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42 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 4 CL ASSROOM TO CLIENT Stress that triggers the fight- or-flight response can be further categorized based on its origin or duration. The cause of stress can be mental (e.g., negative speculation about the reaction of your boss to a client complaint), emotional (e.g., grief over the death of a loved one), or physical (e.g., pain from a soft-tissue injury). It can be short- lived (e.g., you mistake your father standing in a darkened kitchen for an intruder) or chronic (e.g., you are under constant pressure at work and do your best each day to suppress it). CHRONIC STRESS AND IMPLICATIONS FOR HEALTH Chronic stress is a situation in which persistent stressors repeatedly trigger the fight-or-flight response leading to the prolonged elevation of stress hormones, especially cortisol and epinephrine (adrenaline), in the bloodstream. These hormones, when not used in a real emergency, wear down the body's systems. In this situation, sometimes referred to as adrenaline and cortisol poisoning, they become destructive to the body and can lead to stress-related disorders like high blood pressure, heart disease, ulcers, impaired immunity, and even psychological changes such as increased aggression or defensive behavior. For example, cortisol can cause the body to digest its own proteins, leading to decreased immunity, sleep disturbances, and an increase of substance P (related to the sensation of pain). After a threat has passed, epinephrine that has not been reabsorbed produces a shaky, nauseous, pumped-up feeling. In situations of chronic stress, epinephrine causes overstimulation of the autonomic nervous system and adrenal exhaustion associated with fatigue and mental weariness. It is possible that the weakest areas of the body—either from injury or genetic predisposition—show wear and dysfunction from chronic stress first. A body under constant stress becomes more susceptible to infections and disease. People adapt quickly to challenging situations and may not recognize that symptoms such as insomnia, chronic tension headaches, or heartburn are related to stress. Massage therapists often deal with habitual tension patterns in muscles. Bracing physically against nonphysical threats may very well be at the root of a good deal of physical tension. One researcher speculates that with cancer, the body would normally eliminate a mutant cell, but if the system is dysfunctional because of a hormonal imbalance due to stress, the cell may take hold and develop into a tumor. 2 STRESS AND MASSAGE We already know that massage activates the parasympathetic nervous system, which balances out the sympathetic nervous system and helps the body to unwind and recuperate once danger has passed. The parasympathetic nervous system slows the body's heart rate and is associated with relaxed breathing patterns. It stimulates the formation and release of urine and the activity of the digestive system so that the body can nourish and detoxify itself. This response