The Road to Wellville

The Road to Wellville

Charlie Bowers tried every stress cure known to man. Here’s what we learned from his journey: a five-step strategy for a calmer, healthier you.

Baltimore magazine, October, 1996

Charlie Bowers hated Wednesdays. Wednesday was meeting day at the small Montgomery County landscaping firm he owned, and lately meetings had not been going well. If the recession was over, as newspapers claimed, Bowers hadn’t noticed. Even now, in 1994, his five salespeople made three times as many calls per sale as they had six years before.

As he drove from his Columbia home down Route 108 toward the office, Bowers could feel his muscles tense up. Sometimes his stomach would hurt. Sometimes his head would ache. But always, Charlie felt a crush of frustration. What was he doing wrong?

Sitting at the head of the company’s teak conference table, Bowers accentuated the positive. "Let's talk about the pipeline,” he said, as he said every week. “What’s in the pipeline? How about the Greenwalds?” (This family had asked for an estimate on a new patio.)

But Bowers already knew what the salesman’s answer would be: “They haven’t decided yet.”

In the 1970s, when Garden Gate Landscaping was young, clients wouldn’t even wait for an estimate before hiring the company. These days, though, they were hesitant, so hesitant that the business was in danger. If Bowers couldn’t turn things around, he might have to lay people off. These were good, hard-working people, and Bowers held their future in his hands. Some days, he felt as if the weight might be too much.

Baltimoreans are stressed and growing more so. Workplace assaults are up, according to the Sheppard Pratt psychiatric hospital unit that helps companies deal with them. And Claudius Klimt, the director of emergency medicine at Greater Baltimore Medical Center, says he sees more and more patients who are in pain but have no injuries. Many suffer from what Klimt calls “decomposition”: They’re simply frazzled to tears.

Baltimore is still steeped in the values of its working-class neighborhoods sup-ported by nearby industries. “It is different from most major urban areas where there is a lot of mobility, “ says Helen Kauffman, a social worker at Sheppard Pratt. Baltimoreans like to stay put, she says, and we like our jobs to stay put as well.

The ground has shifted beneath us. Businesses shrink, close or move away. And because of those changes in the workplace, home is no oasis, either. Even in house-holds with two parents, both parents often work. We have less time for the children, less time for each other, less time for ourselves.

But if Baltimoreans have more reasons to feel stress, we also have more resources to help us cope. With its wealth of doctors and other health practitioners, the city is especially able to help distressed denizens a grip. Historically, medical doctors may have been slow to see stress as a cause for physical illnesses. But today, some local docs are tops at helping get your body in synch with your mind.

With so many stress cures out there, how do you tell which one will work for you? Luckily, it’s not as complicated as it seems. As Charlie Bowers’s journey shows, there is a logical order of solutions to try. Think of it as a five-rung ladder to wellness. When you find the tactic that addresses the cause of your stress, you’re on your way to a cure.

When Bowers and his partner bought the landscaping business in 1968, he was fresh out of college. Bowers could barely contain his excitement for the job. But by 1982 as the economy slowed, and he spent more and more time at work, trying to keep the company afloat he found himself dreading work.

He had felt stress before, but it wasn’t until this recession that it started getting the better of him. He felt frustrated and angry all the time, not just while he was at work. His stomach hurt constantly, but doctors could find no trace of an ulcer. He kept antacid in a desk drawer.

The little free time he had, Bowers spent with wife Dianne and their four children, playing tennis, camping or watching the kids’ plays. He and Dianne went to parties occasionally, but many times, he just did not feel up to it.

“Life was never any fun, because he would always say, ‘Don’t make any plans, because I don’t feel well,” says Dianne.

Ironically, Bowers’s breaking point came on a vacation in 1983 or 1984--he can’t remember which.

On a family trip to Roanoke that was intended to relax him, Bowers took his children to an amusement park. As the day wore on, he started feeling funnier and funnier. He felt like there was a hat on his head, a very heavy hat. Finally, Bowers went to a walk-in clinic, agitated, frightened and confused. But the doctor there was as mystified as Bowers, and eventually the patient was dismissed.

The experience jolted him. He knew that the stress of work was bothering him, but why should he feel so much stress when he was away from work? The answer would take years for him to find.

What is stress exactly? It's a physical reaction to a mental state: the fight-or-flight response. This ancient response helps you survive. If someone points a gun at you, for example, you logically sense danger. This information races to the hypothalamus, where thought becomes emotion. Suddenly, your heart is racing, your muscles tense, you start to sweat. You’re ready to beat it out of there—or to do battle, if you must.

Great stuff for fleeing hungry tigers. But the body hasn’t quite adapted to modern-day paper tigers. In contemporary life, the fight-or-flight response is sometimes triggered at an inappropriate time. “It could happen when you get a bill that you weren’t expecting,” says psychologist Rick Waranch. “Your body could gear up in a similar way.”

If you don’t know how to send your body the all-clear signal, you might end up with chronic stress. That was what sent Charlie Bowers to the walk-in clinic. His systemic nervous system was running at full throttle. Before long, his body hit a wall.

Stress managers say this is a common problem for people who go through the day dodging one perceived threat after another. “They live in a state of hypervigilance,” says University of Maryland psychiatrist Hinda Dubin. “Every time a door slams, they jump.”

This hypervigilance wears the body down. Increased hormonal levels can cause headaches and high blood pressure. Perpetually tensed muscles can lead to gastronomic problems and heart disease. Infertility is another possibility. So are anxiety disorders, depression and insomnia. These symptoms, in turn, can become sources of additional stress, turning the whole thing into a vicious cycle.

Modern-day stress is not all bad, of course. Skiing can cause stress, as can romance. It isn’t stress in itself that causes problems. It’s the failure to react to stress constructively—to listen to the messages your body is sending you. “What causes the distress is when you don’t think you have any ability to man age stress,” says social worker Kauffman.

Some people feel stress because they don’t know how to relax. That’s why a self-calming technique like meditation or yoga is the first stress solution you should try. Whom is it most likely to help? People whose stress is caused by activity overload—what some practitioners have taken to calling “hurry sickness.”

“I find people who have a list of 12 things they have to do at red lights,” laughs the University of Maryland’s Dubin. “They’re going to floss their teeth, balance their checkbook. These days, it is the only time in your life that goes unaccounted for.”

Life’s quicker pace makes some people see down-time as an unaffordable indulgence. Dubin adds: “You can’t be just a couch potato anymore; you must be aerobicizing. You can’t just play with your children; you have to have ‘quality time.” But such a view is ultimately self-defeating. Without time to rest and reset your reaction system, you might end up too stressed to enjoy your many activities.

“Some people love what they do. They don’t want to stop doing it, “ says Russ Hibler, a psychologist at Union Memorial. “They just don’t want to burn out.” Relaxation techniques like yoga, meditation and biofeedback—or even just scheduling regular times for rumination or prayer—can help prevent that kind of burnout. All these strategies work by helping you control your physiological reaction to stress.

Charlie Bowers first tried biofeedback. It’s a big word for a simple system of doctors’ tools that measures heart rate, body temperature and other physiological signs of stress. The measurements are displayed as lines on a computer screen or printout. The calmer you are, the higher your temperature line gets.

Hooked up to these devices, Bowers learned to will calm. He did deep-breathing and other relaxation exercises and watched the lines dip and rise in exact correspondence to his mental state and felt a new sense of control. It was like finding a muscle he never thought he had—one that he could flex when he felt under pressure. If things got hectic at work, Bowers would close, practice the relaxation techniques he had learned and think soothing thoughts. “In 20 minutes I was the most relaxed person you could run into,” Bowers recalls.

But an hour later, his body was once again receiving the warning signals that sent him back into distress. His calming thoughts would quickly dissipate. It seemed as if, for Bowers, learning to relax was a Band-Aid that slid off during the first shower of difficulties. Clearly, relaxation alone was not the solution to his problem.

The second rung on the stress reduction ladder is tuning up your body. Eat right, exercise, get enough sleep. You’d be surprised how life can go awry (or seem like it has) when you’re not fit to deal with it. “People who don’t get enough sleep are impaired in the ability to pick up social cues, body language,” says Thomas Hobbins, a physician at the Maryland Sleep Disorder Center. “They don’t function very well.”

And what does this cause? You guessed it. Stress. The same holds true for exercise the few hours you spend working out each week you might easily make up in improved productivity. “On a physiological basis, exercise is probably the simplest, most effective means of stress reduction,” says Steve Ehasz, an exercise technician at the Bennett Institute.

It stands to reason. Aerobic exercise builds stamina, so that when you find

yourself in a perceived fight-or-flight situation, your body reacts naturally. Increased heart rate, tense muscles? Been there, done that, your body says. A well-exercised body can better handle the physiological changes of stress. More importantly, after the crisis, it will slip more readily into a relaxed state.

When Charlie Bowers learned that exercise could relieve stress, he immediately bought a Nordic Track machine. He works out on it four times a week. He does feel better, Bowers says, and better able to handle stress.

But his stress was not caused by neglecting his health (although some people’s stress is). And so merely taking better care of himself was not the whole solution for Bowers.

What's the third step toward solving your stress problem? A mental tune-up. Maybe there’s some-thing in the way you think that’s causing unnecessary agitation.

Zen Buddhists liken the mind to a drunken monkey, and with good reason. It jumps from topic to topic, is quick to anger, unreasonable, selfish and grabby. Worst of all, it tends to overreact, treating current problems as catastrophic when in retrospect they will seem only mildly annoying. If your expectations for yourself, friends and strangers are unreasonable, your own personal drunken monkey might be extra wild, needlessly triggering your stress system.

“In our society, we compare our-selves to other people, and companies compare themselves to each other all the time,” says Owings Mills-based stress management therapist Patricia Armour. “Are we fit enough? Are we trim, enough? Are we young and beautiful enough? All of a sudden we have all these new rules of what we should be.”

To teach your stress system not to cry wolf, you must evaluate your expectations and adjust them where necessary. You can do this alone, with the help of books or friends, or with a professional therapist. But however you do it, it’s a lot harder than it sounds. If you’re successful, some local practitioners believe, you’ll be rewiring your brain, actually making physiological changes in the paths thoughts travel. Does a shop clerk’s flippant attitude feel like an attack? Your immediate thought should be that this person’s history has nothing to do with yours. Not only is it counter-productive to take such flippancy personally, it’s narcissistic. Learning to tell yourself these things is relatively easy. The hard work comes in learning to believe them.

Cognitive therapy can help. A therapist doesn’t have to root around in your subconscious for Freudian complexes. Through conversation, the therapist can help you see the sometimes-unspoken assumptions you hold about life and explain how these assumptions influence your emotional reactions.

By rearranging your thought processes and your priorities, you can come to see stress as a positive force. George Everly, chief psychologist at Union Memorial Hospital, recalls a speech about stress he recently gave to a group of local CEOs. “These are hard-driven people who don’t want to hear anybody say ‘Find a quiet corner and think positive thoughts,'” Everly says. “Many of them will never retire because they enjoy what they do.”

People like this tend to see stress as a benefit, Everly says. It gives them an edge over weaker competitors who might not be able to hack the same pressures. “In a good market, everyone does well,” Everly notes. “In a crisis situation, people who don't have their act together don’t do as well.”

Charlie Bowers read some self-help books on relieving stress, and dutifully followed their prescriptions. Over time, he also consulted one psychiatrist and two psychologists. Their suggestions for thinking differently worked for a spell, and he felt guilty when his stress came rumbling back.

Sure, he realized that he blew some things out of proportion. What difference did it make that at the mega-hardware store he frequented, the clerks were indifferent to his requests for help? This skimping on service, after all, was a reasonable management response to the slower economy.

But just knowing his expectations were a bit unreasonable didn’t save Bowers from the headaches or the stomach-aches And on Wednesday mornings, it didn’t keep those old, tense feelings from flooding back.

Still, Bowers began to learn how stress operated in his life. And it was this understanding that would eventually help him heal himself.

If you've tuned up your body and your mind and you’re still feeling stressed, the stress is not coming entirely from inside you. It’s time to try stress reduction step four: Get your life in balance. With your newly gained self knowledge, strive to isolate the cause of your stress. Listen to the signals your body sends you. What causes your nervous system to go on alert?

When you figure out where your stress comes from, reorganize that, part of your life to make it work for you. For example, a Type-A personality who wants to keep his low-risk job for family reasons might ease the stress of boredom by taking up an exciting hobby like rock climbing. Or if a marriage has become the source of tension, rearranging the relationship might help. The couple could decide they need to spend more time together, or to grow as individuals by spending time apart.

The key is achieving a balance between work, family and fun. Your body is telling you that something is out of whack. It’s giving you an opportunity to fix it.

Charlie Bower's progress toward balancing his life took a great leap for ward when he met internist Mort Orman. The Towson-based doctor spent two therapy sessions just asking Bowers questions about his life. At the end of the second session, Orman asked an offhand question: “That list of yours,” he said. “How many items does it have?”

Now, Charlie Bowers did have a to-do list, but he had never mentioned it to the doctor. Yet from Bowers’ answers to other questions, Orman knew he had such a list, and the doctor knew it was a long one. How long was it exactly?

“About 10 items,” Bowers said. “I want you to cut that list to 10 items,” Orman ordered. “Ten items only. Delegate the rest. Oh, and one more thing: Get a hobby, Charlie.”

Bowers took up still-life photography, a hobby that gives him some distance from his all-consuming work life. This distance proved invaluable in solving the rest of his problem. Because by stepping back from his business, Bowers could do what Orman taught him to: Rather than suppress or defuse his stressed-out feelings, he heard what they were saying. His business was causing him distress. In order to ease it, he had to root out the cause of the dis tress and find a way to fix it.

Since the latest recession began five years before, Bowers had fretted over lackluster sales. He sent his staff to seminars, made them listen to motivational tapes, gave them endless pep talks. But no matter how he tried to pump up his staff, sales held steady. Salespeople who worked there at the time say the additional sales calls that the new economy required were draining their motivation to sell. They preferred shepherding their company’s progress on the gardens’ and decks of clients they’d already sold.

Infuriating? Perhaps. But when Bowers took a step back from the situation, it all made perfect sense. His salespeople were experts, trained in landscape design. When sales were rapid, these experts had plenty of time to enjoy that aspect of their jobs. But when sales slacked, the extra sales calls left salespeople less time for their first love: helping clients design and build out their gardens. As longtime Golden Gate salesman Don Law says, “I’m not in it for the kill.”

Bowers had no control over the sluggish economy. He did, however, control the way his company was organized. And the way he had organized it during boom times wouldn’t work anymore. His sales staff was separate from the people who later laid out and built the gardens. As soon as one client had signed a contract, the salespeople could have been on to the next prospect. But that wasn’t what they’d signed up for, and so they weren’t happy. This conflict between what the salespeople loved and what the economy demanded was the crux of the problem not only for Garden Gate, but for Bowers, as well.

Here was Bowers’s brainstorm: He made the salespeople team leaders, responsible for overseeing all aspects of landscaping. Granted, the new system might not generate as many sales as Bowers had expected before. And to implement the system, Bowers was forced to lay off some of his separate design staff. But instead of pressuring himself and his staff to dig up business where there simply was none, Bowers created more enjoyable jobs for the employees he could afford, and let the company “seek its own level.”

Of course, not all of us have the power to change what’s causing our stress. If your job is stressful but you’re not the boss, there’s only so much you can do. Anyway, you might find yourself in a profession or in a living arrangement that simply can’t be fixed to suit you. If you find yourself in that position, it’s time to consider stress-reduction step five: remove the cause of the stress.

“Some persons are introverted and some are extroverted,” explains Alan Romanoski, a psychiatrist at Johns Hopkins Hospital. Certain jobs, hobbies and spouses are simply never going to be natural for you, he says. "If you have thin skin, you don’t play baseball for the New York Yankees.”

Does this mean people can't adapt to stressful parts of theft lives? Not at all, says Union Memorial’s Everly: “There’s overwhelming evidence that the nervous system can be tuned, like a musical instrument. “An extrovert can learn to find happiness is a reference librarian, and many a tightly wound mother has loved a difficult child.

Whether such a radical change is always worth the effort is another question, though. Often, you will get more from your life if you seek your own level. And someone who has earnestly tried remedying a stressful lifestyle through relaxation, physical and mental tune-ups, and life balancing might decide that drastic action is called for. These are the people who quit jobs, sell houses, leave spouses, join monasteries and, most importantly, don’t regret it later.

If this five-step path to tranquility sounds too easy, that’s because in some ways it is. Quite often, the cause of our stress is staring us in the face. Locating the cause is the first step to remedying stress, but it’s also the easiest step. Ending harmful stress requires a brutally honest, patient determination to change.

This prescription is not a popular one in these instamatic times. But then, aren’t the times what cause such stress in the first place? As Union Memorial’s Everly points out, "It's a McDonald’s-mentality world. We’re the culture that invented the fast-food restaurant, and then we had the audacity to invent the drive-up window.”

But in reckoning with the tensions that this hurly-burly creates, there are no drive-through answers.

--Joab Jackson