Why Zebras Don't Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping

Book Review-Why Zebras Don’t Get Ulcers – The Causes and Cures for Stress

In this final installment of my three-part review of Sapolsky’s book Why Zebras Don’t Get Ulcers we walk through the causes of stress and what we can do to “cure” stress by minimizing its impact on us. We started this review with The Physical Impacts of Stress and followed that up with The Psychological and Neurological Impact of Stress.

It’s good to understand the impacts of stress on our bodies and on our minds, but what do we do about it? How do we avoid stress and deal with it when it does come? Partial answers to these questions are what makes Why Zebras Don’t Get Ulcers so useful.

Lack of Control

Humans have evolved rapidly from creatures totally dependent upon dumb luck to survive. We’ve created agriculture (which ironically created its own stress-related problems). We’ve put men on the moon and brought them back home. We’ve learned so much about our bodies and our worlds. We like to believe that we’re in control. We enjoy the illusion, but it’s just that. It’s an illusion. (See Compelled to Control for more on control.)

Why would someone voluntarily work half time – 12 hours a day, every day – for very little, if any pay, a large degree of risk, and the associated health risks of higher stress? The answers vary, but the label for all of them is the same – entrepreneur. What do entrepreneurs believe that they get with their decision to “be their own boss”? Some argue that there’s a financial upside (and there is). Others argue that there’s no one telling them what to do (which isn’t true – they’ve got customers who are the ultimate bosses). One real answer is the freedom. Yes, you can and perhaps too often do work 12 hour days – but you get to pick which 12 hours. The freedom to choose when you work and what you work on mitigates the stress that you might feel from the other factors.

Studies have proven that when you give animals the perception of control of – or influence on – their situation, their stress levels are lower. Perhaps that’s why we have so many religions and superstitions. Marx said, “Religion is the opiate of the masses.” Perhaps our superstitions are our way of trying to make ourselves believe that we have control of our world.

Put Out the Fire

Frustration Outlets

Even if we can’t get control, we experience less stress when we have an outlet for our frustration. When we have something – anything – that we can do, it makes it better. You probably know people – perhaps when looking in the mirror – who obsessively clean when they’re stressed. In truth, this helps them feel better along multiple vectors. First, the exercise itself will increase blood flow and will generally lighten someone’s mood. Secondarily, and more importantly, the belief that you’re doing “something” will help.

If you’ve ever been stuck in traffic waiting on other people to get out of your way, you’ve experienced that lack of control. Many people will choose routes which take longer if they are able to travel at a reasonable speed, because they don’t experience the helplessness of being caught in traffic. We’ve also seen those folks who constantly switch lanes as they try to relieve their frustration.

Giving Ulcers

Have you ever considered what you want someone to say at your funeral, or what you would want on your tombstone (and not the pizza kind)? While it may be morbid to think about, consider the guy whose answer was, “He didn’t get ulcers, he gave them.” There are some folks who follow their animal kingdom ancestors and inflict random terror on others in their lives. While this isn’t a helpful technique for the receiver, the sender gets the benefit of a frustration outlet. So, in giving ulcers, he avoids getting them himself. (Obviously, this isn’t literally true.)

Unfortunately, the animal kingdom speaks to the hierarchies of domination and the undeserved infliction of pain that travels down the social hierarchy. There are also intergenerational impacts of the competition for social status and being able to continue your genes in the next generation.

Evolution

Darwin stumbled across the idea of survival of the fittest. Since then, we’ve come to realize that the genetic mutations that are favorable get the chance to reproduce, and those that aren’t advantageous don’t get a chance to replicate. Thus, those genes which are the most suitable to the situation get copied. This has created a set of behaviors in the animal kingdom where new social leaders will exterminate the offspring of previous leaders and even harass the pregnant females to the point where they’ll abort pregnancies that are in progress.

If you’re looking to get your genes to replicate into the next generation, killing off the offspring of the previous social leader means that your children won’t have to compete with that lineage. Terminating the pregnancies increases the number of wombs available for creating your progeny. Obviously, this emphasizes the genes which can take control of the social order at the expense of those who are not. However, strangely, genetics aren’t the only way that behaviors and patterns are replicated.

Fetal Origins of Adult Disease

Adverse Childhood Events (ACE) was a study that indicated the downstream impacts of a set of adverse events on children. The number of these events could predict, years into the future, the health and longevity of the children being studied. (See How Children Succeed for more on ACE.) However, this study focuses on what happens after the child was born. David Barker, in a study called “Fetal Origins of Adult Disease” (or FOAD), studied the impacts of stresses before birth.

Prenatal care is well known to be important. How a baby starts out life is a strong predictor of many health measures in childhood; however, what David Barker found was that it’s a strong marker for long-term health issues as well. For instance, a low birth weight predicts an increased risk of diabetes and hypertension. The presence of a high number of glucocorticoids during the fetus’ development – because the mother is stressed – seems to program the child for a stressful world.

Strangely, the change in the glucocorticoid levels for the child remain high even when they’re an adult, so it’s possible for the mother to expose their child to the same high levels of glucocorticoids that they were exposed to intrauterine – thus replicating a cycle of stress without the benefits of gene replication.

The relationship we have with our environment is sometimes spooky. A famine can replicate impacts across generations just by changing the environmental factors in the first generation’s mother’s body.

Relationships

While factors like FOAD and ACE do have an impact on our worlds as adults, those effects aren’t a destiny. We’re shaped by our past – including our distant past – but we’re also shaped by our here and now. Once you get past the necessities of food, water, and shelter, a huge predictor of your life expectancy is the relationships you have. The fewer the relationships, the shorter the lifespan. (See my post Trust => Vulnerability => Intimacy for more.)

It’s not just any relationship that matters: you need not go out and collect the most Facebook friends, Twitter followers or connections on LinkedIn. The kinds of relationships that matter most are those relationships that are intimate – people with which you can share, on whom you are not just projecting some sort of an image. (See High Orbit-Respecting Grieving for more on types of relationships.)

The Facebook Effect

Interestingly, the number of Facebook friends we have can reduce our health instead of improve it. The factors at play are the same ones that led Sapolsky to conclude that one of the most harmful things that we may have done is come up with agriculture.

The problem seems to come back to our social rank. It seems like we’ve got an engine for comparing our status with those around us. If our neighbors have a new car and we don’t, then we’re not as high up in the social status as they are. Though we may live in a big house and drive a nice car, we don’t have as nice of a car. We evolved not to assess whether we have enough food, but whether we get the pick of the best food. We assess our socioeconomic status (SES) not by an absolute measure, but rather through a subjective or relative measure – a subjective SES.

Our relative perception of our SES drives our long-term health. If you remove or reduce the supports of SES such as education, income, or occupational position, a person’s overall health declines. So, what is Facebook’s role?

In the past, we didn’t get to see all the fun activities that people are doing all the time. We didn’t get to see their new car or the fact that their child just got accepted to a prestigious school. Once a year, we’d get a Christmas letter from them, and wonder whether you were still on the list so they could brag or if they really did value their relationship with you.

With the barrier of postage and a printed card removed, we’ve become Facebook friends with people that we’d never send Christmas cards to in real life. We now get to see their travel, their excursions with their presumably loving family, and their new purchases. Now we get nearly constant reminders that our SES is lower than that of our “friends.”

To me this is sad on multiple levels. First, we’ve got more consumer debt and more spending of money we don’t really have than at any other time in history. We’ve mortgaged our futures to pay for our perceived economic status today. Second, most of what we’re talking about here is fleeting. The car will eventually break down. The child who got into the prestigious school may get kicked out. Third, who cares? Obviously most people care. We’re wired to care, but should we? If you knew that you were never going to truly need anything you wouldn’t have, would you still be worried about what everyone else has? The kinds of things that really matter in life aren’t the kinds of things that can be posted on Facebook. The thing that really matters is your ability to love other people.

Love and Tenderness

If you want to reduce stress, pet a dog. (Unless you’re allergic to them.) Quite literally, the neurochemicals that are released when you pet a dog help to calm you and reduce stress. You may have seen pet therapy pets in hospitals. Having friendly domesticated animals is just one form of love that can reduce stress.

I’ve mentioned several times before that the ancient Greek language had three words for what we today in English simplify into one word: “love”. (See How to Be an Adult in Relationships.) What the Buddhists would call “compassion”, the Greeks would call “agape”. There’s a tenderness to this concept. There’s an acceptance of where people are and accepting their faults. When you practice compassion, you accept others’ faults – and in doing so, you make your own faults and limitations easier to accept in yourself.

Perhaps the best way to reduce stress is to learn to love. Sapolsky mentions an interview where he has a fabulous marriage. I can tell you from my experience that it’s a great way to reduce your stress. Having someone who will take care of you – and you know you’ll take care of them – is the pinnacle of love and tenderness, but any relationship that is close and mutual can reduce stress.

For our children, they know they’ll never have to worry about starving and they’ll always have a place to stay. These commitments are a part of the safety net that we put underneath them to help them understand that they will be OK. Their stress is reduced by the knowledge that they don’t have to fear and by the simple fact that they are loved. Our children are for the most part lucky; they’ve won the cortical lottery.

Cortical Lottery

In The Happiness Hypothesis, Johnathan Haidt spoke of a set, internal point for happiness, and how some folks have a higher happiness “default” than others. In effect, these lucky people have won the cortical lottery. They get to be happier than their peers – even in the same circumstances with the same coping strategies. They’re just happier by their makeup.

While one can’t change their “default” happiness point, nor can they change their basic biological responses to stress, they can choose to change their mindset on how they approach stress and how they cope with it.

Mindset

Carol Dweck’s work Mindset exposes two fundamental mindsets about a person. The first mindset, a fixed mindset, is that what the person is capable of is fixed. The second is a growth mindset, that they can change and grow. A similar split exists between approaches to stress.

One can view stress from the entirely emotional point of view, with threats to survival creating the stress; or they can view stress from the lens as a biological response driven by basal, neurological processes without the benefit of higher-order reasoning. In the language of the Rider-Elephant-Path from The Happiness Hypothesis, the emotional elephant can be left to his own devices, or the rider can hop down from his position on top of the elephant, always trying to reign him in and gently patting the elephant’s shoulder, letting him know that it will be alright.

The most practical example of this is a game called “worst-case scenario.” Some people play this game and they somehow connect the trivial to the end-of-the-world. However, others work through this game with a reasonability filter applied. For instance, in doing this blog post I could assume that the worst-case scenario is that Robert Sapolsky will have great issue with what I’ve written and sue me for libel or something like that. Is that possible? Probably not. He’s much more likely to send me a note correcting me or asking me to take the posts down than suing me. So I can take the view that he’ll sue me – and be totally under the control of my elephant – or I can apply the reasonability filter and say, he’s substantially more likely to ask me to correct something or take the posts down. When you play worst-case scenario with the reasonability filter applied (sometimes you may need help from a friend with this), then you can decrease your stress.

The opposite view, which is appropriate when you’re willing to entertain the worst case, is the “best-case scenario.” Here, too, reasonability should be applied. The unreasonable response might be to get an invitation to spend the weekend with Sapolsky and his wife at their house. A reasonable response might be that he and I get to start a conversation that leads to a friendship.

If you do worst-case scenario first and best-case scenario at the end, you’re likely to think more positively about whatever stressful situation you might be considering.

God

Sapolsky’s end to the book includes references to his beliefs about God – or the lack thereof. He cites evidence from recognized researchers that praying for someone when they don’t know about it doesn’t improve outcomes – though praying when the person knows about it may. This seems like it might be our old friend hope reaching in to lend a hand. (See The Psychology of Hope.) It could be that we evolved to believe in God because it gave us greater belief of our control – through our ability to petition God. (See Spiritual Evolution for more.)

While Sapolsky says that he recognizes that belief in God improves health outcomes, he cannot himself believe in God. This for me is sad. I believe in God because it leads me to be and become the best person I can be. I care very little whether my belief is validated or disproved in the future. The truth of the matter is that my belief helps shape who I want to become. If I’m wrong about my belief, it’s still been helpful to me. Perhaps it is my own placebo. But I’ll take it because it helps me not be stressed. Maybe zebras believe in God and that’s Why Zebras Don’t Get Ulcers.

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  1. […] the challenges and fears that we have in this world are essentially our own mental creations. (See Why Zebras Don’t Get Ulcers – The Causes and Cures for Stress for more on our ability to create stress where it doesn’t exist.) The implication in this […]

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