Any treatment of socio-culturally caused distress must be perforce two-prong, dealing, in fact, with its socio-cultural aspect and its neurophysiology. The following is a brief outline of our position on the subject allowing us to call it alternative.

I. SOCIO-CULTURAL ASPECT

Although this part of our approach is somewhat more conventional as compared to our view of the neurophysiology of stress, it still differs from most – particularly in terms of the most important programmatic conclusions.
Our premise is neither strictly sociological nor socio-psychological but medico-anthropological. As such, while recognising the social, political, economic and socio-psychological roots of most stressors, it places a very strong emphasis on the issue of values, hence culture.
Our main postulates:

1. Stress "does not exist"
Paradoxical as this affirmation might sound, if one accepts the most basic premise of systems theories, it may be claimed that either everything is stressful or nothing is stressful. Indeed, every system, whether social or for that matter physical, keeps all its individual elements under constant and relentless stress. In other words, an individual as part of any social system (family, interest group, work environment, etc.) is constrained by the requirements of this system to be (and behave) differently from the way he or she is and would behave as a “singularity”, that is a totally independent “socially un-compromised” human entity. These requirements and these constraints are nothing but stresses, or more precisely systemic stresses. Without them there would be no dynamic adjustments between the system and its individual elements as well as between the individual elements within the system. Without them the system itself would not be possible. Going a little further it may be claimed that any desire, in the widest possible sense of the term, is nothing but a stressor, thus representing not only the basis for all creativity but also the most important not to say the only mechanism of social adaptation.
Therefore, it is not the “stress” that is analytically important but the distress that some of the stressors may cause.
In this context, the first step in our work with individuals, groups and organizations alike is to identify which stresses are systemic and which are not.
The non-systemic ones can be eliminated more or less completely. As far as systemic ones are concerned, we must isolate and identify first and most of all the distress-causing ones. Since those stressors are systemic and cannot be disposed of by definition, the only way to deal with them is to help the distressed groups or individuals to develop the appropriate coping mechanisms. The indispensable component of this task is to provide at least a working definition of what a member of society may perceive as a distress-causing stressor.

2. Stress as a metaphor
In our opinion, the contemporary West is too far-gone on the road of all encompassing “cultural narcissism”. One of its most common current “perversions” is to treat concrete flesh-and-blood manifestations of reality (i.e. rape, genocide, hunger, not-too-distant “water boarding” and the like) as almost total abstractions suitable for discussion in the press and on university campuses but not raising anyone’s individual blood pressure. On the other hand, such epistemological ephimera or mere explanatory principles as “success”, “instinct” and, most eminently, “stress” acquire in our society the power of concrete and tangible phenomena. Consequently, our aggressively determinist and reductionist societies start treating them in an absurdly mechanical fashion demystifying them in substance and over-mystifying them in form. This results correspondingly in an avalanche of “how- to” books (for example, “How to Achieve Success”, “How to Fight Stress”, or even “How to Make Your Head Work” and “How to Talk to Your Children”) and in the never-ending production of the massive amounts of arcane and mostly superfluous terminology used by quacks and experts alike.
We emphasise the fact that stress demystified is by no means stress explained, and vice versa. Stress is but a metaphor describing a systemic paradox, a contradiction. Most of distress-causing stressors represent a discrepancy between the myth and reality, or, better still, between reality as an ideological construct and reality as actuality. The former refers to values most of which are acquired in childhood and adolescence, cultural preconceptions, imperatives and the expectations related thereto. Actual reality may be way “ahead”, way “behind” or simply more or less radically different from those constructs. Just think of the family as an example. Most of the Western world is still entertaining an essentially Judaeo-Christian ideology of family as a basically corporate elementary unit of society with fixed roles, patri/matriarchal power relations and the predominance of the so-called “traditional” legitimacy of authority, based on “given” rather than “acquired” characteristics and identities. Even the modern family itself is far from this model in actuality, to say nothing about modern corporate enterprise. And yet a large number of companies belonging to the latter keep, wittingly or unwittingly, a significant “traditional-family” component in their rhetoric. Just think of the “corporate loyalty” paradigm, for one. As a matter of fact, the more a certain enterprise is based on the fierce pursuit of profit, the more it is ready to fire any of its employees for causing this pursuit the slightest impediment, the more such a company would be prone to require total loyalty from the said employees – at least, as we said, on the level of its rhetoric. However, it is important to acknowledge the fact that these existential scissors or, as we called it, the discrepancy between the myth and reality, may be extremely distressing to some individuals, slightly stressful to others and totally irrelevant for others still. Perhaps being totally indifferent may, in turn, cause yet another type of distress to that third group. Even the contemporary neuroscience is beginning to admit that perception is not as much reception as it is inference and interpretation. So much more so with such metaphors as stress, loaded with pre-conceived cultural expectations. The conclusion is that in assessing anything as a potential stressor one must take into account not only the individual gradient of perceptions that may and do indeed differ from person to person, but also the cultural gradient: what may cause distress a member of one culture may be totally indifferent or even beneficiary to the member of the other.
Parenthetically, it must be noted on this point that the overwhelming majority of literature on stress – particularly in the field of human resource management – comes from the Anglo-Saxon milieu, especially from the United States. It is subsequently used rather indiscriminately in all other countries of the world. The American precepts come from a culture with predominantly “good-works”-oriented protestant ideology, essentially teleological ethics, weak family, strong institutions, formal institutional arrangements, mastodon enterprises and the long-standing tradition of management. How can those precepts apply to, say, Italy with its basically deontological business ethics, strong family insinuating itself in every fibre of the country’s socio-economic fabric, weak institutions, informal patronage-based socio-economic networks, small family-based enterprise and the virtual absence of the managerial class in the true sense of the term? The aggressive, essentially Marxian, economic determinism won the day: the culture has been taken out of the equation almost completely. And yet, being the sole supplier of value systems it is culture and very little else that imbues an action with meaning. Perception is culturally coded and any attempt to understand and deal with stress, disregarding culture is patently fallacious.
The task of a responsible stress manager or a life coach is to rigorously identify the existential scissors in point. This requires both the “patient’s” socio-cultural (and not necessarily psychological) profile and a careful objective analysis of the “patient’s” actual reality. The consequent action should not involve any (futile and potentially harmful) attempts to “adjust” the “patient” to reality by changing his or her socio-cultural personality, a.k.a. “working on yourself”, “taking charge of your life”, “putting your foot down”, “fighting stress” and other such improbabilities feasible only in a situation of non-systemic stress. Even less should it bombard actual reality with recommendations on how “it” should change to better suit its distressed member. Be “reality” a particular family or an enterprise, more often than not it consists of long pre-set and systemically determined patterns most of which are independent from the “decision makers’” wills and good or for that matter bad intentions.
The alternative exists, however. And it is as radical as it is concrete. For brevity’s sake we’ll call it here “homeopathic”. Scrupulously and consistently applied, it may even turn a distress-causing stressor to the “patient’s” advantage. Very briefly, it consists of dealing with stress in terms of the stress itself. That is, we don’t eliminate but compensate. That means that for the lack of more “luxurious” alternatives (see below in the physiology part), the period of “rest” from stress should consists of remaining under the same type of stress and only changing the form of the stressors. It must be emphasized that this “keep-the-stress-but-vary-stressors” approach requires a careful empirical assessment of both the “patient’s” socio-cultural profile and the principal real as well as purported socio-cultural paradigm of his or her stress-environment. That would involve not only rhetoric, expectations and group and individual epistemology, but also the treatment of such notions as incorporation/integration, solidarity/competition, open/close-system mentality, sovereignty, merit and ethics, to name only a few. Only after having identified the main friction points between the public field and private perception, may one proceed towards concrete recommendations.

3. A Shot of Actuality
Thus “re-metaphorised” stress re-acquires its transcendental elements and with them the complexity of both its understanding and treatment. However, complex as any stress situation may be, the reality in toto, in which distress occurs, is always an immensely more complex environment. Exacerbated by the already discussed reductionism and pseudo-technical mechanical approach both to work and to what is unfortunately referred to as “free time”, the distress-causing situation often makes the “patient” lose sight not only of his or her actual problem but of the rich complexity of reality itself. The “patient” increasingly tends to abide in the rarefied atmosphere of technicalities explaining the problem away, of various catch phrases and how-to manuals. What is essentially forgotten and, worse, regarded as embarrassing to mention by those who still remember it, is the fact that life as well as multi-faceted social situations of which most human life consists, is so immensely complex a phenomenon that the only reliable way of dealing with it is more or less poetic. Good sociology, good psychology, even good medicine in general is primarily art and only to a very limited extent a hard science. As far as distressful social situations are concerned, we regard bringing “patients” back to earth as an important additional tool in developing the coping mechanisms. We call it giving a “patient’s” personal reality a healthy shot of actuality. In this regard, exposing ”patients” to various forms of art and particularly to animals is of great help. In fact, one of our particularly fruitful methods is hippo therapy (see Summary).

II. PHYSIOLOGY

1. Linear Model
The model that has been dominating and continues to dominate neurophisiology of stress is essentially Pavlovian or linear. To put it schematically, it recognises three basic phases of response to a stimulus (a “negative” one in the case of distress-causing or “uncompensated” stress): a. exponential; b. flat; c. paradoxical.

a. response grows proportionately both to stimulus and to the time of its application: this is typical for a healthy organism in full command of its defence facilities;

b. response reaches its upper threshold and remains unaltered while the stimulus increases or simply continues being applied: this response plato indicates that the organism has reached the limit of its “conventional” defensive capabilities. The organism can remain at this stage for surprisingly long periods of time: in the case of socially caused stresses (at work, in the family, etc.) – even for several decades.

c. a stronger or simply continuing stimulus causes a diminished response, that is, inhibition. The stronger the stimulus or the longer it continues, the stronger the inhibition. This is an “emergency” stage often identified by the pavlovian physiology as “shutdown stage”: to avoid permanent damage the organism “goes possum” producing inhibition that may reach a trance-like, almost catatonic intensity or simply produce a languid “spaced-out” reactive pattern that may last for years. While being adaptive to the trans-threshold stimuli, this “emergency shutdown” is certainly non-adaptive as far as the general long-term functioning of the organism is concerned.

The obvious solution implied by this model is withdrawing from the trans-threshold stress for a period that would be long enough for the organism to recover and to recuperate its “conventional” defensive strengths. This withdrawal from or of stress is best described by the conventional term “rest”. Such a strategy is perfectly feasible granted the possibility of removing the stress for a period commensurate with the period of its application. That is, if the period of stress is described in terms of years, the period of rest must be no shorter than a year.
Earlier we called this “a luxurious alternative”. As a matter of fact, in some working environments it is applied by law. For instance, clinical psychiatrists working full-time in mental institutions, are required to withdraw to a different-type job, usually after a ten-year period. Another example: Quite contrary to what appears to be the popular opinion to-date, the primary function of the university faculty is not teaching but generating new knowledge, that is, essentially doing research, both theoretical and empirical. As a matter of fact, the heavy teaching loads imposed on the faculty by the “educational supermarkets” of contemporary Western universities, represent the principal stressor as far as the faculty’s research possibilities are concerned, thus putting at risk their very ability to do research at all (i.e. causing the “burnout” so sadly common among contemporary academics). Hence the institution of a more or less quadrennial sabbatical at least supposedly dedicated to research and writing.
Unfortunately, this “luxurious alternative” is impossible in most working environments, leave alone family and many other aspects of personal life. And yet most people resort to the so-called “rest” without a slightest suspicion that it is not stress but the incompetently applied “rest” that is or may be of most danger.

2. Non-Linear Model; Parabiotic Theory

A vast amount of empirical research conducted, for example, in various “executive environments” shows that a large number of strokes, myocardial infarctions and other coronary morbidity occur not immediately before but rather after the so-called “vacations”. The linear model does not explain this phenomenon adequately enough.
The foundations of the non-linear analytical approach towards the neurology of stress were laid by such physiologists as Cannon, Richter et al. Rather than an alternative to the linear model, it incorporated the latter into a larger and more complex paradigm. One of its main merits is that it introduces a third and very important criterion of assessing stress: in addition to the pavlovian criteria of intensity and duration, the parobiotic theory also takes into account the rhythm, the dynamics of stress application. This approach revolutionises the entire picture, for it regards most of the periods of “rest” not as the alternative to but part of the stress. What it means is that, the “luxurious alternative” apart, periodical withdrawal from or of stress that we call “rest” is not long enough to restore the defence mechanism to its original strength. And yet it removes the essentially protective inhibition described by the third stage of the linear model. In other words, this periodical application of “rest” renders the entire process of stress application into a dynamic broken pattern that may and in many situations indeed will cause the fourth, “parabiotic” or inverted stage. The deadly aspect of this stage is not that the strong stimuli continue to cause inhibition but that the weak stimuli start causing a disproportionately strong, even violent response. Cannon identified this inversion even on the strictly organic level of the peripheral nervous system where the effects of sympathetic and parasympathetic innervation also flip. Thus, for example, a strong fright puts the organism to sleep while a sudden soft sound of mild music causes it violent adrenal discharge, sweating, sharp rise of blood pressure, tachicardia and the like. This is a totally non-survival stage, and the main agent of reaching it is “rest”, providing the process of stress-application with a deadly defence-destroying dynamism.
The best and perhaps the only solution was already mentioned. It lies in compensating rather than eliminating distress-causing stress, or as we said earlier, keeping the stress while varying stressors.

To Sum Up

Nothing is new under the sun, and the only road towards concrete and adequate results is still a theory-based carefully structured research.
After having identified cognitive, that is, socio-cultural aspects of main stresses it must be established which ones may potentially cause distress. Subsequently, a practitioner may proceed towards a careful analysis of the dynamics whereby those stresses manifest themselves. Only this and not the meaningless ideological invocations and fashionable catch phrases will enable the qualified practitioner to provide an individual or a company with valid and concrete recommendations and coping strategies.