggressive medication
Stage Five: Stage of despair. At this stage, the person has been
through many successive breaking points resulting in multiple stress
disorders: depression, panic disorder, psychotic disorder, high
blood pressure, Fibromyalgia, irritable bowel syndrome, etc. He has
probably been traumatized by the treatment process as well, and so
he does not trust either therapists or doctors. He is fearful of
drugs, or he is on multiple drugs for his multiple stress disorders.
He has no clue, no trust, no hope and no desire even to try to get
help. He has frequent suicidal thoughts. He considers himself
totally and permanently disabled. He is constantly trying to get on
some type of disability program. None of his healers seems to have a
clue as to how he reached this stage of devastation.
Picture 12: Five stages of stress: from robust health to despair.
Suggested Further Reading
About Dr. Kamath
Dr. Kamath, a Board Certified psychiatrist,
has been in private practice in Cape Girardeau, Missouri since
1982. Dr. Kamath specializes in Stress and the
psychopharmacological treatment of stress-related disorders such
as depressive and anxiety disorders. He has been licensed to
practice medicine in Missouri since 1977. To know more about him
visit his website.
|Copyright: Reproduced with the permission of Dr. Bob
Kamath, M.D. ©2007. All rights reserved. Graphics,
Illustrations and Cover Art by Nikki Brown.