Actions or situations that place physical or psychological demands on people over time will cause stress. Both physical and mental stress are required for normal and healthy growth and moderate amounts in the workplace can increase productivity. But if not managed properly, stress can eventually lead to burnout as well as to physical problems. In the workplace, one of the chief causes of stress is the feeling of inequity or unjust treatment. Effective stress management addresses employees both physically and mentally. Easy and economical treatment at the workplace includes provisions for music and physical exercise with suggestions for rest, diet, and meditation. Management can also reassign tasks and provide more flexible work schedules. Workplace stress is expensive because it can cause absenteeism, increased sick leave and medical costs, and high turnover rates.
Definitions.
Burnout. "Physical or emotional exhaustion, especially as a result of long-term stress or dissipation." (Microsoft Bookshelf, 1995).
Equity. The concept that employees should be treated fairly.
Psychological trauma. "The state of severe fright that we experience when we are confronted with a sudden, unexpected, potentially life-threatening even over which we have no control, and to which we are unable to respond effectively no matter how hard we try" (Flannery, 1995, p. 7).
Stress. Stress can be any action or situation that places special physical or psychological demands upon a person.
Stressor. "An agent, a condition, or another stimulus that causes stress to an organism." (Microsoft Bookshelf, 1995).
Stress Management. The methodology used to alleviate stress.
Why Stress Management is Important.
Hollin (1995) states that "It has been known since the beginning of the century that the experience of stress can have quite serious effects on health" (p. 119). However, because we all respond to stress differently, "stress-related disease is not easily predictable from objective measures of environmental stressors" (p. 120).
Restak (1988) says that "the more life stress a person experiences, the greater the likelihood of developing a physical disorder like heart disease, infection, allergies, even cancer" (p. 152). According to Restak (1994) one of the ways the ego sometimes responds to stress is dissociation, where whole blocks of memory are repressed and forgotten. According to Flannery (1995), very stressful experiences can lead to psychological trauma, which, in turn, can lead to post traumatic stress disorder.
Jung (1978) considered stress to be essential for the birth and growth of the ego. He writes, "It [the ego] seems to arise in the first place from the collision between the somatic factor and the environment, and, once established as a subject, it goes on developing from further collisions with the outer world and the inner" (p. 5). Thus some degree of stress is essential for a healthy growing ego. A problem arises when the ego is presented with more stress than it can adequately handle. This is also true for stress in the workplace, as noted by Waxler (1993) who points out that moderate stress often fosters productivity.
Equity.
Henri Fayol, a pioneer of management science, contributed several specific principles of management. Among the most important was equity--the concept that employees should be treated fairly. This concept was developed into equity theory by J. Stacy Adams. According to Schoderlok (1988),
Equity theory assumes that employees compare their situations to the situations of their coworkers to determine whether or not they are being treated fairly. Specifically, people compare their ratio of outcomes to inputs in a given situation with that of another person or group. Important outcomes include pay, fringe benefits, status symbols, compliments, promotions, and job assignments. Important inputs include effort, education, and experience. (p. 276)
The equity theory model is as follows:

The =? sign indicates an equality only if equity exists, but equity is usually questionable (thus the question mark). According to this model, a person perceives inequity when his or her output to input (O/I) ratio is less than another's output to input (O/I) ratio. Thus equity and inequity are perceived to exist or to not exist. It is the employee's perception of fairness that is important, rather than actual fairness, which would be impossible to define in any case. For employees to perceive equity, they must feel like they are being treated equally with their co-workers.
In the case of high workload among professional employees, for employees to perceive inequity they must either feel like they work harder/longer than their co-workers, or that their work is not as appreciated.
Closely associated with equity theory is expectancy theory. According to Baird (1990),
Expectancy theory holds that motivation derives from what people expect to happen as a result of their efforts. Equity theory states that motivation derives from the equity people perceive to exist between their circumstances and comparable situations . . . If a worker assumes that no amount of increased effort will be enough to complete a certain assigned task, then his motivation to begin working on it will be either very low or nonexistent. p 391-192.
Baird (1990) states that, according to expectancy theory, motivation is equal to the product of expectancy and valence. That is,
M = E x V where,
M = motivation
E = expectancy, perception, or prediction of the probability that a specific
action will have a specific result
V = the positive or negative value attached to the expected outcome.
Although Baird uses the term valence, many writers prefer value. Because motivation is a product of expectancy and value, if either is absent or zero, then motivation will also be absent. In the same sense, the higher the expectancy or value, the higher the level of motivation.
Many studies have been conducted to determine the relationship between pay and equity. According to Kinard (1988),
Equity theory predicts that people who feel overpaid on an incentive plan will increase their input by producing better but fewer items to reduce inequity. Those who feel underpaid will raise their output by producing more lower-quality items. Under an hourly wage plan, people who feel overpaid will reduce their inequity by increasing their input, but those who feel underpaid will reduce both their input and the quality and quantity of their output. (p. 281)
Virtually all studies have concluded that an employee who perceives inequity will try to compensate, in some way or another, to reach equity. Adams (1990) writes that perceived inequity causes tension,
When the normative expectations of the person making social comparisons are violated, when he finds that his outcomes and inputs are not in balance in relation to those of others, feelings of inequity result . . . First, the presence of inequity in [a] person creates tension in him. The tension is proportional to the magnitude of inequity present. Second, the tension created in [a] person will motivate him to eliminate or reduce it. The strength of the motivation is proportional to the tension created. (p. 113-115)
The tension that is caused by an employee's perception of inequity is a form of stress. Van Fleet (1988) says,
We contribute our education, experience, expertise, and time and effort, and in return we get pay, security, recognition, and so forth. Given the social nature of human beings, it should come as no surprise that we compare our contributions and rewards to those of others. As a result of this comparison, we may feel equity or inequity. (p. 395-396)
Most psychologists would agree that feelings of inequity are a natural human trait. Van Fleet's (1988) model for equity/inequity is shown in the figure above.
According to this model, employees will consciously or unconsciously make a comparison between themselves and their co-workers. This comparison will result in perceptions of equity or inequity, depending on the situation. Employees with feelings of equity will attempt to maintain the situation. Employees with feelings of inequity will attempt to change something. Failure to make satisfactory changes leads to frustration and stress.
Stress.
There are several definitions of stress available. According to Douglas (1980),
Stress is defined as any action or situation that places special physical or psychological demands upon a person . . . Too little stress can be harmful . . . Researchers have discovered that there are basically two types of people: racehorses and turtles. Racehorses thrive on high stress levels. They are happy with vigorous, fast-paced lifestyles. Turtles are happier in peaceful, quiet environments. Either type, if placed in the opposite environment, will function poorly . . . Moderate stress may bring about improvements in performance. Severe stress can lead to greater errors and even to accidents. (p. 244-246)
It is important to note, that too little stress is as important as too much. According to Van Fleet (1988),
Stress occurs when a person is subjected to unusual situations, to demands that are difficult to handle, or to extreme expectations or pressures. (p. 630)
Van Fleet and many others agree that working long hours is among those things that can induce stress. In addition to causing problems at work, stress also can result in physical problems. According to Laird, Laird, & Fruehling (1983),
Work-related stress is becoming a subject of increasing concern to public and private health officials. They have found that stress can cause many health problems, such as heart disease, hypertension (high blood pressure), alcoholism, drug abuse, ulcers, and anxiety. Some consider stress to be the number one health problem today . . . To achieve success at work, all workers must give things up at times. For the executive driven to reach the top, the cost can often be less time with the family. This can produce feelings of guilt and stress . . . The nature of the work organization can contribute to the sense of stress workers feel. (p. 199-202)
Gordon (1986) presents the standard stress-reaction model as follows:
1. A threat exists to a person's need fulfillment or motives.
2. The person becomes aware of the threat.
3. The threat is appraised.
a. No response necessary: Coping process.
b. Response is needed: Secondary Appraisal.
(1) What is the source of the threat?
(2) Do I have some alternatives?
(a) Yes: Coping process.
(b) No: Do I have enough power to attack?
1 Fight/active response.
2 Flight/withdraw.
This model says that a person will either learn to cope with stress, or will try to fight it or flee from it. According to Coon (1986), "Stress triggers bodily effects, upsetting thoughts, and ineffective behavior" (p. 246). Coon (1986) suggests exercise and meditation to eliminate stress by relaxing. He recommends music, taking nature walks, and hobbies. He also proposes a method of "progressive relaxation." This method teaches stress victims to tighten each of their muscles and then voluntarily relax them. It was designed by Edmund Jacobson in 1970. According to the adherents of this method, by tensing and relaxing each area of the body, it is possible, with practice, to greatly reduce tension. Coon (1986) also states that stress over long periods can lead to burnout. Dyer (1990) lists the following three states for stress:
1. Alarm Stage
2. Resistance Stage
3. Exhaustion Stage
His consequences of stress include: subjective effects, behavioral effects, cognitive effects, physiological effects, and organizational effects (poor productivity, high turnover rate, job dissatisfaction). His list of stressors in the work environment include:
(1) Physical: lighting, noise, temperature, vibration, air pollution.
(2) Individual: role conflict, work overload ("too much work for the time allowed").
(3) Group: lack of group cohesion, inadequate support, conflict.
(4) Organization: climate, structure ("Inappropriate divisions"), leadership influence (style and impact of leader).
According to Lefton (1985),
Stress at work usually occurs because a workload is too light and understimulating or because ... it is too heavy and burdensome . . . Coping strategies should begin at the biological level. (p. 505-507)
The psychological insight of Zimbardo (1985) needs to be considered as well. Zimbardo (1985) states that, "Stress is the pattern of specific and nonspecific responses an organism makes to stimulus events that disturb its equilibrium and tax or exceed its ability to cope," and he adds, "A stressor is a stimulus event that places a demand on an organism for some kind of adoptive response" (p. 496). Thus he throws a psychological light on the subject, and opens up stress to an organism's response to a disturbing stimulus. He points out that stress effects competence and intelligence, and that it can actually lower a person's IQ. His stress model, slightly revised for burnout due to workload, is in the figure below.
Virtually all authorities agree that the result of too much stress (too much workload) over a long period of time is burnout.
Burnout.
Whenever a person encounters a stressor, their physical body will automatically respond with what Potter (1980) calls the general adaptation syndrome, or GAS. As shown in the figure below, there are three stages to the GAS: alarm, resistance or adaptation, and exhaustion.
During the alarm stage, the body prepares to "fight or flight." It is accompanied by various physiological changes including muscle tension and increased heart and breathing rates. Physical activation is very high. The first stage is too intense for the body to sustain for any length of time, so the body enters the second stage. In the second stage the person resists the stressor while seeking to find a viable means to control or eliminate it. Physical activation remains high but begins to drop. In this stage, we look for an "if-then formula" which is a trial and error mode of searching for a solution. If a solution is found, the body enters the third phase of exhaustion. In burnout, however, no solution is found and a high physical activation continues until frustration turns to futility whereupon the third stage is entered. Maintaining a high activation is costly to health and also leads to emotional problems such as the loss of motivation and depression.
Work overload means having more work to do than we can do in a normal 40-hour work week. When employees are overloaded, they become harried. They become worried about meeting deadlines and schedules. Work overload stimulates the GAS response. Such employees are candidates for burnout, although burnout is not always the result. Whether or not an employee burns out depends largely on the person. As long as the work overload is viewed as a challenge, burnout is unlikely. However, over long periods of time, impossible tasks are likely to result in burnout of the employee.
Given the wrong conditions, anyone can burn out; everyone is susceptible. Any time an employee is faced with responsibility with little or no influence over events, burnout is possible. Such conditions can be found in virtually any bureaucratic organization. Zaleznik, Kets de Vries, & Howard (1977) conclude that bureaucratic organizations lead to stress and burnout, and that survival requires effective defense skills. Dumaine (1988) quotes a new Princeton research study that found one-third of 3,000 managers surveyed reported increasing work pressure, up from only 22% in 1980.

Activation level is the degree of activity in a person's autonomic system. This includes the heart and respiratory rates as well as muscle tension. The figure above illustrates the relationship between activation level and performance. When an employee's activation level is low, boredom sets in and performance suffers. Performance also drops when the activation level is high. A moderate activation level is optimal for peak performance. Peak performance is required for high quality work output. The figure above shows that if an employee's performance deteriorates because of under or over activation, burnout is likely. This figure can be used as a general warning signal for burnout. If an employee's activation level is frequently in the high or low critical zone, burnout is likely to be the result.
Jackson and Schuler (1983) state the current situation as follows:
Increasing numbers of once qualified, energetic, and productive employees are becoming victims of burnout. And unless organizations act now, it is likely that these numbers will continue to increase. (p. 195)
According to Gordon (1986), the first sign of burnout is often a feeling of being emotionally exhausted from one's work. Three typical burnout effects are:
1. emotional exhaustion
2. depersonalization (a callous attitude toward others and the organization)
3. feeling of low personal accomplishment
Five things that contribute to burnout are:
a. Unrealistically high expectations.
b. Constraints placed on worker by policies and procedures.
c. Inadequate resources to perform job.
d. Uncooperative or rebellious co-workers.
e. Lack of feedback about one's successes.
Table 1 below, from Jackson and Schuler (1983) summarizes the major causes, reactions, and consequences:

Pines and Aronson (1988) are careful to distinguish between stress and burnout:
Stress, in and of itself, does not cause burnout. People are often able to flourish in stressful, demanding careers if they feel valuable and appreciated and that their work has significance. They burn out when their work has no meaning and stress continuously outweighs support and rewards. (p. 11)
They present a model with two major pathways. Their model, shown in the figure below, is a simplified version. The model suggests that two possibilities are likely to occur in a high-stress working environment. Burnout weakens motivation, while the sense of significance and success strengthens it.

According to Pines and Aronson (1988), one of the main causes of burnout is overwork brought on by the bureaucratic demand for both quantity and quality in work performance. They say,
Why does overload cause burnout? Because overload puts people in situations in which failure is built-in. If they comply with the bureaucratic demand for quantity (see a new patient every 20 minutes), they fail the demand for quality service. If they spend the time needed to do the work the way it should be done (which in some cases may mean seeing a patient for 40 minutes), they are sure to fail the demand for quantity. This failure is particularly devastating for people who care deeply about their work, and for whom success at work is a prerequisite for finding meaning in life. (p. 104)
Stress Management.
The methodology to alleviate stress (i.e., reduce stress to acceptable or even helpful levels) is called stress management. Douglas & Douglas (1980) give four methods to alleviate stress as follows:
1. Develop a different attitude
2. Get a checkup
3. Get adequate rest
4. Watch your diet
Dyer, Daines, & Giauque (1990) suggests six ways to reduce/manage stress within the organization:
1. Task redesign
2. Worker autonomy
3. Flexible work schedules
4. Career development
5. Design of work setting
6. Team building
They also suggests four ways for individuals to reduce stress:
1. Physical fitness
2. Relaxation training
3. Time management
4. Therapy (for serious problems)
For those with time-related stress, Kotnour (1993) suggests constructing a time management schedule. Garfield (1986) states that many managers conduct self-inspections to aid in their personal stress management. These managers monitor themselves for eight explicit symptoms of burnout as follows:
1. General physical pains
2. Insomnia
3. Hating your work place
4. Hiding behind rules and formalities
5. Resisting change
6. Reduced productivity and performance
7. Getting along with peers or supervisors
8. Increased personal and family stress
Stress management courses are becoming popular. Sullivan (1987) states that one in five of the Fortune 500 companies now offers at least one of several stress-management programs. These programs range from alcoholism programs (the most common) to exercises and meditation classes. He offers New York Telephone Co., as a typical example.
New York Telephone requires periodic health examinations and offers meditation training for those with stress-related problems. These programs are said to have cut the "corporate hypertension rate" from 18%, which is about average, to half that amount. New York Telephone has stated that it is currently saving about $130,000 a year in reduced absenteeism.
One of the most-suggested techniques of stress management is meditation. Sullivan (1987) states that meditation, in general, and Transcendental Meditation (TM), in particular, have also proven successful in relaxing stress-wracked bodies. He points out that TM was introduced to the United States in the late 1950s by Marharishi Mahesh Yogi, a Hindu monk from India. It is a heightened state of consciousness that combines extreme mental alertness and deep physical rest. Test results have indicated that TM practitioners feel rested and more creative. According to Sullivan (1987), and others (Goleman, 1996; Walsh, 1996), scientific studies have shown that TM can produce physiological changes, especially in heartbeat and blood pressure, which are said to fall dramatically.
Another important technique of stress management is biofeedback. This technique is said to allow managers to will away such stress symptoms as insomnia, muscle tension, and even high blood pressure. The term was coined by Barbara B. Brown, a California psychologist. Sullivan (1987) states that clinical biofeedback techniques are now widely used to treat tension headaches, migraine headaches, disorders of the digestive system, both high and low blood pressure, and Reynald's disease. Biofeedback machines include the electromyograph (EMG, for measuring muscle tension), the electroencephalograph (EEG, for measuring brain waves), the galvanic skin response (GSR, which measures sweat), and the thermistor (keeps track of body temperature).
Meditation and biofeedback techniques do not require a religious belief. Charlesworth & Nathan (1984) write, "Many people are exploring meditation as a form of stress management. Meditation is often associated with Eastern religions, but it can be practiced with or without a religious emphasis" (p. 74). They describe a technique called progressive muscle relaxation, which allows a person to relax each muscle group of their body. The primary technique used is visualization. They suggest picturing yourself on a boat floating along a river. They also suggest playing your favorite music as a technique for stress management.
Zimbardo (1985) also notes the importance of relaxation and biofeedback. He states that the "relaxation response" is a condition in which muscle tension, cortical activity, heart rate, and blood pressure all decrease and even the breathing slows. He gives four conditions that must be met for this:
1. A quiet environment
2. Closed eyes
3. A comfortable position
4. A repetitive mental device
Veninga & Spradley (1981) acknowledge that stress and burnout are complicated processes, and no easy solution is going to work for everyone. They write,
But we cannot reduce job burnout to a simple, uniform condition with a single personal treatment strategy. Consider these facts:
Unrelieved stress comes in packages of every conceivable shape and size.
The risk factors can combine in a variety of ways to bring on job burnout.
Each individual has a unique job-burnout threshold. Some people can take much larger doses of unrelieved stress than others before they burn out.
The symptoms of burnout will vary from one person to the next.
Each individual will learn to perceive stress in a unique way.
The severity of job burnout changes as it goes through each of the stages.
Each individual will learn a different combination of stress safety valves to cope with job burnout and will need a unique combination to recover. (pp. 124-125)
According to the Upper Chesapeake Health System (1992), the best indicators of too much stress are physical symptoms such as an increase in the frequency of backaches, colds, stomachaches, or headaches. They suggest regular exercises to "de-stress" such as neck rolls, shoulder shrugs, and reaching upward with both arms. They also suggest a good night's sleep. They conclude that stress is like our temperature. If it's too high or too low, we can't survive. The right balance is needed to help us meet life's daily challenges.
Although stress and burnout are complicated, there is something that we can do. Perhaps the easiest technique is given by Hellriegel, Slocum & Woodman (1989) who state that the ability to identify stressors at the work place, and to pinpoint their effects, is the first step toward copying with stress. In other words, the very recognition of possible burnout is the first step in any sound stress management program.
Summary
Equity theory addresses a worker's perception of fairness, including the sense that work is being assigned equally among all workers. Feelings of inequity lead to discontent that often causes stress. High stress coupled with a sense of job meaninglessness can lead to burnout. Although burnout is difficult to measure, it is usually accompanied by well-defined symptoms such as a high turnover rate which can be measured.
Stress in the workplace needs to be managed. Stress management programs
often include music, physical exercises, and various relaxation techniques. They can
also include meditation and biofeedback techniques.
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