The Pleasure Principle

Sometimes the source of stress is not having enough sources of pleasure. We live a lifestyle based on shoulds rather than on enjoyment. We work hard and take life too seriously. Or if we are procrastinating and "wasting time," we don't really enjoy ourselves; we simply pass the time or spend it worrying about the work that is not getting done. Even our recreational pursuits have become overly organized and goal oriented. The North American work ethic has taught us to focus on productivity and frown upon "wasted time." Our culture's motto seems to be "No pain, no gain." As we learn to channel our energy into productive directions, we often cut ourselves off from the simple daily pleasures life offers. Instead, we focus on obtaining those things that only represent, but do not really deliver happiness: grades, a degree, a good job, the "right" relationship, and money. In the process of becoming more and more productive, we forget how to enjoy a sunset, smell the flowers, play with children. We forget how to relax. When we find ourselves with a few moments and nothing to do, we fill the void with diversion rather than enjoyment. Lacking pleasure, we feel empty inside. Something is missing.

FEELING GOOD: THE PSYCHOPHYSIOLOGY OF PLEASURE

Medical research tends to focus on the negative. We hear about the negative health effects of stress, depression, and anxiety. We study how feelings of stress, loneliness, hostility, and alienation can lead to hypertension, artery disease, drug abuse, and other ills (see Chapter 3). This reflects our culture's medical orientation: find out what's wrong, then try to fix it. Health is often seen merely as the absence of illness rather than a state of well-being. Fortunately, some researchers have stopped to ask a very simple but important question: If negative emotions cause negative health effects, can positive emotions cause positive health effects? Can feeling good help us overcome health problems and promote high-level wellness? Preliminary research suggests that feeling good is in fact good for us.

    To begin with, pleasure is often associated with a relaxed contentment and feeling of well- being. Such feelings activate the relaxation response, which is the antithesis of the stress response. You'll remember that the stress response activates the sympathetic branch of the autonomic nervous system while the relaxation response activates the parasympathetic branch. Parasympathetic activation lowers heart rate, breathing rate, and blood pressure; it helps muscles relax, digestion proceed smoothly, and so on. While a chronic stress response leads to an assortment of negative health effects, frequent relaxation helps prevent these ills; it tugs your body in the other direction. Many people mistakenly believe stress reduction is best achieved from esoteric relaxation techniques. In fact, simple activities such as taking a long walk or a soothing hot bath can be as effective for reducing tension as more structured relaxation techniques such as meditation (Druckman & Bjork, 1991).

    But the healthy effects of pleasure seem to go beyond a mere cancellation of negative stress. Feeling good is more than not feeling bad. The goodness itself seems to have positive health consequences, although science is just beginning to explore what these might be. We know that emotion is a body-mind biochemical event. Further research will no doubt continue to unravel the biochemical changes associated with pleasure and to elucidate what Norman Cousins (1989) called "the biology of hope." At this point, all we can say is that optimistic, happy people tend to be healthier and live longer than cynical pessimists. Best of all, they enjoy themselves.

FEELING PLEASURE OR KILLING PAIN?

As you begin to think of ways to make your life more pleasurable, it is important to distinguish between pleasures that increase stress resistance and experiences that more closely resemble maladaptive coping responses, activities that may initially feel good but bring you more stress down the road. Cigarette smoking, binge drinking, and sleeping through morning classes are three examples. These feel good and seem pleasurable at the time but they will likely have negative consequences in the future because they interfere with effective coping and have negative health effects. Sometimes the pleasure people associate with certain negative habits has more to do with killing pain or satisfying addictive cravings than with providing true pleasure.

WHAT IS ADDICTION?

People commonly use the word addiction with reference to substance abuse. Heroin addicts, alcoholics, and crack houses spring to mind as well as cigarette and caffeine habits. But people can also become addicted to unproductive relationships, food, gambling, work, taking risks, exercise, and probably even to being a student! To become addicted is to devote or surrender oneself to something habitually or obsessively. It is ironic that the word addiction is derived from the Latin verb meaning "to give assent" since we tend to think of addicts as being incapable of giving assent, having lost control of the habit in question. The hallmark of addiction is a reliance on something outside of oneself to cope with life and manage stress. Although people initially become addicted to something because it feels good, after a short while true addictions do not provide pleasure so much as temporary relief, and addicted people do not feel good most of the time.

USE, ABUSE, OR ADDICTION?

As you can see from the Addiction Self-Assessment questions, addiction is not simply a function of frequency or amount of use; rather, it relates to the reasons for and context of use and the effect of the substance or behavior on the user. You might think of addiction as part of a continuum that extends from abstinence, through use and abuse, to addiction.

Abstinence Controlled use   Abuse     Addiction

    We can illustrate this continuum concept with alcohol. Alcohol is a powerful depressant drug that slows the nervous system. Alcoholism is the most common drug addiction problem in North America. Alcohol presents an interesting addiction illustration because our culture sends mixed messages about it. On the one hand, its use is sanctioned and it is fairly accessible, even for minors. Yet the effects of alcoholism are tremendously costly and destructive.

    At one end of the continuum is abstinence. Abstinence refers to no use at all. A desire to avoid the devastating effects of alcoholism is one reason to abstain from imbibing. People may stay away from alcohol for many other reasons as well. Some believe the health risks of alcohol consumption outweigh any benefits. Some do not enjoy drinking or feel that alcohol calories could be better spent on something more interesting.

    While some people claim to drink solely because they enjoy the taste, alcoholic beverages are also consumed for their intoxicating effect. Intoxication develops gradually, beginning for most drinkers with a feeling of relaxation. A glass of wine with dinner, a beer with friends while you work on your motorcycle, and a glass of champagne at a wedding are examples of controlled use of alcohol. The intoxication is mild (or nonexistent), it causes little harm to the drinker or others, and the drug is consumed in a structured social environment in an appropriate fashion. People who use alcohol in a controlled fashion claim that at its best, a small amount of alcohol can enhance an occasion, helping users to become more sociable and relaxed. In other words, alcohol is consumed in moderation and for positive reasons. It is not used to dull emotional pain, escape from reality, or to help the drinker avoid a situation.

    Abuse occurs when the consumption of alcohol hurts or endangers the drinker or those around him or her. Alcohol abuse can occur in a single episode of drinking; driving while intoxicated is always considered alcohol abuse. However, alcohol abuse often consists of frequent heavy drinking that can lead to many health and behavioral problems. Such things as going to class or work while intoxicated, getting into legal trouble as a result of drinking, experiencing blackouts, and getting injured while intoxicated are indicators of a drinking problem. Surveys show that about half of all college students become intoxicated at least occasionally. Although they may restrict drinking to social occasions, once they start drinking they aften drink too much because this is considered normal party behavior on many campuses. Although most students will grow out of such use and stop drinking or develop controlled drinking patterns, a significant number of college students do go on to develop an addiction to alcohol. (And for some, alcohol abuse in college reinforces an alcohol addiction developed in high school.)

    Controlled users drink to enhance an occasion and enlarge their experience; people with an addiction to alcohol drink simply to cope. Addicts feel that they need alcohol to function, that life and its occasions are miserable affairs without it. Controlled users may enjoy the feeling of increased sociability that comes with a small amount of alcohol; addicts rely on alcohol for permission to socialize. They may feel incapable of social interaction without becoming intoxicated. When drunk, they feel like they are "the life of the party." When sober, they feel like they have nothing to say. Some people become addicted to alcohol because it shields them from difficult issues. Instead of trying to solve problems, they drink. Drinking temporarily eases the hurt of painful emotions and provides a way to put off dealing with conflict (Steele & Josephs, 1988). Eventually, addicts can no longer tolerate any amount of uncertainty or anxiety. New experiences and challenges cease to call forth innovative ideas and creative expression; they become simply an excuse to have another drink.

ADDICTION: AVOIDING LIFE

Addiction is the opposite of stress resistance. The example of alcohol addiction is an obvious illustration. Most of us have some understanding of how substances such as alcohol can be used to avoid confronting reality. Some types of addiction are not so obvious, however. Addictive involvements in work and unhealthy relationships, for example, have received less attention because to a large extent they are sanctioned by our culture. Let's take another look at the meaning of addiction by examining addiction to work.

    The word workaholic has been coined to refer to someone who works too much and in the process neglects other important parts of life, such as family and recreational pursuits. A hard-driving, Type A business executive springs to mind, or the straight A student who does nothing except study and obsess about grades. As in the alcoholism example above, however, the superficial behavior is only part of the story. The motivation behind the work involvement defines whether it is truly addictive or not.

    People with work addictions use work to shield themselves from involvement with others and other parts of life. They enjoy being busy with a task more than involvement in the work itself. Having something concrete to perform helps them deal with the uncertainty of how to deal with problematic children, unpredictable spouses, or lingering questions about the meaning of life. This is in direct contrast to people who work long hours absorbed in a meaningful project. Dedicated students, teachers, artists, scientists, and entrepreneurs, for example, are not concerned with the empty, compulsive, ritual routine of work but are rather personally fulfilled through a stimulating participation that contributes to their growth and satisfaction.

    A similar parallel can be drawn for relationships. Devotion to a lover becomes an addiction when that relationship becomes a limitation to involvement in life and personal development (Peele, 1975). An extreme example is co-dependency. A codependent person typically believes he or she is responsible for the behavior and problems of others, especially a partner (Edlin & Golanty, 1992). Relationships for co-dependent people serve as limitations because the needs and problems of others serve to define and control the co-dependent's life to an extreme, so that the person's own needs go denied and unmet.

    At their best, relationships with friends and lovers enlarge your experience; teach you about yourself and the world around you; and stimulate you to meet new people, try new activities, and have more fun. These friends and lovers help you find creative solutions to problems, increase your self-esteem, and serve as a bountiful source of healthy pleasures. On the other hand, addictive relationships get you stuck in a rut. They limit your experience and discourage you from developing your personal potential. If you remain in a relationship simply because it is convenient, you feel needed, or you are afraid of being alone, you should question its value and your motivations for staying.

HEALTHY PLEASURE

Medical researchers Robert Ornstein and David Sobel (Ornstein & Sobel, 1989a) believe that "our health, happiness and future depend upon understanding and reversing [our] deep-rooted cultural denial of sensual pleasure and leisure.... Feeling good pays off not only in immediate enjoyment but also in better health" (p. 13). In their book Healthy Pleasures, which provides the inspiration for many ideas in this chapter, they present research to support their notion that Americans should quit worrying and start "living optimistically, with pleasure, zest and commitment." Their advice makes sense. And, best of all, it's fun!

    For you to increase the amount of time you spend enjoying yourself, two things must happen. First, you must expose yourself to pleasant experiences; second, you must be open-with your body, mind, and spirit-to the enjoyment and appreciation of these experiences. The first is by far the easier. It begins with exploring your five senses and experiencing pleasurable sensations.

SENSATION-SEEKING REDEFINED

True pleasure often comes from enjoyment of the little things in life. Some people equate feeling excited with feeling good and mistakenly believe that the only way to feel pleasure is to experience an adrenaline rush. Feeling thrilled and excited can be fun, but remember the concept of eustress from Chapter 1: fun and excitement is still a form of stress from which you must eventually unwind. People are so often on sensory overload they forget how to enjoy simple sensory pleasures and find contentment in daily life. Getting back in touch with easily accessible sensory pleasures can help you unwind and experience the pleasure of relaxation. As you consider the five senses, think about pleasurable experiences you may wish to add to your Twenty Pleasures list.

The sun's warmth on a fresh spring day, a cool breeze on your cheek, a loving caress, a cat's soft fur, a leisurely hot bath, a young child asleep in your arms. Your skin, the largest organ in the body, is constantly transmitting sensory information from the people and environment around you. Tuning in more carefully to the positive messages coming in increases your pleasure. What are these messages? With touch, people communicate comfort and caring. Touch heals the sick (Dreschler, Whitehead, Morrill-Corbin, & Cataldo, 1985; Weiss, 1986) and relieves pain (Fishman, Turkheimer, & DeGood, 1995). Without the minimum daily requirement of touch, babies fail to grow (Reite, 1984) and grownups get grumpy.

    North Americans of Northern European descent do not score very high on the international touch scale. Our puritanical upbringing has taught us to be rather conservative about touching each other. Touch is reserved for lovers and young children. The sexual revolution of the 1960s and 1970s has "liberated" us enough to jump in bed with a total stranger (which usually brings unsatisfying communication along with the risk of disease), but we are hesitant to hug our close friends. In fact, for many people, touch is a four-letter word. Nice people just don't do it, except perhaps in the privacy of their bedrooms. And let's not talk about that. Massage is associated with prostitutes and two men hugging each other are labeled homosexuals. Preschool teachers are afraid to cuddle their young students for fear of sexual abuse charges.

    Other cultures, and subcultures in our own country, have a very different view. Hand-holding between friends, a stroke on the arm, a kiss on the cheek are more commonly seen in other cultures. One interesting study (Jourard, 1966) compared the number of times couples in cafes touched each other in several countries. In San Juan, Puerto Rico, couples touched on the average 180 times per hour. In Paris, 110 contacts per hour were recorded. In Gainesville, Florida, the count was down to only twice an hour. And in jolly old England? The couples never touched. A study of young children and their adult caregivers in three countries found a similar result. When caregivers in Greece, the Soviet Union, and the United States were chasing or punishing their charges, touch levels were similar. But in other interactions such as soothing and playing, American children received much less touch (Gibson, Wurst, & Cannonito, 1984).

    Touch is enjoyable only if it feels right, if it communicates comfort and caring in a nonthreatening way. You can increase your daily touch enjoyment by learning more about what feels good for you. Trading back rubs with a friend, caressing your child or lover, petting your dog or cat, and learning how to massage the muscles of your own face and neck are enjoyable touch experiences.

    One of the most pleasurable sensations our skin brings us is warmth. Most people love hot tubs, saunas, and warm climates. Research has shown that these offer potent stress relief as well. Saunas, on which the most research has been done, seem to decrease muscle tension (deVries, Beckmann, Huber, & Dieckmeir, 1968) and to increase endorphins, chemicals produced by our bodies that relieve pain and produce feelings of relaxation and euphoria (Jezova, Vigas, Tatar, Jurcovicova, & Palat, 1987). Hot baths and showers provide easily accessible sources of pleasure for many people.

Sight

Pleasant sights produce enjoyment and relaxation. Although the concept of "pleasant" varies from person to person, an overwhelming majority of people find natural outdoor scenes to be most pleasing. In one study, when people were asked to view natural and urban photographic slides, they reported more positive feelings for the natural scenes. Natural scenes were also associated with lower physiological arousal (Ornstein & Sobel, 1989b; Ulrich, 1981).

    Most people must adapt to an indoor world at certain times in their lives. And many people live in urban areas devoid of waterfalls, prairies, and forests. However, introducing even small tokens of the natural world into your indoor environment can significantly increase your pleasure and your stress resistance. Plants, aquariums, and paintings and photographs of natural scenes can all combat the lifeless atmosphere of many home and office environments (Ornstein & Sobel, 1989a).

    Some people experience a great deal of stress when deprived of adequate natural lighting, a condition appropriately known as SAD, for Seasonal Affective Disorder (Jacobson, Wehr, Sack, James, & Rosenthal, 1987). They become depressed in winter when days are short and they must spend more time indoors. People with SAD tend to sleep and eat more in the winter and feel generally depressed from November through March. Some researchers estimate that up to 5 percent of North Americans are affected by SAD ("Boosting winter's light," 1992). Many others suffer from milder symptoms. Treatment for SAD involves lighting up your life: when you are indoors, spend time near windows when possible; exercise outdoors during the daylight hours. Using bright, full-spectrum lighting in your home and work areas is expensive, but it is helpful if SAD is a serious problem.

Sound

The sounds in your environment can provide pleasure or jangle your nerves. Birds singing, crickets chirping, rain falling, ocean waves breaking on the shore-as with sight, nature sounds tend to be more relaxing. On the other hand, horns honking, jackhammers pounding, and engines revving make people nervous. When exposed to such noise for long periods, as when living or working next to a construction site, people become tense and irritable; they can even develop stress-related illnesses. Too much sound, even constant television or radio "background" noise, can be irritating.

    Pleasure seekers must do what they can to minimize noise pollution and add pleasant sounds to their environment. Ear plugs are a marvelous invention for soothing nerves as well as protecting your hearing. Covering construction and similar noise with "white noise" such as radio static or recordings of ocean waves, waterfalls, and similar sounds can be helpful. Periods of quiet can be very therapeutic (although hard to come by in some places); enjoy them when you can. Recordings of nature sounds can help you relax.

    Music in some form has been important to every human culture. Music awakens a wide array of emotions. It can soothe and calm or stimulate and arouse. It lessens pain, speeds post-operative healing, lowers heart rate and blood pressure, and decreases anxiety and depression (Hatta & Nakamura, 1991; Spintge & Droh, 1983; Standley, 1986). Many readers probably included "listening to music" on their Twenty Pleasures list earlier in this chapter. Tuning in to how you respond to various types of music helps you learn to use your music collection to adjust your mood. Many people have favorite relaxation music that helps them unwind and recover from stress.

Smell

Smell is probably the most overlooked source of sensual pleasure. Your sense of smell is connected to the areas of the brain that generate emotions, which is why smells have such interesting effects on mood and memory (Gibson et al., 1984). A smell that reminds you of your grandmother's house that you visited as a child does more than awaken a picture of what her house looked like. Instead, it reminds you of the total feeling of being there. The smell transports you back to your childhood, back to the you that was visiting your grandmother.

    What smells are pleasurable to you-freshly baked bread; roses; peppermint tea; a certain incense, soap, or perfume? Notice your response to various fragrances and try to use them in new ways to enhance your pleasure.

Taste

In our diet- and weight-conscious culture, many people regard the pleasure of good-tasting food as a mixed blessing. We have been conditioned to regard the pleasure of eating with suspicion. We joke that if it tastes good, it can't possibly be good for you.

    Our prehistoric ancestors benefited from a taste for sweet, salt, and fat, which led them to consume the nutritious, high-fat foods essential for survival in prehistoric times when getting enough calories was the difference between life and death. We have inherited these tastes, and now, in a land with an abundant food supply and a high availability of processed foods, we cannot rely solely on what tastes good to choose what we eat. But with a little nutrition education, we can still make healthful choices and enjoy the pleasure of eating.

    Many North Americans worry too much about what they eat. We've heard that eating the wrong way leads to a wide array of ills including obesity, artery disease, diabetes, and hypertension. Most of the advice we get focuses on what not to eat. After years of trying to ignore our appetites and going on and off restrictive diets, food comes to be seen as the enemy. Food and appetite acquire an enormous importance and power the more we curb our appetites and deny ourselves pleasure. In extreme cases, powerful food cravings drive compulsive eaters to wolf down unnatural volumes of food in an effort to satisfy their emotional hunger. The fact that dieting and eating disorders have reached epidemic levels in our culture indicates that something has gone wrong with our relationship to food (Black & Held, 1991).

    There is no denying that good nutrition and good health (and stress management) go together, as discussed in Chapter 9. But the way we respond to this connection can be the difference between a healthy desire to take good care of ourselves and an unhealthy obsession with eating. Most dieting and disordered eating evolves not from a desire for good health but from a desire for a certain appearance: a drive to be very thin and a fear of fatness. Statistics show that at least half of all people claiming to be on a weight-loss diet are not overweight by medical standards. They may be five or ten pounds heavier than fashion models and be battling their genetic heritage in an effort to attain an impossible physique. Is it worth the fight? Research has shown that staying somewhat over-weight is healthier in the long run than repeatedly gaining and losing weight, a process familiar to chronic dieters known as weight cycling (Van Dale & Saris, 1989). Weight cycling occurs because, as discussed in Chapter 9, restrictive diets don't work. They are an unnatural way of eating, based on monotony and selfdenial. They are difficult to live with and do not teach dieters how to develop a healthy relationship with food. People on very low-calorie diets often experience frustration, fatigue, depression, low self-esteem, and uncontrollable food cravings. The stress created by very low-calorie diets is often much worse for your health than being somewhat overweight and enjoying your food. And ironically, restrictive diets may prevent you from losing weight and in the long run, lead to weight gain.

    So if diets don't work, what is to be done? Throw caution to the wind and indulge our way to a heart attack? What does work for long-term health and increased stress resistance is moderation combined with enjoyment of our food and getting back in touch with our appetites. We can learn to use our nutrition knowledge and our positive outlook to develop a pleasurable eating plan. We can make healthful eating choices most of the time while enjoying occasional sweets and treats. Healthful weight control and disease prevention develop from eating habits you can live with for a lifetime, based on eating when you are hungry, enjoying your food, and not eating when you are satisfied.

    You can get more pleasure from eating if you experiment with your food choices. Cultivate variety, flavor, and texture. Try various spices and other flavorings. Most of all, eat slowly and focus on the pleasure of eating.

ACCEPTING PLEASURE

Cultivating pleasurable experiences and allowing them into your life is a good first step. Small things, like enjoying a cup of coffee, watching the birds at the bird feeder, and listening to a favorite piece of music make a big difference in the way you feel. Much of the pleasure people feel is psychological in origin. If the mental pleasure gates are not open, sensations of pleasure cannot get in. Perhaps you've been there: you are at your favorite vacation spot and it's a beautiful sunset. You can't explain it but although nothing is really wrong, you just don't feel happy.

    Where do happiness and pleasure come from? Do they just happen, dropping in unannounced from time to time? Do they depend on our achieving certain goals or being in certain situations? Is there a way to cultivate positive emotions and experiences? Most psychologists believe the latter-that with practice you can develop a more optimistic outlook that helps you become more receptive to pleasurable experiences.

    Happiness (like stress) is often equated with major life events: winning the lottery, graduating from college, finding the right partner, landing a well-paying job. But just as research indicates that it's the daily hassles that wear people down, so the small daily moments of pleasure define whether people consider themselves happy (Argyle, 1987; Ornstein & Sobel, 1989a). If we adopt the attitude that we can't be happy until some specific goal is achieved, we are forever waiting in the wings of life's theater. If only this paper were written or I had enough money to buy a car ... I'll be happy once this week is over, the summer is here, I get my promotion, I lose 20 pounds ... Something more is always looming on the horizon to serve as an excuse for not trying to be happy now.

    Ornstein and Sobel write, "Happiness lies in narrowing the distance between where you see yourself and where you expect to be" (Ornstein & Sobel, 1989a, p. 129). Unhappiness comes from the perception that things should be better than they are. Happiness comes when you perceive that things are going pretty well for you. How do you tell? It's all relative, and it all comes down to your point of view. We will talk more about perception and stress in Section IV. For now, let us introduce the idea that reality is quite subjective. We create for ourselves beliefs and concepts about what's going on out in the world as well as how we are faring in the scheme of things. If you compare yourself to an unfortunate refugee in some wartorn part of the world and count your blessings, you will decide you are really quite well off. If instead you compare yourself only to people who are smarter, richer, and better looking than you, then life is lacking.

    Let's face it: reality can be depressing. The world is full of suffering, injustice, and pain. But there are also beauty, love, meaningful relationships, and satisfying work. Optimists tend to focus on the latter, to see the glass of life as half full. They are resistant to stress because they view demands as challenges rather than obstacles; they feel hopeful, not helpless. They emphasize the positive and tend to play down the negative. This denial of the negative allows them to move on with their lives in a productive, happy way and not become overwhelmed with stress or stuck in depression. And while we might think that being in touch with "reality" is a sign of mental health, the truth is that mental health is associated with a certain amount of healthy illusion (Bresnitz, 1983; Coleman, 1985; Lazarus, 1979). For example, healthy people tend to overestimate somewhat how much control they have over future events (Dobson & Pusch, 1995; Taylor & Brown, 1988). Remember that a sense of control is an important element of stress resistance. The stress resistance comes not from how much control people actually have but from their perception of having control. Obviously, having too many illusions can cause stress (Colvin, Block, & Funder, 1995). If you overestimate your abilities and underestimate the demands of an upcoming exam, you will probably perform poorly. Healthy illusions give you enough optimism to work hard and achieve. Unhealthy illusions impair your ability and create stress.

    When presented with the idea that illusions can be healthy, many students are confused: Is this good or bad? Should we ignore the suffering and injustice so that we can be personally happy? Of course not, and optimists don't do this. Ironically, by focusing on the positive, optimists are more likely to effect social change because they are prepared to take on a challenge. Would a realist ever run for government office or go into social services? No, because these jobs take energy, hope, and stress resistance. By focusing on control, commitment, and challenge, stress-resistant optimists can muster the energy to accomplish meaningful work.

    What does optimism have to do with healthy pleasures? An optimistic attitude opens the daily pleasure channels. Seeking and expecting pleasure, you are more likely to find it. Stress-resistant people count their blessings many times each day and appreciate the good things in their lives. They realize that happiness comes not from momentary triumphs but from how much of the time each day a person spends feeling good. 

CULTIVATE YOUR SENSE OF HUMOR

Laughter is good medicine. Its salubrious effects are both physical and psychological. As physical exercise, it increases breathing rate, raises blood pressure and heart rate, speeds up metabolic rate, stimulates immune function, and gives face and abdominal muscles a workout while relaxing other muscles (Dillon, Minchoff, & Baker, 1985; Fry, 1992). Finding the humor in life increases your stress resistance. People who value humor and actively introduce a humorous perspective during times of difficulty are better able to weather stress (Kuiper, Martin, & Olinger, 1993; Martin, Kuiper, Olinger, & Dance, 1993) and experience fewer negative health effects (Martin & Lefcourt, 1983) than those who look only at the dark side. A sense of humor seems to protect the immune system from negative stress effects (Martin & Dobbin, 1988). Humor seems to be especially helpful for combating stress-related depression (Nezu, Nezu, & Blissett, 1988). People with a good sense of humor report less depression and loneliness and seem to have higher self-esteem (Frecknall, 1994; Kuiper & Martin, 1993; Overholser, 1992). Laughter reduces feelings of stress (White & Winzelbert, 1992). A good sense of humor is associated with optimism and positive feelings (Kuiper, Martin, & Dance, 1992). Humor enhances creativity and helps people get along (Hampes, 1983; Morreall, 1991).

    Research suggests that simply appreciating humor that comes your way is not enough; you must actively use humor in stressful situations for it to increase your stress resistance (Martin & Lefcourt, 1983; Nezu et al., 1988). Humor is most helpful when it is used appropriately-not to deny the problems you face but to help you deal with feelings of stress. Humorous remarks must not be destructive to others, or be used to avoid communication. Have you ever tried to discuss something with a flippant, sarcastic person who turned your serious conversation into a joke? This is not constructive humor because it alienates people. Humor is an effective coping skill when it connects you to others and makes everyone feel good.

    How can you cultivate your sense of humor and invite more laughter into your life? Here are a few ideas. Maybe you would like to add some to your Twenty Pleasures list.

1. Look for incongruities, for these are the sources of humor (Hillson & Martin, 1994). We overlook many of these each day. We can also learn to see everyday happenings with a humorous perspective. Make up funny stories about a stranger you see on the street. Give your car a name and a personality. Children are especially adept at finding incongruities and seeing stories in simple events. Take a stressful event you have recently experienced and turn it into a funny story.

2. See yourself as a humor-appreciator, as playful and humorous. Believe that humor cultivation is an important part of your life.

3. Have joke books and other sources of humor available. Collect jokes and funny quotes.

4. Read the comics every day and notice what makes you laugh. Save comics that make you laugh out loud, and look for books with these characters. Post favorite comics in convenient spots: your desk, the refrigerator, bulletin boards. Watch funny movies.

5. Try keeping a humor journal. Write down jokes and include comics that make you laugh and funny things that have happened to you. Use this journal to cheer you up on bad days.

One of the most often overlooked sources of pleasure is helping others. When we are in dire straits, sometimes the last thing we think we have energy for is giving, but giving often gives energy back to us-with interest. Several studies have found that people receive a great deal of beneficial pleasure by giving pleasure and helping others. Altruism has even been associated with better health. One study found that men who did no volunteer work were two and a half times as likely to die over the course of the study as men who volunteered at least once a week (House, Robbins, & Metzer, 1982).

    One of the reasons pleasure increases stress resistance is that it takes us out of our heads. So does altruism. Research has shown that one of the personality characteristics most related to negative health effects is self-involvement. Self-involved people are overly absorbed in themselves, their feelings, their thoughts, and their activities. They refer to themselves more often in conversation than less self-involved friends: you will hear the words "l," "me", 'my," and "mine" more frequently from these folks. Researchers believe such speech reflects how people tend to see the world, and when people feel isolated, they focus more on themselves (Scherwitz, Graham, & Ornish, 1985). Medical researcher Dean Ornish believes that "anything that promotes isolation leads to chronic stress and, often, to illnesses like heart disease. Conversely, anything that leads to real intimacy and feelings of connection can be healing" (Ornish 1990, p. 87) (italics are Ornish's). When we help others, the focus shifts away from ourselves. Herbert Benson, a cardiologist who has done a great deal of research on the therapeutic effects of relaxation techniques, believes that altruism may induce the relaxation response that lowers heart rate and blood pressure, increases immune response, and decreases sensitivity to pain (Benson, 1984).

    Altruism is most pleasurable when you become involved with other people, even if only for a few hours a week. Donating money doesn't give you the same good feelings. Look for volunteer opportunities near you that match your time availability and interests.

RECREATION

In Chapter 10 you learned about the stress-resistance effects of physical activity and the importance of finding activities that are enjoyable for you. Physical activities, hobbies, and other leisure-time pursuits are forms of recreation, activities that refresh you by means of enjoyment and relaxation. Recreation re-creates you; it renews your energy and creativity. just as preferences vary regarding physical activity, so do they vary regarding recreational activity in general. Studies that have asked people about leisure-time activity preferences have found that such activities provide many types of reward (Tinsley & Eldredge, 1995). They can increase your selfesteem, sense of social support and altruism, sensual enjoyment, mental stimulation, and creativity; they provide opportunities for competition as well as relaxation. It's important to make time for activities you enjoy.

Adequate restful sleep provides an important cornerstone of a stress-resistant lifestyle-and a healthy pleasure as well. But just as stress can wreak havoc on eating habits, it can reduce the quantity and disrupt the quality of one's sleep (Weller & Avinir, 1993). just when you need a good night's sleep the most, you may be least likely to get it!

    Almost everyone has trouble sleeping occasionally, especially when stress levels are high. Fortunately, a few sleepless nights cause no lasting damage, although they may dampen your good humor and interfere with your mental alertness (which is why studying all night before an exam is a self-defeating practice!). Chronic sleep deprivation, on the other hand, can seriously impair your mental and physical health and your ability to manage stress.

Insomnia

Insomnia may include any or all of the following symptoms:

1. Taking a long time to fall asleep
2. Awakening frequently during the night
3. Awakening too early in the morning
4. Feeling tired and dissatisfied with one's sleep on awakening

    Insomnia that lasts more than a few weeks requires medical attention since it may be an indication of depression or other serious health problems.

The first step in overcoming insomnia is to figure out the cause of the problem. Examine lifestyle factors that may be responsible. Eliminate or reduce caffeine consumption. Caffeine is a drug that is broken down very slowly in your body, so its effects are very long lasting. Caffeine may keep you awake long after the caffeine buzz is gone. Many people believe alcohol will help them relax and go to sleep, but like sleeping pills, alcohol disrupts the sleep cycle. While alcohol may help you fall asleep, it usually produces a light, restless sleep, and you may awaken suddenly in the night, unable to go back to sleep. Tobacco smoke and smokeless tobacco products contain nicotine, which is a stimulant. Smokers tend to report more sleep problems than nonsmokers (Lexcen & Hicks, 1993).

    If psychological stress is the cause of insomnia, develop your stress-management skills. Address sources of stress and practice relaxation training exercises. Professional counseling can be helpful as well.

The Sleep Environment

Create an environment conducive to sleeping. The sleep environment should be comfortable, restful, and associated with relaxation and sleep. A small dormitory room must provide areas for both intense studying and restful sleep. How can this be done? Try not to study in bed; your mind may come to associate the bed with mental activity rather than relaxing sleep. Let your bed be a haven for relaxation and sleep. Try ear plugs or white noise machines to cover disruptive noise. Most people sleep best in a cool room (60'-65'F). Shades that block light can help darken rooms with windows near streetlights or keep out the early morning sun.

College students are prone to sleep problems because they often develop very erratic sleeping habits. They may go to bed at a different time every night, get up early one day but sleep until noon the next, and nap when time for napping is available. Add to this schedule a healthy helping of stress, and insomnia begins. If insomnia is a problem, a regular sleeping schedule may work wonders. Try to get to bed at the same time each night, get up at the same time each morning, and avoid napping.

    While a small bedtime snack may help you sleep, a large meal before bed can inhibit sleep. Exercise improves sleep quality, but exercise too close to bedtime can wind you up instead of down. Sleep experts generally recommend exercising in the late afternoon.

    Develop a relaxing bedtime routine that helps you go to bed with a peaceful mind. Read something fun, listen to soothing music, write a letter, or knit a sweater. Lie down to sleep only if you are sleepy. If you haven't fallen asleep after 10 minutes, get up and do something relaxing until you get sleepy.

What about Napping?

Many cultures endorse an afternoon siesta. Unfortunately, this practice has gone by the wayside in many industrial countries. If a daily nap is a source of solace and stress relief and does not interfere with your lifestyle, enjoy! Question your napping if you are getting more than 8 or 9 hours of sleep a day; too much sleep may be a symptom of depression or other illness. Consider also whether you are using sleep as a means of procrastination. Sleep is a fairly healthful coping technique, but sources of stress must still be addressed. The biggest problem with napping is that your body wants to sleep at the same time every day. What happens if you have a 1:00 class after you have become accustomed to napping at that hour? Professors generally frown on students who use class time to catch 40 winks!

Anyone who has ever loved a pet knows the magic of the person-animal relationship. Many readers probably included something about their pets like "playing with Winkie" or "petting Fluffy" on their Twenty Pleasures list. And indeed, pets give a great deal of pleasure. They look nice and do funny things. They force you into the present moment as you interact with them. Dogs and cats are the most popular pet friends, but people report pleasant relationships with all manner of creatures, from birds to reptiles.

    The health benefits of pets seem to go beyond simple daily pleasures (Beck & Katcher, 1983; Vines, 1993). Pets provide companionship and give us something to care for. Like altruism, caring for a pet takes our focus away from ourselves. Furry pets are a pleasure to touch; petting furry friends creates a sense of closeness between owner and pet and causes a relaxation response (Vormbrock & Grossberg, 1988). Pets give us unconditional acceptance. (Dogs give us love and cats may at least deign to bestow upon us an accepting glance now and then.) Although the circumstances of our lives change from day to day, our pets respond to us with constancy. Our partners may leave us, our health may decline, we may lose our jobs, but our pets don't care; we are still the same in their eyes. Pets love you even if you are old, disabled, or depressed (Beck & Katcher, 1983).

Living with stress is easier if you have "islands of peace" or take "pleasure breaks" throughout the day (Ferguson, 1986). just because all hell breaks loose in the morning, you need not ruin your afternoon. Many of the items on your "Twenty Pleasures" list probably take five minutes or less and can serve as a way to calm, focus, and regenerate you. In a sense, they provide a sort of mini-vacation that increases your stress resistance and clears your mind. Make the little things count: watching the squirrels in the yard, spending a few minutes petting your dog, watering the plants, enjoying a cup of tea, playing a favorite piece of music, or maybe just thinking about an upcoming vacation. Many of the little things we do without thinking during the day can be cultivated into islands of peace that soothe and refresh. Longer activities are useful, too. Many people find that a walk at the end of the work day helps them unwind. An enjoyable dinner hour can help heal the stress wounds of the day.

MINDFULNESS

Where you focus your attention during pleasurable moments has a lot to do with how much pleasure you experience. Mindfulness simply means being totally aware and in the present moment. Your awareness includes not only sensory information but your thoughts and emotions as well. You are aware as an observer of your thoughts and experiences, which creates a compassionate distance that can bring much learning. Mindfulness is used with meditation, but it can also be used with daily living, to live more fully in the moment, and appreciate life with all your senses (Gillespie & Bechtel, 1986). Try the Mindful Awareness exercise below to increase your sensory awareness. 

    Don't be surprised if this exercise is more difficult than it sounds. Our inner voices are accustomed to delivering commentary and chattering away every moment of the day. These voices are especially fond of drifting into the future, worrying about what is around the corner, or wandering back into the past to rehash problems and mistakes. This mind chatter often has important messages for us, so our goal here is not to squelch it but to simply acknowledge it without getting involved.

    Essential to any kind of relaxation technique is an attitude of "trying not to try." Once we start trying to achieve a goal and do a good job of relaxing, our ability to relax gets worse. Let it go. Stop judgment, and accept whatever happens.

EXPRESSIVE WRITING ENHANCES MINDFULNESS AND RELIEVES STRESS

Many students include writing letters or writing in their journals on their Twenty Pleasures lists. Expressive writing enhances mindfulness and can serve as a productive way to cope with stress (Francis & Pennebaker, 1992; Gelles, 1994; Spera, Buhrfeind, & Pennebaker, 1994). Part of the therapeutic effect of writing in a journal appears to stem from the fact that formulating an explanation of stressful events enhances coping (Burt, 1994). Both letter writing and keeping a journal may help with problem solving and coping with thoughts, feelings, and emotions (Seaward, 1994). Both help you get in touch with your feelings. Some research has shown that when people write or talk about stressors, their physical health improves (Pennebaker, 1993). Writing letters contributes to a sense of social support.

    One of the pioneers in the use of journal keeping for therapeutic purposes was Jungian psychologist Ira Progoff (Progoff, 1975). Progoff believed that structured journal writing could help individuals get in touch with "the inner resources" of their lives. He promoted journal writing as a means of finding meaning in life. In his book At a Joumal Workshop, which describes his recommendations for keeping a journal, he describes how this meaning is gradually revealed. "[W] hen a person is shown how to reconnect himself with the contents and the continuity of his life, the inner thread of movement by which his life has been unfolding reveals itself to him by itself Given the opportunity, a life crystallizes out of its own nature, revealing its meaning and its goal" (Progoff, 1975, p 10). Progoff teaches the journal-keeper to recognize that meaning "lies not in the events of his life in themselves ... but in his inner relationship to those events" (p. 11). Thus, effective journal entries are not merely a chronicle of external events but also include the writer's thoughts, feelings, associations, memories, and perceptions sparked by events.

    Some students are lucky to have had a teacher along the way who encouraged journal writing; they are already comfortable facing a blank page and recording their thoughts and feelings. Beginners who would like to give journal writing a try may begin with paper and pen. Keep in mind the following suggestions for making the most of your journal writing.

      1. Take a moment to relax and focus before you begin. Close your eyes and take a few deep breaths, practice the Mindful Awareness exercise, or listen to some soothing music. journal writing works best when you maintain an inward focus and are in touch with your thoughts and feelings.

      2. Keep your journal private. Write only for yourself. Censorship, even when imaginary, can be stifling. Honest self-disclosure is key to a journal's therapeutic effect. Write whatever you wish without fear of repercussions. Keep your journal in a private place safe from prying eyes.

      3. Suspend judgment and write whatever comes to mind. Don't worry about logic and the other constraints that you must impose on the writing you do for others. If you become famous and someday wish to publish your journal you can always go back and edit!

      4. Use your writing to practice creative problem solving, as described in Chapter 5. Avoid turning your journal into a dump for frustration and anger only (although there is plenty of room for all emotion). Journal writing can provide a wonderful stimulus for brainstorming and analysis. Use your writing to bring insight and resolution, not to fan the flames of anger with judgment and justification. Analyze sources of pleasure as well as stressors.

      5. Advanced journal keepers who feel that their writing is getting stale may wish to try various techniques to inspire creativity. Try your hand at poetry, write in phrases rather than sentences, draw pictures, or describe books and other writing you have found meaningful. Analyze your dreams, write stories, or create imaginary conversations between yourself and other people or mythical figures.

SUMMARY

1. Positive emotions are associated with positive health effects and increased resistance to the negative effects of stress.

2. It is important to distinguish between pleasurable experiences that increase stress resistance and those that more closely resemble maladaptive coping responses, activities that may initially feel good but bring you more stress in the future.

3. To become addicted is to devote or surrender yourself to something habitually or obsessively. Although people may initially become addicted to something because it feels good, after a short while true addictions do not provide pleasure so much as temporary relief.

4. Addiction is not simply a function of frequency or amount of use, but rather the reasons for and context of use and the effect of the substance or behavior on the user.

5. Experiencing pleasure requires exposing yourself to pleasant experiences and allowing yourself to be in the right frame of mind to experience pleasure. Appreciating the sensory pleasures from touch, sight, sound, smell, and taste can increase your stress resistance.

6. The experience of happiness comes partly from the perception that things are going pretty well for you on a day-to-day basis rather than from major life events. 

7. Optimists emphasize the positive in life and are happier than pessimists.

8. Laughter and finding humor in life increase your resistance to the negative effects of stress. Humor helps people combat stress-related depression, improves immune function, enhances self-esteem, stimulates creativity, and helps people get along.

9. Helping others can make you feel good.

10. Pleasurable recreational activities renew your energy and creativity. They can increase your self-esteem; provide a sense of social belonging, sensual enjoyment, and mental stimulation; enhance creativity; and provide opportunities for competition as well as relaxation.

11. Adequate restful sleep is essential for stress-resistance and good health.

12. Pets increase stress resistance by providing companionship and unconditional acceptance.

13. Simple relaxing experiences can provide "islands of peace" throughout the day.

14. Mindfulness means being totally aware and in the present moment. Mindful awareness enhances your enjoyment of healthy pleasures.

15. Expressive writing enhances mindfulness and relieves stress. Both keeping a journal and writing letters can improve problem-solving skills and help you cope with thoughts and feelings.

Argyle, M. The Psychology of Happiness. London: Methuen, 1987.

Beck, A, and A Katcher. Between Pets and People: The Importance of Animal Companionship. New York: Putnam, 1983.

Benson, H. Beyond the Relaxation Response. New York: Berkeley Books, 1984.

Black, DR, and SE Held. Eating disorders and athletes: Current issues and future research. DR Black (ed). Eating Disorders Among Athletes: Theory, Issues, and Research. Reston, VA: American Alliance for Health, Physical Education, Recreation and Dance, 1991.

Boosting winter's light. University of California Berkeley Wellness Letter, Jan 1992, p 7.

Brehm, BA. Essays on Wellness. New York: HarperCollins, 1993.

Bresnitz, S (ed). The Denial of Stress. New York: International Universities Press, 1983.

Burt, CDB. Prospective and retrospective account-making in diary entries: A model of anxiety reduction and avoidance. Anxiety, Stress, and Coping 6: 327-340, 1994.

Colvin, CR, J Block, and DC Funder. Overly positive self-evaluations and personality: Negative implications for mental health. Journal of Personality and Social Psychology 68: 1152-1162,1995.

Cousins, N. Anatomy of an illness (as perceived by the patient). A Monat and RS Lazarus (eds). Stress and Coping. New York: Columbia University Press, 1991, pp 48-61.

Cousins, N. Head First: The Biology of Hope. New York: EP Dutton, 1989.

Davis, M, ER Eshelman, and M McKay. The Relaxation and Stress Reduction Workbook. Oakland, CA: New Harbinger, 1988.

DeVries, HA, P Beckmann, H Huber, and L Dieckmeir. Electromyographic evaluation of the effects of sauna on the neuromuscular system. Journal of Sports Medicine 8: 61-69, 1968.

Dillon, K, B Minchoff, and K Baker. Positive emotional states and enhancement of the immune system. International Journal of Psychiatry and Medicine 15: 13-18, 1985.

Dobson, KS, and D Pusch. A test of the depressive realism hypothesis in clinically depressed subjects. Cognitive Therapy and Research 19: 179-194, 1995.

Dreschler, VM, WE Whitehead, ED Morrill-Corbin, and MR Cataldo. Physiological and subjective reactions to being touched. Psychaphysiology 22: 96-100, 1985.

Druckman, D, and R Bjork. In the Mind's Eye. Washington, DC: National Academics Press, 1991.

Edlin, G, and E Golanty. Health and Wellness: A Holistic Approach. Boston: Jones and Bartlett, 1992.

Ferguson, T. Dr. Pelletier's guide to do-it-yourself stress management. Medical Self-Care, Sept/Oct 1986, pp 46-47+.

Fishman, E, E Turkheimer, and DE DeGood. Touch relieves stress and pain. Journal of Behavioral Medicine 18: 69-79, 1995.

Francis, ME, andJW Permebaker. Putting stress into words: The impact of writing on physiological, absentee, and self-reported emotional well-being measures. American Journal of Health Promotion 6: 280-287, 1992.

Frecknall, P. Good humor: A qualitative study of the uses of humor in everyday life. Psychology 31:12- 21,1994.

Fry, WE The physiologic effects of humor, mirth, and laughter. Journal of the American Medical Association 267: 1857-1858, 1992.

Gelles, EB. Letter writing as a coping strategy: The case of Abigail Adams. The Psychohistory Review 22: 193-209, 1994.

Gibbons, B. The intimate sense of smell. National Geographic 170: 324-360, 1986.

Gibson, J, KK Wurst, and M Carmonito. Observations on contact stimulation provided young children in selected areas of Greece, USA, and USSR. International Journal of Psychology 19: 233-243, 1984.

Gillespie, PR, and L Bechtel. Less Stress in 30 Days. New York: New American Library, 1986.

Goleman, D. Vital Lies, Simple Truths: The Psychology of Self-Deception. New York: Simon & Schuster, 1985.

Goleman, D, and T Bennett-Goleman. Moving toward mindfulness. American Health, Mar 1987, pp 80-88.

Gurin,J. Doing better, feeling worse. American Health, July/August 1988, pp 105-110.

Hampes, WP. Relation between humor and generativity. Psychological Reports 73: 131-136, 1993.

Hanh, TN. Present Moment, Wonderful Moment; Mindfulness Verses for Daily Living. Berkeley, CA: Parallax Press, 1990.

Hatta, T, and M Nakamura. Can antistress music tapes reduce mental stress? Stress Medicine 7:181- 184,1991.

Hillson, TR, and RA Martin. What's so funny about that? The domains-interaction approach as a model of incongruity and resolution in humor. Motivation and Emotion 18: 1-29,1994.

House, JS, C Robbins, and HL Metzner. The association of social relationships and activities with mortality: Prospective evidence from the Tecumseh Community Health Study. American Journal of Epidemiology 116: 123-140, 1982.

Jacobson, FM, TA Wehr, DA Sack, SP James, and NE Rosenthal. Seasonal Affective Disorder: A review of the syndrome and its public health implications. American Journal of Public Health 77: 57-60, 1987.

Jezova, D, M Vigas, P Tatar, J Jurcovicova, and M Palat. Rise in plasma beta-endorphin and ACTH in response to hyperthermia in sauna. Hormone and Metabolic Research 17: 693-694,1985.

Joseph-Vanderpool,JR, and NE Rosenthal. Phototherapy for Seasonal Affective Disorder. Drug Therapy, Jan 1988, pp 57-64.

Jourard, SM. An exploratory study of body-accessibility. British Journal of Social and Clinical Psychology 5: 221-231, 1966.

Kuiper, NA, RA Martin, and KA Dance. Sense of humour and enhanced quality of life. Personality and Individual Differences 13: 1273-1283, 1992.

Kuiper, NA, and RA Martin. Humor and self-concept. Humor 6: 251-270, 1993.

Kuiper, NA, RA Martin, and LJ Olinger. Coping humour, stress, and cognitive appraisals. Canadian Journal of Behavioural Science 25: 81-96, 1993.

Lazarus, R. Positive denial: The case for not facing reality. Psychology Today, Nov 1979, pp 44-60.

Lexcen, FJ, and RA Hicks. Does cigarette smoking increase sleep problems? Perceptual and Motor Skills 77: 16-18, 1993.

Martin, RA, and JP Dobbin. Sense of humor, hassles, and immunoglobulin A: Evidence for a stress- moderating effect of humor. International Journal of Psychiatry in Medicine 18: 93-105,1988.

Martin, RA, and HM Lefcourt. Sense of humor as a moderator of the relation between stressors and moods. Journal of Personality and Social Psychology 45: 1313-1324, 1983.

Martin, RA, NA Kuiper, LJ Olinger, and KA Dance. Humor, coping with stress, self-concept, and psychological well-being. Humor 6: 89-104, 1993.

Morreall, J. Humor and work. Humor 4: 359-373, 1991.

Nezu, AM, CM Nezu, and SE Blissett. Sense of humor as a moderator of the relation between stressful events and psychological distress: A prospective analysis. Journal of Personality and Social Psychology 54: 520-525, 1988.

Ornish, D. Dr. Dean Ornish's Program for Reversing Heart Disease. New York: Ballantine Books, 1990.

Ornstein, R, and D Sobel. Healthy Pleasures. Reading, MA: Addison-Wesley, 1989a.

Ornstein, R, and D Sobel. Healthy pleasures. American Health, May 1989b, pp 53-58+.

Overholser, JC. Sense of humor when coping with life stress. Personality and Individual Differences 13: 799-804, 1992.

Peele, S, with A Brodsky. Love and Addiction. New York: Signet, 1975.

Pennebaker,JW. Putting stress into words: Health, linguistic, and therapeutic implications. Behavioral Research and Therapy 31: 539-548, 1993.

Prerost, FJ. Use of humor and guided imagery in therapy to alleviate stress. Journal of Mental Health Counseling 10: 16-22, 1988.

Progoff, 1. At a Journal Workshop. New York: Dialogue House Library, 1975.

Reite, M. Touch, attachment, and health: Is there a relationship? CC Brown (ed). The Many Facets of Touch. Skillman, NJ: Johnson &Johnson Baby Products, 1984.

Seaward, BL. Managing Stress. Boston: Jones & Bartlett, 1994.

Scherwitz, L, LE Graham, and DM Ornish. Self-involvement and the risk factors for coronary heart disease. Advances 2: 6-18, 1985.

Spera, SP, ED Buhrfeind, and JW Permebaker. Expressive writing and coping with job loss. Academy of Management Journal 37: 722-733, 1994.

Spintge, R, and R Droh (eds). Music and Medicine. New York: Springer-Verlag, 1983.

Standley,JM. Music research in medical/dental treatment: Meta-analysis and clinical applications. journal of Music Therapy 23: 56-122, 1986.

Steele, CM, and RAJosephs. Drinking your troubles away 11: An attention-allocation model of alcohol's effect on psychological stress. Journal of Abnormal Psychology 97: 196-205,1988.

Taylor, SE, and JD Brown. Illusion and well-being: A social psychological perspective on mental health. Psychological Bulletin 103: 193-210, 1988.

Tinsley, HEA, and BD Eldredge. Psychological benefits of leisure participation: A taxonomy of leisure activities based on their need-gratifying properties. Journal of Counseling Psychology 42: 123-132, 1995.

Ulrich, RS. Natural versus urban scenes: Some psychophysiological effects. Environment and Behavior 13: 523-556, 1981.

Van Dale, D, and WHM Saris. Repetitive weight loss and weight regain: Effects of weight reduction, resting metabolic rate, and lipolytic activity before and after exercise and/or diet treatment. Ameyican Journal of Clinical Nutrition 49: 409-416, 1989.

Vines, G. Secret power of pets. New Scientist 140: 30-34, 1993.

Vormbrock, JK, and JM Grossberg. Cardiovascular effects of human-pet dog interactions. Journal of Behavioral Medicine 11: 509-517, 1988.

Weiss, SJ, Psychophysiological. effects of caregiver touch on incidence of cardiac dysrhythmias. Heart & Lung 15: 495-506, 1986.

Weller, L, and 0 Avinir. Hassles, uplifts, and quality of sleep. Perceptual and Motor Skills 76: 571- 576,1993.

White, S, and A Winzelbert. Laughter and stress. Humor 5: 343-355, 1992.