What Is Stress? – Dr. Ali’s Stress Course

Majid Ali, M.D.

Stress, first and foremost, is an oxygen problem. The negative health effects of what is commonly called stress are caused by disruptions of oxygen homeostasis, whether starting with deep disappointments of life or with disruption of bowel and liver ecosystems. I present my guidelines for preventing negative bodily effects of stress in a companion article entitled “The Seven for Stress.” Chronic stress is biologic addiction, a subject I discuss in a companion article entitled

My patients with severe, chronic stress have given me four insights:

First, the common notion of stress being the fight-or-flight response launched by the adrenal gland is so superficial as to be clinically irrelevant.

Second, the prevailing idea of mind-over-body healing is a cruel joke, and, in essence, pours salt on their wounds

Third, spiritual and ethical equilibrium, not psychology, is the answer to the problems of life’s disappointments.

Fourth, the best long-term results are obtained when works with ethics and spirituality is integrated with issues of toxic foods and toxic thoughts.


Long hours of listening to highly stressed patients has taught me that the general practice of searching for relief of the agony of the present through working out the problems of the past’ is little more than a cortical trap—the mind endlessly recycles past pain or precycles feared, future misery. Psychology, by and large, keeps us incarcerated in obsolete models of disease and sufferings. Spirituality sets us free.

When Life Begins, It Begins to End

In essence, life consists of injury and healing, only to be followed by yet more injury. The injury-healing-injury continuum of life is the true nature of stress. Looking through the prism of oxygen homeostasis, life begins with oxygen and is terminated by events controlled by oxygen signaling. The central importance of this statement—The Oxygen Model of Stress, simply stated—is that every threat to an individual’s oxygen-governed bodily systems must be recognized and addressed for best long-term clinical results. All my tutorials on mental health matters are devoted to various theoretical and practical (clinical) aspects of this model.

Many “stress experts” hold that it is an organism’s fight-or-flight response to a threat to his survival, and that it is followed by an adaptation response by which the organism adjusts to its altered condition. Furthermore, the stress response is considered to be mediated by the adrenal gland. In my view, these notions are mere artifacts created by animal mutilation experimenters and are so inadequate as to be clinically irrelevant.

The adrenal gland, the putative seat of the fight-or-flight response, is not a hermit organ. It senses and responds to its internal and external environments like every other body organ. Similarly, adrenal hormones influence—and, in turn, are influenced by—all other hormones and messenger molecules in the body. The idea that stress can exist as a discrete adrenal malfunction is neither tenable on theoretical grounds nor consistent with my clinical observations.

Life is an ever-changing kaleidoscope of energetic-molecular events. In biology, when one thing changes in one way, everything changes in some way. We can neither understand nor effectively address issues of stress in clinical medicine by applying narrow-focused, reductionistic and artificial notions of the stress response. What is required for this purpose is a deep, holistic understanding of the energetic-molecular relationships in human biology.

This is an exciting time. Nearly each month I see scientific studies that validate at least one of the ancient healing arts or philosophies. Science catches up with empirical medicine. As far as stress in clinical medicine is concerned, this means an end to the era in which animals are burned, drugged, drowned, electrocuted, or decapitated by experimenters so they can develop “scientific” theories of what stress is and isn’t. Science is not only self-correcting, it is also liberating.

Children on Metabolic Roller Coasters

I see little children living troubled lives on metabolic roller coasters. They suffer wide mood swings—behaving as loving little angels one moment, then kicking their mothers’ shins the next. Punishment is frequent at home, and they face daily indignities at school. They are tormented by sugar roller coasters that are recognized neither by their parents nor by school psychologists. Their food sensitivities remain undiagnosed, and their mold allergies remain unrecognized and untreated. School psychologists are quick to label them with learning disabilities, hyperactivity and attention deficit disorder—and their pediatricians are quick to offer Ritalin prescriptions. How does the suffering of these children coincide with the prevailing notions of fight-or-flight stress response?

Antidepressants for Human Canaries

I see young women and men who not too long ago were athletic teenagers. Their common colds were aggressively treated with massive doses of antibiotics that battered their bowel ecosystems. Their sinus headaches were treated with painkillers, and the symptoms of caffeine addiction and anxiety were suppressed with Ativan and Valium. Their undue tiredness was chalked up to shirkers’ syndrome, Yuppie syndrome, all-in-the-head and other insolent diagnostic labels. For indigestion and bloating they were prescribed antacids and ulcer drugs. Their physicians never bothered to look for nutritional and environmental causes of their suffering. Finally, when their symptoms became disabling, they were labeled with chronic fatigue syndrome and were awarded prescriptions for antidepressants. How does their anguish fit into the fight-or-flight stress response?

Hollow Tin Dolls

I hear gynecologists praise synthetic estrogens and progesterones, speaking as if those hormones were little marbles rattling noisily in hollow tin dolls. I never hear a word about how female hormones are affected by sugar-insulin-adrenaline roller coasters. Nor do I hear gynecologists acknowledge roller coasters. Nor do I hear gynecologists acknowledge interactions between female hormones and other hormones produced in the thyroid, pancreas, pituitary and pineal glands. They are always silent about the roles of yet other hormones produced in the bowel, lung or heart. They excitedly talk about their patients as if the female bodies were hollow vessels—as if estrogens and progesterones turn, twist and bump into each other in empty cells.

But my female patients are not hollow tin dolls. They are living, breathing beings. The tissues under their skin teem with a thousand ever-changing molecular kaleidoscopes. When they suffer wide mood swings, the jitters and headaches associated with PMS, it’s not just estrogens that trick their bodies. When they are shocked with hot flushes one minute and cold waves the next, mere estrogenic pranks are not at fault. During the night, when they awaken drenched in sweat, it can’t simply be chalked up to a frenzy of sex hormones.

How do sugar-insulin-adrenaline roller coasters feed—and how are they fed by—estrogen roller coasters? What does a confused thyroid gland have to do with hot flushes? What does a bowel in revolt against yeast overgrowth have to do with a patient’s nocturnal misery? Allergic triggers light up oxidative fires in their blood streams. What do such fires in blood have to do with their brain fog and muscle symptoms? How do chemical triggers fan those oxidative fires? Gynecologists do not ever concern themselves with such questions—at least not the ones I know. How does all that fit in with the fight-or-flight stress response?

Sleeping with Machines

Recently, The New England Journal of Medicine discovered that young people are sleepy during the day if they do not sleep soundly at night. (How desperately do we need such insight?) The Journal further reported that in a sleep study, one-fourth of the young male volunteers revealed evidence of sleep-disordered breathing (328:1230; 1993). Then the study concluded that those young men would benefit from sleeping with a sleeping machine stuck up their noses. Amazingly, the Journal does not bother to ask how the young sufferers’ sleep patterns became deranged in the first place.

When we sleep, we are not dead. That is self-evident. What happened to those young men during the day to interfere with their sleep at night? After a sleepless night, people tend to drink large amounts of coffee to stay awake at work. The caffeine keeps their neurotransmitters revved all day and prevents deep restful sleep during the night. The next day begins just as the previous one. How does sleep-disordered breathing coincide with the fight-or-flight stress response?

The Unstoppable Has No Motivation Now

Some time ago, a 29-year-old man consulted me for chronic fatigue, migraine headaches, recurrent sinusitis, irritability and heart palpitations. He had single-handedly built a small and highly successful commodity brokerage firm.

“I was athletic. I suffered sinusitis and migraine headache attacks, but I did okay with them. I was a very high-energy person. I always performed four or five tasks at a time. I was unstoppable, Dr. Ali.” He spoke with pride, then added ruefully, “But now I’m drained all the time. I drink a lot of coffee, but simple tasks still seem impossible. I have no motivation left in me.”

How does chronic fatigue and lack of motivation coincide with a fight-or-flight stress response?

When Hospitals Aren’t Healing Places

A patient kindly sent me a video of a Nova program. It showed sad stories of nurses who contracted a mysterious malady. They developed incapacitating weakness, confusion, headaches, skin rashes, joint pains and breathing difficulties. Many of them cried as they described how they were finally disabled by the malady. After prolonged consultations with world-famous medical specialists and extensive batteries of diagnostic laboratory tests and scans, the illness remained undiagnosed.

What went wrong? The nurses made a grave error: They breathed the air in the operating rooms of Harvard’s Brigham and Women’s Hospital in Boston. The mystery was finally solved by some medical sleuths who identified the elusive offender molecule: glutaraldehyde, which is used to sterilize surgical instruments in operating rooms. The scene then changed and the video showed some high-powered environmental specialists talking about multi-million-dollar renovations to eliminate the problem. I have doubts about their success. The diminished antioxidant and immune defenses of the hospital staff are as much a part of the problem as is the virulence of the offending molecule. All the millions spent on structurally renovating the hospital building will not restore the damaged antioxidant, enzyme and immune defenses of the hospital staff.

I know that to be true because I have seen too many people crippled by such stealthy tormentors. How does Hans Selye’s fight-or-flight stress response coincide with the unmitigated misery of those nurses?

Nitric Oxide: a Guardian Angel or Killer?

I hear internists talk about the role of nitric oxide in high blood pressure and heart disease. That’s their scientific rationale for prescribing their favorite drugs. Somehow the nitric oxide story is accepted as scientific validity for the long-term use of drugs that block one or more cellular receptors, enzymes, membrane channels and messenger molecules. Invariably, such blockade medicines create long-term chemical toxicities.

What my internist-friends do not see is that nitric oxide is a molecular Dr. Jekyll and Mr. Hyde. Nitric oxide protects the healthy heart in some ways and attacks a damaged one in other ways. How does an internist know when nitric oxide will be a guardian angel and when it will be a remorseless destroyer? Internists rarely ask such questions.

Iron is also a molecular Dr. Jekyll and Mr. Hyde. A part of hemoglobin, it is essential for transporting oxygen to the tissues. Yet excess free iron is also toxic, causing oxidant injury

to the liver, adrenal glands and heart. Adrenaline also plays dual roles—essential for survival in life-threatening emergencies as well as a dangerous oxidizing molecule. How do such molecular vagaries coincide with the adrenal fight-or-flight stress response?

How well does a psychologist understand stress if he is unfamiliar with the havoc wrought on his client by sugar-insulin-adrenaline roller coasters? How effectively can a psychiatrist treat depression caused by chemical sensitivity if he vehemently denies that chemical sensitivity can cause depression? How competent can a cardiologist be in helping a young woman with mitral valve prolapse caused by stress of rampant yeast overgrowth? (Indeed, most cardiologists will probably scoff at the very idea.) How successful will a gastroenterologist be in soothing a rebellious bowel if he insists that food sensitivities cannot cause colitis? Surgeons enthusiastically perform sympathectomy—an operation that cuts sympathetic nerves out—for patients with arterial spasms. What is the true value of such an operation when arteries are tightened by unrelenting stress of oxidatively damaged blood cell membranes? Or when the blood proteins are literally cooked by simmering oxidative coals kept lighted by viral activation syndromes?

Psychoneuroimmunology experts are creative folks. They are busy propounding complex theories of how the psyche punishes the nervous and immune systems. In the past decades, we spent hundreds of millions of dollars on research establishing the psyche, brain and immune system as discrete segments of the human condition. How ironic that we are now wasting larger amounts of public funds trying to link them back again! Long live the gurus of our fight-or-flight stress industry!

Every day in my clinical practice, I see the folly of fight-or-flight thinking through the true-to-life suffering of my patients. And every day I wonder why our fight-or-flight experts cannot see something so obvious: Life is an injury-healing-injury continuum—and that is the true nature of stress.

Spontaneity of Injury, Spontaneity of Healing

The beginning of life as well as its ending are spontaneous phenomena. This is not a romanticist’s view, nor is there anything metaphysical about it. These two aspects of life are observable phenomena and constitute the two sides of life’s essential energetic-molecular equation.

Oxidation is the loss of electrons. It is a process by which high-energy molecules are turned into low-energy molecules. Common examples of oxidation are the wilting of fresh flowers, spoiling of fruit, decomposition of meat and rusting of iron. Spontaneity of oxidation in nature determines that the process of electron loss—breakdown of high-energy molecules—requires no external triggers. It is triggered solely by internal cues. It has nothing to do with demand for change. (I devote a large part of the companion volume RDA: Rats, Drugs and Assumption to this subject.)

Healing is also a spontaneous phenomenon—it occurs in response to inner cues. Some folks are enchanted by notions of spontaneous healing. I am at a loss as to the source of their excitement. For nearly three decades as a hospital pathologist I studied the healing phenomenon in injured tissues with a microscope. I do not know of any unspontaneous healing. We pathologists have limited ideas about some observable aspects of the healing response. However, the truth is that we have no inkling about the internal energetic-molecular signals that molecules, cells and tissues heed during the course of healing. (I devote a large part of the companion volumes The Cortical Monkey and Healing and The Dog, Directed Pulses and Energy Healing to this side of life’s equation.)

Spontaneity of Living

In this volume I include some personal observations and reflections on the third element of what I call the trio of spontaneities: the spontaneity of living.

Living was once spontaneous. For one thing, no one knew how to be unspontaneous. For another, everyone entered this world spontaneously—without any prior planning. People did what needed to be done—when it needed to be done. The ancients recognized that death was also a spontaneous process.So where did things go wrong?

“Doubt grows with knowledge,” the German philosopher Johann Wolfgang von Goethe wrote. The novelist Virginia Woolf lamented that literature is strewn with the wreckage of men who have minded beyond reason the opinions of others. At least, we have some understanding of what happened along the way—how we were reduced to living unspontaneously—and miserably.

Now here, you see, it takes all the running you can do to keep in the same place. If you want to get somewhere else, you must run at least as fast as that.

                                             Charles Lutwidge Dodgson

How could the English writer and mathematician, Dogdson (alias Lewis Carroll) see the future so clearly? How did he know that all we would do would be to keep running to keep in the same place? Did he know that would happen within a mere hundred years after his death? A perceptive rogue, that Mr. Dodgson!

Andy Warhol, our modern-day prophet, thought people forgot what emotions were supposed to be during the 1960s. “And I don’t think they’ve ever remembered,” he concluded. Mr. Warhol, it seems to me, mistook the 1960s for the beginning of the human era. The phenomenon of forgetting what human emotions are is much older.

How does one live spontaneously? Once lost, how does one recapture one’s innocence? When we know something, we cannot unknow it, my friend, Choua, often says. How do we say no to Goethe’s knowledge that creates doubt? How do we unknow? How do we detect—and sidestep—the wreckage of other men’s ideas that Virginia Woolf warned us against?

Socrates pronounced that an unexamined life wasn’t worth living. Now all we ever do is examine our lives. Could Socrates have imagined that? Then we re-examine and “re-re-examine” until the process of examining life totally excludes all possibility of living.

The past lives in the present, psychiatrists and psychologists teach us. Then they go on to promulgate their theories about solving the problems of the present through analysis of past suffering. We learn our lessons well. Under their able tutelage, we learn to recycle past misery—and when that doesn’t suffice, we precycle feared, future misery.

My patients teach me something different. They have found that the endless recycling of past misery only causes endless misery—it does not free them from the misery of the moment. They have learned that they cannot clever-think their way out of all their problems. Neither stress nor healing are intellectual phenomena.

One clinical observation in my work has influenced my thinking more than anything else: Tissues do not lie. The thinking mind is the only part of the human condition that deceives. Where do the distortions in spontaneous healing come from? I asked. The mind—that was the obvious answer. If the mind was the only part of the human condition that lies, why should I heed it in matters of healing? This simplistic notion was reassuring.

There Aren’t Enough Tibetan Caves

The early African who walked out of the Rift Valley and looked up understood something about his linkage with the larger presence that surrounded him at all times. He understood something about injury-healing-injury cycles and about the real source of healing. The early African bequeathed those insights to the ancient Indians. The notion of the reverence for all life and the ancient Jain concept of ahimsa, on which it is based, is rooted deep in human history.

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