SOURCES OF STRESS:Sources in the Family, An Addition to the Family

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Health Psychology PSY408

Lesson 16

SOURCES OF STRESS

Sources in the Family

The behavior, needs, and personality of each member of a family have an impact on and interact with those

of the other members of the family system, sometimes producing stress. Interpersonal conflict can arise

from financial problems, from inconsiderate behavior, or from opposing goals, such as which television

program to watch. Living in an overcrowded household increases conflict over privacy and the use of family

resources such as the bathroom. Of the many sources of stress in the family, we will focus on three: adding

a new family member, divorce, and illness and death in the family.

An Addition to the Family

A new child in the family is a joyful event, but it also brings stress--particularly to the mother, of course,

during pregnancy and after the birth. But an addition to the family is stressful to other family members, too.

For instance, the father may worry about the health of his wife and baby or fear that his relationship with

his wife may deteriorate, and both parents may feel the need to earn more money.

After the baby is born, parents experience stress from their new responsibilities in caring for the child. An

important factor in parental stress relates to the child's personality. Each baby comes into the world with

certain personality dispositions, which are called temperaments. Pediatric nurses and physicians, well aware

of the unique combinations of temperaments that babies show right from birth, describe infants broadly as

"easy" babies and "difficult" ones. These terms do, in fact, capture the general dispositions of most infants

fairly accurately on the basis of differences in the way babies react to feeding, cuddling, bathing, and

dressing and undressing.

Temperamentally difficult babies tend to cry a great deal--often very loudly--and efforts to soothe them

do not seem to work very well. They resist being introduced to new foods, routines, and people, and their

patterns of sleep, hunger, and bowel movements are hard to predict from day to day. Although only about

10% of babies are classified as difficult,' displaying most or all of these traits fairly consistently, many others

show some of these traits at least occasionally. A child who reacts in a very negative manner to minor

irritations is very stressful to parents. Although children's temperaments are fairly stable across time, with

aspects of these traits continuing for many years, many difficult children show changes toward the

development of easy traits.

The arrival of a new baby can also be stressful to other children in the family. This stress seems to be

particularly strong among children who are very young, say, 2 or 3 years old, and who may not want to

share their parents with the new brother or sister.

After the baby arrives, these children may show increased clinging to the mother, as well as increased

sleeping and toileting problems. If the children are older, they are less likely to view the baby as a rival for

their parents' attention, and their stress seems to relate to changes in family behavior and rules, such as not

making noise when the baby is asleep.

Divorce

A divorce produces many stressful transitions for all members of the family as they deal with changes in

their social, residential, and financial circumstances. In the case of the children, they may move to a new

neighborhood, be left with new sitters, or have to take on new chores at home. The custodial parent may

not be very available to the children because of work or other preoccupations. According to psychologist

Judith Wallerstein (1983, 1986), the way children react to the stress of divorce depends in part on their age.

Very young children may feel responsible for the divorce, worry that the custodial parent will also leave, and

develop sleep disturbances.

Health Psychology PSY408

Older children and adolescents tend to react with anger, often siding with one parent and blaming the other.

Adapting to divorce usually takes several years, and some family members may never adjust fully. Parents

can do several things to enhance their children's adjustment to a divorce. They can maintain a loving secure

home life and:

· Tell the children in advance of the impending separation.

· Encourage open communication and answer the children's questions truthfully, but sensitively.

· Gear information to the children's levels of understanding, with concrete and accurate explanations of

what will happen to all members of the family.

· Recruit help and advice from others, such as relatives, parent organizations, counselors, and the children's

school personnel.

· Encourage the children to have contact with both parents.

Family Illness, Disability, and Death

The following is a familiar story to many parents: In the middle of a frantic day at work, the parent receives

a call from the school nurse, who says, "Your child is sick. You'll have to come and pick him up." Having a

sick child adds to the stress in an already stressful day.

When children have a serious chronic illness, their families must adapt to unique and long-term stresses.

Part of the stress stems from the amount of time needed to care for the child and from the reduced

freedom family members have in their schedules. For example, children with the respiratory disease called

cystic fibrosis generally need physiotherapy two or three times a day to reduce the mucus that collects in

their lungs. The family also faces many difficult decisions and must learn about the illness and how to care

for the child. The medical needs of chronically ill children are expensive, and this burden adds to the

family's stress.

Relationships between family members may also suffer. The parents are likely to feel that having a

chronically ill child reduces the time they have to devote to each other. In addition, other children in the

family may feel isolated and deprived of parental attention.

Adult illness or disability is another source of family stress. The strain on their financial resources is

especially severe if the sick adult is a principal breadwinner. Having a physically ill or disabled adult in the

family restricts the family's time and personal freedom and produces very important changes in

interpersonal relationships. For example, suppose a man has a heart attack. His spouse may experience

stress from fears that he may have another attack and changes in his behavior, such as being more irritable

and dependent.

Although the couple may show increased affection for one another during convalescence, their sexual

relations are generally curtailed--often because of fears that sex could induce another attack. And the roles

of family members change: the healthy spouse and the children who are old enough take on many of the

responsibilities and tasks of the recovering spouse. As the convalescing adult begins to show good physical

recovery, the stress generally diminishes in the family.

Does the stress a family experiences when an adult is seriously ill depend on the sick person's age? Often it

does. For instance, advanced cancer in an elderly person has a very different meaning than the same illness

in someone at 30 years of age, especially if the young adult has one or more children. In the latter case, the

disease is inconsistent with the person's roles and threatens the family unit. Chronic illness is likely to

produce intense frustration, distress, and anger if it is out of step with expectations and needs for the future.

But if an elderly person who is ill or disabled must live with and be cared for by relatives, the stress for all

those in the household can be severe, especially if the person requires constant care and shows mental

deterioration. Elderly spouses who provide care for such individuals are often emotionally distressed and

show heightened physiological strain, making them more susceptible to infectious disease.

Health Psychology PSY408

Age is also an important factor in the experience of stress when a family member dies. Some children suffer

the loss of a parent during the child-hood years--one of the most traumatic events a child can face.

Children under about 5 years of age seem to grieve for the lost parent less strongly and for a shorter time

than older children and adolescents do. This age difference probably results from their different levels of

understanding about the nature of death. Children's concept of death changes between 4 and 8 years of age.

Young children often think death is reversible: the person is simply living somewhere else--such as

underground--and can come back.

By about 8 years of age, most children understand that death is final and involves an absence of bodily

functions.

An adult whose child or spouse dies suffers a tremendous loss. Losing a child creates other losses--for

example, bereaved mothers reported that they had lost important hopes and expectations for the future

(Edelstein, 1984). Parents who lose their only child lose their identity and role as mothers and fathers, too.

When a spouse dies, the surviving spouse also loses important hopes, expectations, and roles-- as well as

the one companion who made him or her feel loved, wanted, special, and safe. Although the loss of a

spouse is difficult at any age, it appears to be especially stressful in early adulthood.

Sources in the Community and Society

Interpersonal contacts people make outside the family provide many sources of stress. For instance,

children experience stress at school and in competitive events, such as in sports and band performances

(Passer. 1982; Sears & Milburn, 1990). Much of the stress adults experience is associated with their

occupations, and a variety of environmental situations can be stressful. We will focus on how people's jobs

and environments can be sources of stress.

Jobs and Stress

Almost all people at some time in their lives experience stress that relates to their occupations. Often these

stressful situations are minor and brief and have little impact on the person. But for many people, the stress

is intense and continues for long periods of time. What factors make jobs stressful?

The demands of the task can produce stress in two ways. First, the workload may be too high. Some people

work very hard for long hours over long periods of time because they feel required to do so--for example,

if they need the money or think their bosses would be unhappy if they did not. Studies have found that

excessive workloads are associated with increased rates of accidents and health problems.

Second, some kinds of job activities are more stressful than others. For example, repetitive manual action,

as in cashier work, can be stressful and is linked to physical symptoms, such as neck and shoulder pain.

Also, jobs that under-utilize the worker's abilities can produce stress.

Another kind of activity that can produce stress is the evaluation of an employee's job performance--a

process that can be difficult for both the supervisor and the employee.

Jobs that involve a responsibility for people's lives can be very stressful. Medical personnel have heavy

workloads and must deal with life or death situations frequently. Making a mistake can have dire

consequences. In an intensive care unit of a hospital, emergency situations are common; decisions must be

made instantly and carried out immediately and accurately. As part of the job, the nurse must reassure and

comfort the man who is dying of cancer; she must change the dressings of a decomposing, gangrenous

limb; she must calm the awakening disturbed overdose patient.

It is hard to imagine any other situation that involves such intimacy with the frightening, repulsive, and

forbidden. To all this is added the repetitive contact with death.

Health Psychology PSY408

These and other conditions of jobs in the health professions take their toll, often leading to feelings of

emotional exhaustion. Similar stressors exist in the jobs of police and fire personnel. Several other aspects

of jobs can increase workers' stress. We will discuss them in our next lecture.

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