We may define future shock as the distress, both physical and psychological, that arises from an overload of the human organism's physical adaptive systems and its decision-making processes. Put more simply, future shock is the human response to overstimulation.
Different people react to future shock in different ways. Its symptoms also vary according to the stage and intensity of the disease. These symptoms range all the way from anxiety, hostility to helpful authority, and seemingly senseless violence, to physical illness, depression and apathy. Its victims often manifest erratic swings in interest and life style, followed by an effort to 'crawl into their shells' through social, intellectual and emotional withdrawal. They feel continually 'bugged' or harassed, and want desperately to reduce the number of decisions they must make.
To understand this syndrome, we must pull together from such scattered fields as psychology, neurology, communications theory and endocrinology, what science can tell us about human adaptation. There is, as yet, no science of adaptation
What actually happens to people when they are asked to change again and again? To understand the answer, we must begin with the body, the physical organism, itself. Fortunately, a series of startling, but as yet unpublicized, experiments have recently cast revealing light on the relationship of change to physical health.
These experiments grow out of the work of the late Dr. Harold G. Wolff at the Cornell Medical Center in New York. Wolff repeatedly emphasized that the health of the individual is intimately bound up with the adaptive demands placed on him by the environment. One of Wolff's followers, Dr. Lawrence E. Hinkle, Jr., has termed this the 'human ecology' approach to medicine, and has argued passionately that disease need not be the result of any single, specific agent, such as a germ or virus, but a consequence of many factors, including the general nature of the environment surrounding the body. Hinkle has worked for years to sensitize the medical profession to the importance of environmental factors in medicine.
Today, with spreading alarm over air pollution, water pollution, urban crowding and other such factors, more and more health authorities are coming around to the ecological notion that the individual needs to be seen as part of a total system, and that his health is dependent upon many subtle external factors.
It was another of Wolff's colleagues, however, Dr. Thomas H. Holmes, who came up with the idea that change, itself – not this or that specific change but the general rate of change in a person's life – could be one of the most important environmental factors of all. Originally from Cornell, Holmes is now at the University of Washington School of Medicine, and it was there, with the help of a young psychiatrist named Richard Rahe, that he created an ingenious research tool named the Life-Change Units Scale. This was a device for measuring how much change an individual has experienced in a given span of time. Its development was an important methodological breakthrough, making it possible, for the first time, to qualify, at least crudely, the rate of change in individual life.
Reasoning that different kinds of life-changes strike us with different force, Holmes and Rahe began by listing as many such changes as they could. A divorce, a marriage, a move to a new home – such events affect each of us differently. Moreover, some carry greater impact than others. A vacation trip, for example, may represent a pleasant break in the routine. Yet it can hardly compare in impact with, say, the death of a parent.
Holmes and Rahe next took their list of life-changes to thousands of men and women in many walks of life in the United States and Japan. Each person was asked to rank order the specific items on the list according to how much impact each had. Which changes required a great deal of coping or adjustment? Which ones were relatively minor?
To Holmes' and Rahe's surprise, it turned out that there is widespread agreement among people as to which changes in their lives require major adaptations and which ones are comparatively unimportant. This agreement about the 'impact-fullness' of various life events extends even across national and language barriers. (The work in the United States and Japan is now being supplemented by studies in France, Belgium and the Netherlands.) People tend to
Given this information, Holmes and Rahe were able to assign a numerical weight to each type of life change. Thus each item on their list was ranked by its magnitude and given a score accordingly. For example, if the death of one's spouse is rated as one hundred points, then moving to a new home is rated by most people as worth only twenty points, a vacation thirteen. (The death of a spouse, incidentally, is almost universally regarded as the single most impactful change that can befall a person in the normal course of his life.)
Now Holmes and Rahe were ready for the next step. Armed with their Life-Change Units Scale, they began to question people about the actual pattern of change in their lives. The scale made it possible to compare the 'changefulness' of one person's life with that of another. By studying the amount of change in a person's life, could we learn anything about the influence of change itself on health?
To find out, Holmes, Rahe and other researchers compiled the 'life change scores' of literally thousands of individuals and began the laborious task of comparing these with the medical histories of these same individuals. Never before had there been a way to correlate change and health. Never before had there been such detailed data on patterns of change in individual lives. And seldom were the results of an experiment less ambiguous. In the United States and Japan, among servicemen and civilians, among pregnant women and the families of leukemia victims, among college athletes and retirees, the same striking pattern was present: those with high life change scores were more likely than their fellows to be ill in the following year. For the first time, it was possible to show in dramatic form that the rate of change in a person's life – his pace of life – is closely tied to the state of his health.
'The results were so spectacular,' says Dr. Holmes, 'that at first we hesitated to publish them. We didn't release our initial findings until 1967.'
Since then, the Life-Change Units Scale and the Life Changes Questionnaire have been applied to a wide variety of groups from unemployed blacks in Watts to naval officers at sea. In every case, the correlation between change and illness has held. It has been established that 'alterations in life style' that require a great deal of adjustment and coping, correlate with illness – whether or not these changes are under the individual's own direct control, whether or not he sees them as undesirable. Furthermore, the higher the degree of life change, the higher the risk that subsequent illness will be severe. So strong is this evidence, that it is becoming possible, by studying life change scores, actually to predict levels of illness in various populations.
Thus in August, 1967, Commander Ransom J. Arthur, head of the United States Navy Medical Neuropsychiatric Research Unit at San Diego, and Richard Rahe, now a Captain in Commander Arthur's group, set out to forecast sickness patterns in a group of 3000 Navy men. Drs. Arthur and Rahe began by distributing a Life Changes Questionnaire to the sailors on three cruisers in San Diego harbor. The ships were about to depart and would be at sea for approximately six months each. During this time it would be possible to maintain exact medical records on each crew member. Could information about a man's life change pattern tell us in advance the likelihood of his falling ill during the voyage?
Each crew member was asked to tell what changes had occurred in his life during the year preceding the voyage. The questionnaire covered an extremely broad spectrum of topics. Thus it asked whether the man had experienced either more or less trouble with superiors during the twelve-month period. It asked about alterations in his eating and sleeping habits. It inquired about change in his circle of friends, his dress, his forms of recreation. It asked whether he had experienced any change in his social activities, in family get-togethers, in his financial condition. Had he been having more or less trouble with his in-laws? More or fewer arguments with his wife? Had he gained a child through birth or adoption? Had he suffered the death of his wife, a friend or relative?
The questionnaire went on to probe such issues as the number of times he had moved to a new home. Had he been in trouble with the law over traffic violations or other minor infractions? Had he spent a lot of time away from his wife as a result of job-related travel or marital difficulties? Had he changed jobs? Won awards or promotions? Had his living conditions changed as a consequence of home remodeling or the deterioration of his neighborhood? Had his wife started or stopped working? Had he taken out a loan or mortgage? How many times had he taken a vacation? Was there any major change in his relations with his parents as a result of death, divorce,
