One Nation Under Stress: The Trouble with Stress as an Idea by Dana Becker is a feminist critique of how the notion of stress has been medicalized and sold to middle and upper middle class consumers, the majority of whom are women. Becker's theoretical bent holds much in common with critical theorists such as Barbara Ehrenreich, the author of many books that investigate the theme of the widening socioeconomic gap between the rich and the poor, a gap gaining centrifugal force by our capitalist and media driven North American culture. One Nation Under Stress also echoes the many books published in the past twenty years about the over diagnosis of the body politic and the ubiquity of Big Pharma in our everyday lives: the body politic transformed into the biopolitical body.
Within this scholarly context, Becker tackles the idea of stress as a clinical and cultural trope that is serving a social function similar to the nineteenth century ideas of neurasthenia and the contemporary concept of post-traumatic stress disorder. These ideas have been deconstructed by many social critics concerned to demonstrate how they serve the social role of individualizing social problems; problems that should be matters of public policy, political will, and collective agency. Becker's book engages the idea of stress on this level: stress is individualized, and the responsibility for its alleviation is placed on the individual in consultation with her doctor's medical intervention, her self-help activities, or her purchases of remedies to achieve inner peace. One Nation Under Stress successfully synthesizes the overall point of these critiques by providing a genealogy of the idea of stress that performs an intellectual antidote to stress as a powerful cultural trope. Her argument is structurally similar to other significant feminist genealogies, for example Nancy Fraser's and Linda Gordan's essay "A Genealogy of Dependency: Tracing a Keyword of the U.S. Welfare State" and Trauma: A Genealogy by Ruth Leys.
For example, Chapter 2 examines the nineteenth century diagnosis of neurasthenia and its trajectory into the social Darwinist Mental Hygiene Movement in the 1930s. This chapter includes intriguing historical insights into passionate advocacy by Harvard physiologist Walter Cannon and endocrinologist Hans Selye to popularize by scientific and promotional means, the notion of social adjustment as the evolutionary necessity of humans to respond to their rapidly changing social environments in the twentieth century. Becker skillfully demonstrates by her genealogy of this popularization of stress how the "masculinization" of stress and its association with coronary heart disease (CHD) reinforced gender role expectations wherein women ought to keep the home as a respite for the Type A male breadwinner to "de-stress" from his demanding job. Women's privatized work as the matriarch of the home was expected to prevent male CHD.
In Chapters 4 and 5, Becker fully develops how "stress has fallen into the male/female 'difference' bin" (81) by reviewing specific instances of how the popular media sensationalizes research findings on the disparate rates of depression among women, conflating race and class and ignoring inequality to produce an elitist and universalist portrayal of women's vulnerability to stress. These chapters rehearse and critique the major popularizers of shibboleths such as the male/female brain, the tending instinct, and other instances of "neurosexism" in the mass media. Becker shows how the sexist advice literature that promotes the "mommy track," the "opt-out" ramp and the "work/life balance" act to middle class white working women ignores problematic workplace policies that disadvantage women who must work the double day of their jobs and as caregivers and homemakers. The popular literature elides women of color who historically have worked in larger numbers and for whom such advice have never been real options. Becker remarks that a telling aspect of gendered inequality in the workplace and at home is that high work demands and low material resources are potent predictors of CHD among women but not among men. (130) By the end of Chapter 5 Becker has deconstructed the concept of stress, rendering it an ambiguous term that encompasses everything and nothing. She shows how the popularized concept obfuscates the socioeconomic, unequal, and unjust conditions that compromise people's wellness depending on what race, sex, and socioeconomic class they occupy.
The most original material in One Nation Under Stress is presented in Chapter 3, in which Becker describes the historical link between the findings of cognitive neuroscience and the link between stress and the immune system. Popularizers such as Richard Lazarus of psychological "coping strategies" sealed collective acceptance of the reality of "stress hormones" and their role in immune system suppression. Becker does not refute the discovered associations between external conditions, personal capacities to cope with those conditions, and effects on the immune system. Rather she proposes that researchers may be asking the wrong questions regarding these associations. She faults this research for "psychologizing the context" thus "turning the environment outside/in." (69) Becker claims that if we look at the socioeconomic and gendered context of these associations, what the researchers' term "chronic stress" is more adequately described as the chronic problems brought by poverty and the lack of personal and relational resources available to address those problems. As a medicalized concept, stress draws attention away from the forms of social inequality that produce disadvantages, including ill health, that can only be remedied by better social services and more just workplace and public policies.
Chapter 6 presents the least original perspective of the book by its review of the critical literature on post-traumatic stress syndrome. Becker's overall point is that we need to focus on inequalities such as socioeconomic marginalization, powerlessness and lack of resources in order to understand what the effects of exposure to a traumatic event means to people. (171) Becker emphasizes that the rapidly expanding diagnostic categories for trauma are reiterating stereotypical gender differentiations and globalizing our North American way of medicalizing and individualizing suffering. She argues that this is to the detriment of alternative cultural ways of mediating suffering caused by external catastrophic events. This chapter resonates with other cultural critiques of this phenomenon such as Ethan Watters' Crazy Like Us. She ends the book on a suggestive note: whether we, as a society, will take greater responsibility for these social tensions or develop yet more individual prescriptions for grappling with stress. (185) Reading One Nation Under Stress in concert with like-minded social critiques, the prognosis is not promising.
© 2013 Kate Mehuron
Kate Mehuron, Associate Dean of Programs and Professor of Philosophy, Eastern Michigan University. Correspondence: [email protected]