The Science behind the ‘West Side Story’ of Health, Relational Wellness and Stress Management.

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To understand how stress differs between men and women, it is necessary to understand the differences between mechanistic and relational health and wellness, and the role they play in the eastern–western paradigm of addressing illness.  Whereas the mechanistic approach refers to how the body works mechanically, relational wellness considers other factors that influence – and are ultimately related to – the optimal functioning of our bodies:  our environment, our relationship with our family and our ability to be happy, just to mention a few. 

Mechanistic Approach	Relational Approach
The heart is a separate organ based on a valve/pump system that is affected by personal choices such as diet, exercise and smoking.	The heart is connected to the entire mind/body experience and is affected by external factors such as the quality of our relationships, our social network of support and the amount of physical contact in addition to the personal lifestyle choices we make.

While the ‘mechanistic’ approach to diagnosing and treating illness probably began with the standardization of autopsy procedures in the 17^th century, the ‘relational’ component of illness is a relatively new concept beginning with studies conducted at the beginning of the 20^th century. In addition to that, gender-based diagnosis and treatment is also in its infancy.  It was only 20 years ago when Congress dictated that women and minorities be included in medical research through the NIH’s Revitalization act of 1993.  Yet generalized, across-the-board treatment of illness based on research conducted in males is still the foundation for treating illness in women.

The relevance of relational wellness in the diagnosis and treatment of illness can be exemplified in the 2003 study by Dr. Karen Grewen.  This study focusing on relational wellness and heart health consisted of dividing 91 couples into 2 groups: one with warm partner contact (WPC), and the other in a controlled environment without physical contact.  The WPC group was allowed 10 minutes of hand holding followed by a 20 second hug with a romantic partner prior to being exposed to a stressful event.  

The results?  The Warm Partner Group showed a lower systolic blood pressure by 24 points, lower diastolic blood pressure and less heart rate increase.   Other studies related to relational wellness and health include independent studies conducted by Dr. Pressman and Dr. Thurston on loneliness and its effect on our immune response and heart disease, respectively.  While being lonely suppressed the immune response for both sexes, there was a significant correlation between loneliness and incidental coronary heart disease only in women.

Stress is a matter of sex 

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So in trying to figure out how to manage our stress the factors we need to consider include not only the relationship between mechanistic and relational wellness, but how these two approaches differ in men and women as well. 

Up until 1995, human stress response studies only included 17% of women, justified by perceived inconsistent results from hormonal level fluctuation during women’s menstrual cycles. However, today’s research  has shown clear differences in men and women when dealing with stress.

So what part does the gender difference play in stress?  It starts with our hormones.  The attitude and reaction we have to stress is a consequence of the hormones released when facing what in our minds are dangerous situations and has been coined as ‘fight and flight’ (male response) vs. ‘tend and befriend’(female response).

While a man’s reaction to stress is related to the release of testosterone - which inhibits the release of oxytocin and promotes the release of vasopressin (the male counterpart of oxytocin) – and has been associated with aggressive behaviors, a woman’s reaction to stress is characterized by the release of oxytocin, enhanced by estrogen, and countering the more “male” aggressive ‘fight or flight’ response. Research has shown that once a woman connects to others, even more oxytocin is released, further countering the stress reactions in her body and a healing and calming effects takes place.      

One thing is for sure:  Oxytocin, the hormone responsible for initiating labor and for milk “let-down” in nursing mothers, has a positive effect on the heart and circulatory system.  A higher level of oxytocin is linked to lower blood pressure and a protected cardiovascular response to stress. 

The ‘Fighters’ and Relationships

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But not all is ‘fight or flight’ when talking about men and stress.  Could it be that men actually respond better to stress under a “tend and befriend” scenario?  After all, what are the characteristics of a ‘tend and befriend” approach to stress, especially in the later part of life?

In the longest, continuing study to date, the Harvard Grant Study, (started in 1939), Dr. George Valliant, a Harvard psychiatrist, and his colleagues studied the predictors of healthy aging over decades of life in men and unearthed the secrets to a happy and purposeful life. 

The study, now into its 75^th year, began with 268 male students.  Sixty eight of them are still alive and well, and continue giving their insights on every aspect of their lives. 

After being evaluated at least every 2 years through questionnaires, personal interviews, neuroimaging scans and DNA analysis (just to name a few follow up techniques), these men provide a unique perspective on what it takes to live life, and what is important at the end of the day:

• Love is the key pillar to a happy and fulfilling life
• Finding ways to cope with stress that don’t push love away
• Their relationships:  A man can have health, wealth and success; however, without the support of a loving relationship he is not happy.
• Connections with their relationships
• A gratifying connection to their job as more relevant than money or even success
• Social ties are linked to longevity, lower stress levels and overall well being

If it is true that the release of oxytocin is a significant component of managing stress, then how do we increase it naturally? Common sense actions lead to a natural way of releasing oxytocin; all based on HUMAN CONNECTION:

• A 20-second hug
• Petting your pet
• Listening to soothing music
• Socializing with friends and family
• A massage

Developing Relational Wellness:  The Four ‘Must Haves’ to Beat Stress

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Relational Wellness, simply put, is finding the time to create connections – with yourself, your family and friends and to your passion in life.  Compassion –learning to be kind to one-self to be able to take care of others, gratitude –remembering to be thankful to those that give meaning and purpose in your life, and growth – the willingness and courage to evaluate yourself and seek help when needed complete the preamble to managing stress successfully.

"All I need is the air that I breathe..." Lessons learned for the daily management of stress 

For those of us in the 70’s generation who listened to Olivia Newton John, we should be finishing the sentence with “and to love you” - curiously, two of the many ways to manage stress.  Have the song stuck in your mind already?  Don’t let it distract you.  Here is a simple exercise that diminishes stress immediately:

• Breathe in and out with your eyes closed, and follow your breath. 
• Place right hand over your belly and left on top of right, while breathing in and out. 
• Repeat in your mind who and what are you grateful for.
• Acknowledge thoughts, feelings or sensations that come to mind.  Name them, let them go and go back to focusing on your breath.

For more information on the Doris A. Howell health focused informational events, visit www.howellfoundation.org.