remarriage, etc.?
In short, the questionnaire tried to get at the kind of life changes that are part of normal existence. It did not ask whether a change was regarded as 'good' or 'bad,' simply whether or not it had occurred.
For six months, the three cruisers remained at sea. Just before they were scheduled to return, Arthur and Rahe flew new research teams out to join the ships. These teams proceeded to make a fine-tooth survey of the ships' medical records. Which men had been ill? What diseases had they reported? How many days had they been confined to sick bay?
When the last computer runs were completed, the linkage between changefulness and illness was nailed down more firmly than ever. Men in the upper ten percent of life change units – those who had had to adapt to the most change in the preceding year – turned out to suffer from one-and-a-half to two times as much illness as those in the bottom ten percent. Moreover, once again, the higher the life change score, the more severe the illness was likely to be. The study of life change patterns – of change as an environmental factor – contributed significantly to success in predicting the amount and severity of illness in widely varied populations.
'For the first time,' says Dr. Arthur, appraising life change research, 'we have an index of change. If you've had many changes in your life within a short time, this places a great challenge on your body ... An enormous number of changes within a short period might overwhelm its coping mechanisms.
'It is clear,' he continues, 'that there is a connection between the body's defenses and the demands for change that society imposes. We are in a continuous dynamic equilibrium ... Various 'noxious' elements, both internal and external, are always present, always seeking to explode into disease. For example, certain viruses live in the body and cause disease only when the defenses of the body wear down. There may well be generalized body defense systems that prove inadequate to cope with the flood of demands for change that come pulsing through the nervous and endocrine systems.'
The stakes in life-change research are high, indeed, for not only illness, but death itself, may be linked to the severity of adaptational demands placed on the body. Thus a report by Arthur, Rahe, and a colleague, Dr. Joseph D. McKean, Jr., begins with a quotation from Somerset Maugham's literary autobiography,
My father ... went to Paris and became solicitor to the British Embassy... . After my mother's death, her maid became my nurse.... I think my father had a romantic mind. He took it into his head to build a house to live in during the summer. He bought a piece of land on the top of a hill at Suresnes. ... It was to be like a villa on the Bosphorous and on the top floor it was surrounded by loggias. ... It was a white house and the shutters were painted red. The garden was laid out. The rooms were furnished and then my father died.
'The death of Somerset Maugham's father,' they write, 'seems at first glance to have been an abrupt unheralded event. However, a critical evaluation of the events of a year or two prior to the father's demise reveals changes in his occupation, residence, personal habits, finances and family constellation.' These changes, they suggest, may have been precipitating events.
This line of reasoning is consistent with reports that death rates among widows and widowers, during the first year after loss of a spouse, are higher than normal. A series of British studies have strongly suggested that the shock of widowhood weakens resistance to illness and tends to accelerate aging. The same is true for men. Scientists at the Institute of Community Studies in London, after reviewing the evidence and studying 4,486 widowers, declare that 'the excess mortality in the first six months is almost certainly real ... [Widowerhood] appears to bring in its wake a sudden increment in mortality-rates of something like 40 percent in the first six months.'
Why should this be true? It is speculated that grief, itself, leads to pathology. Yet the answer may lie not in the state of grief at all, but in the very high impact that loss of a spouse carries, forcing the survivor to make a multitude of major life changes within a short period after the death takes place.
The work of Hinkle, Holmes, Rahe, Arthur, McKean and others now probing the relationship of change to illness is still in its early stages. Yet one lesson already seems vividly clear: change carries a physiological price tag with it. And the more radical the change, the steeper the price.
'Life,' says Dr. Hinkle, '... implies a constant interaction between organism and environment.' When we speak of the change brought about by divorce or a death in the family or a job transfer or even a vacation, we are talking about a major life event. Yet, as everyone knows, life consists of tiny events as well, a constant stream of them flowing into and out of our experience. Any major life change is major only because it forces us to make many little changes as well, and these, in turn, consist of still smaller and smaller changes. To grapple with the meaning of life in the accelerative society, we need to see what happens at the level of these minute, 'micro-changes' as well.
What happens when something in our environment is altered? All of us are constantly bathed in a shower of signals from our environment – visual, auditory, tactile, etc. Most of these come in routine, repetitive patterns. When something changes within the range of our senses, the pattern of signals pouring through our sensory channels into our nervous system is modified. The routine, repetitive patterns are interrupted – and to this interruption we respond in a particularly acute fashion.
Significantly, when some new set of stimuli hits us, both body and brain know almost instantly that they are new. The change may be no more than a flash of color seen out of the corner of an eye. It may be that a loved one brushing us tenderly with the fingertips momentarily hesitates. Whatever the change, an enormous amount of physical machinery comes into play.
When a dog hears a strange noise, his ears prick, his head turns. And we do much the same. The change in stimuli triggers what experimental psychologists call an 'orientation response.' The orientation response or OR is a complex, even massive bodily operation. The pupils of the eyes dilate. Photochemical changes occur in the retina. Our hearing becomes momentarily more acute. We involuntarily use our muscles to direct our sense organs toward the incoming stimuli – we lean toward the sound, for example, or squint our eyes to see better. Our general muscle tone rises. There are changes in our pattern of brain waves. Our fingers and toes grow cold as the veins and arteries in them constrict. Our palms sweat. Blood rushes to the head. Our breathing and heart rate alter.
Under certain circumstances, we may do all of this – and more – in a very obvious fashion, exhibiting what has been called the 'startle reaction.' But even when we are unaware of what is going on, these changes take place every time we perceive novelty in our environment.
The reason for this is that we have, apparently built into our brains, a special noveltydetection apparatus that has only recently come to the attention of neurologists. The Soviet scientist E. N. Sokolov, who has put forward the most comprehensive explanation of how the orientation response works, suggests that neural cells in the brain store information about the intensity, duration, quality, and sequence of incoming stimuli. When new stimuli arrive, these are matched against the 'neural models' in the cortex. If the stimuli are novel, they do not match any existing neural model, and the OR takes place. If, however, the matching process reveals their similarity to previously stored models, the cortex shoots signals to the reticular activating system, instructing it, in effect, to hold its fire.
In this way, the level of novelty in our environment has direct physical consequences. Moreover, it is vital to recognize that the OR is not an unusual affair. It takes place in most of us literally thousands of times in the course of a single day as various changes occur in the environment around us. Again and again the OR fires off, even during sleep.
'The OR is big!' says research psychologist Ardie Lubin, an expert on sleep mechanisms. 'The whole body is involved. And when you increase novelty in the environment – which is what a lot of change means – you get continual ORs with it. This is probably very stressful for the body. It's a helluva load to put on the body.
'If you overload an environment with novelty, you get the equivalent of anxiety neurotics – people who have their systems continually flooded with adrenalin, continual heart pumping, cold hands, increased muscle tone and tremors – all the usual OR characteristics.'
The orientation response is no accident. It is nature's gift to man, one of his key adaptive mechanisms. The OR has the effect of sensitizing him to take in more information – to see or hear better, for instance. It readies his muscles for sudden exertion, if necessary. In short, it prepares him for fight or flight. Yet each OR, as Lubin underscores, takes its toll in wear and tear on the body, for it requires energy to sustain it.
