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Stress. Anxiety. Even before coronavirus, stress was a prominent fixture in our society. A Gallup “World Emotions Report” was based on interviews in 2019 with over 150,000 adults in more than 140 countries to gain a snapshot of how people around the world assessed their positive and negative daily experiences.1 The report found stress levels worldwide had set a new record and that last year “Americans were more likely to be stressed and worried than much of the world.”2

Regardless of the ongoing stressors or events behind each individual’s anxiety, is there anything we can do on a day-to-day basis to manage it?  While we hear a lot about the helpfulness of self-care in managing stress (such as exercising, eating a healthy diet, meditating, and getting enough sleep),3 those methods aren’t especially useful in the moments when we are crippled by anxiety.

Stanford University professor, Alia Crum, is doing some fascinating work on how mindsets can be deliberately changed “to affect organizational and individual performance, physiological and psychological well-being, and interpersonal effectiveness.”4 She has published some headline-grabbing studies demonstrating measurable physical changes in people’s bodies that were brought about by changing their mindsets.

One study explored the effect that mindset can have on the relationship between exercise and health. It involved 84 housekeeping staff members of 7 different hotels where instructional posters were displayed. Physiological measurements were taken before the study (weight, blood pressure, BMI, etc.). One group was simply encouraged to exercise regularly (a poster was prominently displayed detailing the benefits of exercise). The other group saw a poster informing them about how many calories they burned doing each housekeeping task (160 calories/hour making beds, 200 calories/hour vacuuming carpets, 240 calories/hour scrubbing bathroom fixtures, etc.).

Four weeks later, the group who had changed their mindset to think that “work is exercise” were found to have a 10 point reduction in systolic blood pressure and lost 2 pounds while the “work is work” group that was only encouraged to exercise had only a 2 point reduction in systolic blood pressure and lost no weight.5 As Dr. Crum concluded, “What this means is that objective health benefits—things like a healthy heart, a healthy weight—depend not just on what we are doing, but what we think about what we do.”6

Another study by Crum’s group explored what we think about food. Using measurements of the gut peptide ghrelin (often called the “hunger home” because of its link to appetite stimulation), 46 study participants were given milkshakes that always consisted of 380 calories. On one occasion, the beverage was labeled as a “sensible” 140-calorie milkshake and on another occasion, the beverage was labeled as a 620-calorie “indulgent” milkshake. Dr. Crum’s team took the subjects’ physiological measurements at three different time points after drinking the milkshakes and found “The mindset of indulgence produced a dramatically steeper decline in ghrelin after consuming the shake, whereas the mindset of sensibility produced a relatively flat ghrelin response. Participants’ satiety was consistent with what they believed they were consuming rather than the actual nutritional value of what they consumed.”7 As Dr. Crum says, “Labels are not just labels, they evoke a set of beliefs.”8

So, what does this have to do with how we manage anxiety and stress? Dr. Crum says that we can either look at stress as debilitating or enhancing. She says that “both of these mindsets are possible, but the rub is that the mindsets that we choose to hold, influence the outcomes that will result. Mindsets change what we pay attention to. Mindsets change what we are motivated to do. Mindsets change how we feel and expect to feel. Mindsets change what our bodies are prepared to do. Through cascading effects on the psychological, behavioral, and physiological mechanisms, mindsets can create the reality that’s implied. In other words, having the mindset that stress is enhancing, ironically is what makes those enhancing effects more likely.”6

Psychologist Kelly McGonigal has taken some of these ideas a step further in her book, The Upside of Stress.9 What began as a TED talk by Dr. McGonigal called “How to Make Stress Your Friend” has been turned into a manual on how to reinterpret anxiety reactions (pounding heart, faster breathing, even breaking into a sweat) as actually being signs your body is energized in a helpful way. As Dr. McGonigal says in her TED talk, “That pounding heart is preparing you for action. If you’re breathing faster, it’s no problem. It’s getting more oxygen to your brain.”10

Citing a Harvard study that encouraged this mindset shift, she said, “Now, in a typical stress response, your heart rate goes up, and your blood vessels constrict…and this is one of the reasons that chronic stress is sometimes associated with cardiovascular disease. It’s not really healthy to be in this state all the time. But in the study, when participants viewed their stress response as helpful, their blood vessels stayed relaxed…their heart was still pounding, but this is a much healthier cardiovascular profile. It actually looks a lot like what happens in moments of joy and courage.”10

A former Navy SEAL’s endorsement is among the praise for McGonigal’s book featured in the front material of The Upside of Stress. While I usually don’t give those comments much thought, this one caught my eye. Retired SEAL, Scott Brauer, wrote, “Kelly McGonigal has pulled back the curtain to reveal what allows exceptional people and organizations like my Navy SEAL brotherhood to thrive through adversity. True excellence is achieved under great adversity and by embracing those challenges with a positive mindset.”9

An article on Big Think does a nice job of summarizing Dr. McGonigal’s three-step process of shifting mindset to deal with anxiety and stress:11

  • Acknowledge stress when you experience it
  • Welcome the stress by recognizing that it’s a response to something you care about
  • Make use of the energy that stress gives you, instead of wasting that energy trying to manage your stress

In getting back to our opening question of whether people can really manage anxiety and stress by adjusting mindset, there seems to be support for a human ability to alter our physical responses by adjusting our understanding of what is happening in anxious moments. Dr. McGonigal’s three-step process offers at least a framework for testing Dr. Crum’s idea that, “The reality we will experience tomorrow is in part a product of the mindsets we hold today.”6

If you can’t remember any of the above advice when trying to manage an anxious or stressful moment, you might be able to recall this mantra from a former Navy SEAL commander used to feed a positive mindset under duress: “Feeling good, looking good, ought to be in Hollywood!”12

References

1Gallup. Gallup 2019 Global Emotions Report. https://www.gallup.com/analytics/248906/gallup-global-emotions-report-2019.aspx

2Ray J. Americans’ Stress, Worry and Anger Intensified in 2018. Gallup News. 25 April 2019. https://news.gallup.com/poll/249098/americans-stress-worry-anger-intensified-2018.aspx

3University of Minnesota. What Lifestyle Changes Are Recommended for Anxiety and Depression? 2016. https://www.takingcharge.csh.umn.edu/what-lifestyle-changes-are-recommended-anxiety-and-depression

4Stanford Profiles. Alia Crum, Assistant Professor of Psychology. https://profiles.stanford.edu/alia-crum

5Crum A. Crum AJ, Langer EJ. Mind-set Matters: Exercise and the Placebo Effect. Psychological Science. 2007 Feb;18(2):165-71. https://www.ncbi.nlm.nih.gov/pubmed/17425538

6Crum A. The Science of How Mindset Transforms the Human Experience. YouTube. World Economic Forum. 21 February 2018. https://www.youtube.com/watch?v=vTDYtwqKBI8

7Crum AJ, Corbin WR, Brownell KD, Salovey P. Mind over Milkshakes: Mindsets, Not Just Nutrients, Determine Ghrelin Response. Health Psychology. 2011 Jul;30(4):424-9; discussion 430-1. https://www.ncbi.nlm.nih.gov/pubmed/21574706

8Spiegel A. NPR. A Milkshake Experiment. 14 April 2014. https://www.youtube.com/watch?v=pIfhxt0JCok

9McGonigal K. The Upside of Stress: Why Stress is Good for You and How to Get Good at It. 2015. Penguin Random House: New York. https://www.amazon.com/dp/1101982934/ref=rdr_ext_tmb

10McGonigal K. How to Make Stress Your Friend. 2013. TEDGlobal 2013. https://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend

11Beres D. Your mind is stronger than the anxiety it creates. Learn to shift your mindset. 13 July 2017. Big Think. https://bigthink.com/21st-century-spirituality/wired-for-anxiety?utm_medium=Social&facebook=1&utm_source=Facebook&fbclid=IwAR06mljlwZUIsfbkGSLlIwPqRzeJbBt3zEB9q-DYWn1C_9pyuYuwuYTsmw4#Echobox=1573629808

12Adams L. Train with the Mantra of a Navy SEAL. 7 August 2015. Runner’s World. https://www.runnersworld.com/runners-stories/a20848559/train-with-the-mantra-of-a-navy-seal/

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