When what’s under the surface makes you sick By Aristocrats-hat via Flickr

When what’s under the surface makes you sick

You may not always be aware that something is bothering you, but this can be detrimental to your health. Does unconscious stress make us sick?

Clinicians often see individuals who demonstrate an inability to report their feelings. They don’t tell you they feel bad or stressed, but show various external signs of stress like muscle tension or distraction.

Currently, I am visiting Ohio State University in Columbus, Ohio, to research whether we can measure stress experiences beyond the usual self-report measures, and whether these experiences are related to increased physiological reactivity and recovery. Previous research has indicated that measures of implicit affect, also called ‘unconscious emotions’, could at least partially explain physiological responses to stress. The notion of ‘unconscious emotion’ has a long history, but has been mostly restricted to clinical practice. Our research group at Leiden University has put forward the hypothesis that unconscious stress is a widespread phenomenon, and is in fact pretty normal for most (or even all) people. We refer to this phenomenon as ‘unconscious perseverative cognition’.

For example, imagine you’re on a train, on your way to an important meeting (or, as I was/in my case, to the American consulate for a visa). How would you feel when it is announced that all trains for your destination have been cancelled? Physiologically, the adrenaline kicks in, which increases your heart rate, and oxygen-filled blood is transported to your muscles. You start to breathe faster. This enables you to run to the one train that will take you into at least the right direction. You find a seat and as the whistle blows you find yourself relaxing a little, but not fully.

Your travel schedule has changed, but you might not make it on time. This frustrates you. Meanwhile, the teenager next to you is listening to music. You can tell because you can hear the beat and fragments of sentences. Two older ladies across the aisle are discussing the beautiful scenery Leiden has to offer, quite loudly in your opinion. You’re annoyed. You notice your bad mood, and try to relax and read the article you brought with you. After about 15 minutes, you’re no longer angry or annoyed. However, your shoulders are still tense, your breathing is shallow and you look up at every unexpected sound. There’s no reason for your body to react, because there’s no actual threat, but it does. Why? Well, after deliberate introspection making the unconscious conscious, I realized that I was actually concerned that I might not be approved for the visa if I turned up late. This worry apparently continued to activate my body and produce responses similar to those seen during actual physical threat.

Continuous activation of physiological processes can have serious health consequences. The inability to become aware of, think about or discuss how one is actually doing may prevent adequate coping with stressors, and thus may lead to continued activation and eventually to adverse health consequences. Imagine that the stressor is not a discrete event such as missing the train, but a long-lasting one, such as work stress or an unhappy marriage. We know that these chronic stressors are risk factors, for example for developing heart disease. During my train ride, I was able to notice the unnecessary worrying and convince myself that it was not rational, but not all individuals can take their underlying fears to a level of intentional processing and not all information that is available is processed consciously. Who knows, maybe this research project can eventually bring the ‘unconscious stress’ of many of us to the surface before it has negative health consequences.