Womanstress The Type E Woman: Doing everything for everyone

We have long known that stress is harmful to the health of human beings. I quote from a recent Harvard Mental Health Newsletter:”…prolonged [stress] can accelerate the aging of body cells, with obvious implications for health and longevity.” We also know that chronic stress can suppress the immune system, increasing vulnerability to illness.

Type A Personality is recognized as the stress-inducing personality of harddriving, antacid-chewing businessmen. The original research indicated that this personality type leads to heart disease. Later research indicated that it wasn’t so much the hard-driving, multi-tasking part of this personality that caused the stress that led to the heart problems, it was the latent anger that was always there and never fully expressed.

Harriet Braiker wrote that women are socialized away from that kind of anger and any expression of it. She wrote the book The Type E Woman: Everything for Everyone, describing the special stress that women find themselves under when they insist on”having it all.” They work outside the home and insist on keeping the same kind of home a stay-at-home mom used to keep, doing the cooking from scratch, all of the cleaning, entertaining family and friends, gardening, attending the children’s functions, etc., etc., etc.

In the 1980s, the stress this multiplerole- fulfilling wonder endured was dubbed the Superwoman Syndrome. In February, an article in Newsweek by Judith Warner let us know the phenomenon was not confined to the lsquo;80s. In her article Mommy Madness, she described her life as a career woman with a baby”… when I was a Good Mommy, I tried to do everything right. I breast-fed and co-slept, and responded to each and every cry with anxious alacrity. I awoke with my daughter at 6:30 a.m. and, eschewing TV, curled up on the couch with a stack of books that I could recite in my sleep. I did this, in fact, many times, jerking myself back awake as the clock rounded 6:45 and the words of Curious George started to merge with my dreams.”

She wrote that she was proud that she got in three hours of quality, intense parenting before and after work. Of course, something had to give, and her day job took the hit. She said she would often fall asleep at her desk and had difficulty remaining coherent in her writing. Finally she realized she couldn’t keep the pace up, and she realized she was not alone. She began talking to many mothers in similar situations and wrote about them in her book Perfect Madness.

It isn’t only in the care of small children that we women do this to ourselves. One of my women patients who was managing someone’s political campaign came in for her weekly session. She plopped down in the reclining chair, leaned back and said,”I feel like I’m nursing a litter of six!” [The readers who know me and have heard this quote before will recognize that it has been severely edited. However, this version expresses the sentiment. It’s where we women frequently are. Doing our best to nurture and support everyone and to take care of everything.]

We do Type E behavior to the extreme. I am amazed (and appalled) at the agenda some of my women patients recite to me. They are on top of everything: they know who in the family has what appointment, when and where the activities are, what is needed for the family larder, what the children’s school projects are, who the teachers are, the medical needs of each family member and so forth. The fathers may help with some of the activities, but it is rare that they take on the responsibility and have the knowhow to orchestrate the goings-on.

We respond to stress physically, mentally and emotionally. Some use maladaptive responses in a vain attempt to cope with the impact of the stress. Examples include irritability, negative thinking, demanding too much of others, blaming others, physical illness, depression, anxiety disorders, smoking, drinking alcohol to excess, overworking, overeating (especially indulging in high-calorie”soul” food such as fried foods and sweets), risk-taking behavior and so forth.

Kaplan amp; Saddock, in Volume II of their comprehensive textbook of psychiatry/ fifth edition, cite Raymond Flannery in listing the four coping strategies of people who manage stress well:

They have personal control. They believe that they are in control of their environment, and they have specific skills to be effective in specific situations.
They possess task involvement. An absorbing task that is meaningful is selected, and the person is willing and able to sacrifice short-term fun for longterm pleasure.
They make good dietary choices, exercise regularly and find daily time for relaxation.
They utilize social supports. They have personal relationships that provide companionship, information, or empathic listening (p. 1237).
When I mention these to the women I work with who are overwhelmed with all they are doing, they just laugh. Building in time for relaxation and recreation and taking time to fix well-balanced, healthy meals seems impossible to them. I recommend that overwhelmed women get help from a friend or a therapist in examining all activities with a very critical eye, then setting priorities. This means completely eliminating some of those activities — quitting a committee, for example, or reducing frequency of cleaning chores (e.g., vacuum less frequently).

Another option is to delegate tasks to others (hire help for the cleaning) and/or negotiate with others to take over some of the duties (even small children can share in the homemaking responsibilities, and they benefit from that). Once this redistribution occurs, it will be possible to create the time for daily exercise and relaxation and to begin to develop relationships that are mutually supportive. I also recommend increasing in assertiveness, especially in the art of saying”no.” Gradually, a sense of being in charge of your own life emerges.

Interestingly, in the first paragraph I quoted from a Harvard Mental Health Newsletter article which stated”…prolonged [stress] can accelerate the aging of body cells, with obvious implications for health and longevity.” Yet in spite of the chronic stress that women endure throughout their lives, they live longer than men. My hypothesis has been that women’s ability to talk about their feelings has helped them to live longer.

Professor Thomas Perls has done research leading to a book, Living to 100. An excerpt was published in healthandage.com. It shows me that my hypothesis is too simplistic. While boys and girls start life in the womb with the boys ahead 115 to 100, at birth the advantage is down to 104 to 100, and by age 25, women outnumber men. Boys’ deaths outnumber girls’ deaths at all stages of life. Between 15 and 24 the male propensity for taking risks, dubbed”testosterone toxicity” by some, takes a higher proportion of male lives.

Nevertheless, for both women and men, adopting Raymond Flannery’s coping strategies for dealing with stress makes sense.

Rosemary J.Stauber, Ph.D., is a clinical psychologist in San Antonio and founding director of the Bexar County Women’s Center.

Author: Rosemary J. Stauber

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