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Jackson M, editor. Stress in Post-War Britain, 1945–85. New York (NY): Routledge; 2015.
I was working, well I was working three, four nights a week, weekends I was, just couldn't keep up with it … I was violently sick going home in the car, for no apparent reason … and then on another occasion the same sort of thing happened, just out of the blue for no reason at all, and er anyway I went in for a check-up and they reckoned it was nerves or something was affecting my stomach. It was actually overwork and stress and stuff like that.1
Stress is ubiquitous in twenty-first century Britain, responsible for millions of lost working days and the focus of a whole industry designed to help us avoid it.2 It was not always thus. This chapter explores how people such as James Lyon, quoted above talking about his work in the oil industry in the 1970s, experienced ‘stress and stuff like that’ in the period between the Second World War and the 1980s, and in particular stress related to their work. By tracing peoples' shifting attitudes towards stressful experiences, examining how they explained those experiences and analyzing the reactions of others to them, this chapter will highlight three key areas of discussion. Firstly, it examines the complex interplay of factors such as status, identity and gender in shaping attempts to make sense of stress. Secondly, it explores continuities and discontinuities in understandings of mental health problems among both sufferers and colleagues across a forty year period. Finally, it reflects on what appears to be a surprising lack of popular awareness of stress in the 1970s despite the work of Hans Selye, Richard Lazarus and others to popularize the concept from the 1950s, and an increasingly prominent discourse around stress within the popular print media.3
Adults experiencing stress in the post-war period were of a generation that grew up without the benefit of the National Health Service (NHS), at a time when, for many, levels of income made the purchase of medical help rare or even unattainable. Amongst this generation, attitudes towards health, whether mental or physical, were largely driven by values arising from a necessary pragmatism. The poor, working-class women surveyed by Marjory Spring-Rice (1887–1970) in 1939 demonstrated clearly a ‘grim and tacit acceptance’ of low standards of health, such that, despite a huge variety of ailments ranging from constant headaches to anaemia and gynaecological problems, many of them felt justified in answering ‘yes’ to the question of whether they generally felt fit and well.4 Their norm of good health was in many cases a state of chronic ill-health, according to Innes Pearce and George Scott Williamson, the founders of the pioneering Peckham Health Centre in South East London.5 The absence of serious debilitating illness was good health for such women and their families and, although working men had more access to professional medicine via panel doctors, men's health was often little better.6
Against such a background, working-and middle-class attitudes toward health and sickness tended towards the stoic and the pragmatic. As one man born in the inter-war years told Mass Observation (MO) in 1997, ‘the state of our health wasn't something we ever talked about as far as I remember’.7 Such a view was supported by popular contemporary household medical manuals, which warned against the ‘unrelieved study of sickness’ which did not reflect ‘the attitude of all healthy people’.8 Dwelling on ill-health was regarded as undesirable and probably indicative of an unhealthy psyche. Despite the economic imperative behind attempts to downplay ill-health, there was a strong sense that an individual's attitude towards their health made a difference and that good health was a matter of individual responsibility.9 Another correspondent told MO in 1939 that he regarded ‘illness as an acknowledgement of weakness in myself and feel ashamed of being ill’.10 Medical self-help books of the period emphasized the importance of an appropriate ‘philosophy of life’ with regard to nervous ailments, one suggesting that if ‘the physician has examined the patient and found no organic disease, the solution obviously rests with the patient, who then becomes his own best doctor’; the patient's achievement of ‘a well-organized mind’ was necessary to ‘dissolve the obscure and complex tensions’.11 People in working-class communities in particular expected (and were expected) to cope with their situation, even if that meant putting on a façade that concealed unpleasant realities.12
In the decades following the creation of the NHS in 1948, therefore, the population generally continued to hold attitudes towards health that were deeply coloured by their experiences before the provision of medical treatment that was free for everyone at the point of service. Indeed, there were strong continuities with the pre-war period in terms of day-to-day experiences of access to, and use of, NHS services that meant that for some there was still a strong culture of self-reliance.13 Within this context, people's attitudes towards stress at the midcentury were consistent with an approach to health that privileged a practical, but sometimes dismissive and even brusque, view of sufferers. Such attitudes tended to be exacerbated in the case of psychological and mental suffering which, presented without the evident symptoms of a broken or diseased limb or organ, were difficult for others to understand, and were still stigmatized by fears of madness.
Seeking evidence of the kinds of experiences that we would now classify as ‘stress’ means accepting a wide range of contemporary synonyms for stress, such as ‘nerves’, ‘nervous’ or ‘nervous breakdown’, ‘pressure’, ‘tension’ and ‘strain’. These terms comprised the popular language of mental distress for much of the twentieth century and, as Watkins has argued in her work on the United States, were often used interchangeably, resulting in an understanding of stress that was shaped as much by the vernacular as the professional discourse.14 While we might now acknowledge differences between tension, anxiety, worry and pressure and the results of internal or external stressors, these examples reflect common usage at the time, which rarely distinguished between them.15 Analysis of post-war British self-help literature, written mostly by medical professionals, reveals a deliberate use of popular terminology reflecting both the language of doctor/patient conversations and a desire to communicate effectively with a lay readership.16 Hence titles such as You and Your Nerves: A Simple Account of the Nature, Causes and Treatment of Nervous Illness, How to Live with Your Nerves and Like it and Peace from Nervous Suffering.17 The wide range of stressors identified by such authors, including the speed of modern life, brain work, heredity and over-indulgence in food and drink and sex, highlights the potential for the lexicon of stress to capture a multiplicity of experiences.
Adopting a similar flexibility of vocabulary has been key in uncovering first-hand accounts of stress. In particular the accounts presented here are based on two key types of source, both of which reflect lived experience and use of contemporary vernacular to describe it. The first is the Mass Observation Archive which was established in the 1930s as an anthropological experiment, allowing volunteers to write about their lives and the lives of those they observed. The second is oral history interviews from the British Library Sound Archive, which were recorded as life histories for themed collections, but which also happen to include accounts of stress. Both sources provide peoples' personal narratives of their experiences and, although they are thus subject to the vagaries of memory and nostalgia, they offer unique accounts of a subject that can otherwise be difficult to access. Before examining the detail of these experiences, it is relevant to reflect on contemporary attitudes to work and health and how these informed the understanding and acknowledgement of stress at work. Closer reading of several individual accounts of work and stress then reveals the ways in which the causes of stress, and the experiences of the stressed, were perceived.
The sources examined here can be used to illuminate how people experienced work and stress in twentieth-century Britain. Contemporary ideas about the effects of both work and unemployment on mental health referred, without exception, to male experiences of work outside the home. In the immediate post-war decades any notion that work could create mental ill-health was tied specifically to the masculine experience of work. It was only much later, with the emergence of second-phase feminism, that women's domestic activities began to be conceptualized similarly as ‘work’ and the psychological effects of those activities were revealed.18
We have relatively limited knowledge of people's attitudes to work, especially in the early twentieth century, and yet work was fundamental to a sense of identity and status, as well as often being the basis for social life.19 That work, or the lack of work, could cause psychoneurotic illness and anxiety states was recognized in the 1930s with unemployment the subject of considerable new research.20 Stage theories of unemployment clearly identified anxiety and mental distress as a key step in the experience, whilst Jahoda identified five latent consequences of employment which were critical to understanding the effects of unemployment, but also had relevance to debates about the function of work to the human condition.21 Those elements focused on the importance of work for imposing a time structure on the day, shared experiences and contacts outside the family unit, links to goals and purposes beyond the individual's own aims, personal status and identity, and enforced activity. Researchers argued that these factors made work psychologically supportive and emphasized how critical to existence the function of work could be, well beyond its obvious economic necessity. This made the experience of work as damaging to health, and particularly psychological health, all the more challenging for those who suffered work-related stress.
There is a further point to make regarding the function of work and in particular its economic drivers. The importance of work as a means of survival changed across the twentieth century. A simple continuum might show the experience of work for the majority of working-class and lower middle-class people ranging from basic economic survival, at one end, to personal fulfilment and self-actualization at the other, with the balance shifting from the former to the latter across the century, particularly following the creation of the welfare state in Britain mid-century. We might contrast the stoic pragmatism of workers in the first half of the century with the increasingly individualist requirements of workers in the latter half. ‘Work was life, without it you did not survive’, according to one retired railway worker recalling his parents in the inter-war period, ‘It came first and last, always waiting to be done’. By contrast, by the late twentieth century, it was ‘essential for people to have a means of expressing their own individuality and feeling their own worth’.22 Work had many different meanings for people, whether offering status, involving duty, providing social interaction or purpose and structure and, for many, it was a key part of their identity. Within that framework it was therefore difficult to make sense of stress in a work context without undermining and threatening those other meanings.
Improvements in people's circumstances due to the safety net of the welfare state, wider educational opportunities and greater material comfort might suggest that people began to expect more from their work as economic survival diminished as the sole purpose. However, greater expectations of work, as a means of satisfaction and self-expression, opened up the experience of work to greater scrutiny and criticism, which may well have contributed to the issue of stress and work coming to the fore by the 1980s as higher expectations bred greater disappointment. Despite physical improvements in working conditions and the fact that by the 1980s most people worked in far superior working environments to their grandparents or even their parents, people were experiencing work as psychologically more problematic than their forebears did. Changes to the ways in which people conceptualized their work and how this was reflected in society made it far easier to interpret an experience of mental distress due to work in a medicalized or psychologized way, so that, by the 1980s, although work for the majority might not be physically dangerous, it now had a greater potential to make them mentally ill.
Such suffering was not unique to the late twentieth century. Throughout the century there were people for whom the experience of work was not only a negative one, but also one which damaged their psychological well-being. As an unemployed man in his thirties told MO in 1983, ‘My mother didn't work but my father did. He was an accountant. It affected our family life because the strain of my father's job was one of the factors that made him an alcoholic’.23 The ‘strain’ of such work permeated the whole family. This not only reveals the nature of work-related stress, but also reinforces gendered interpretations that regarded only occupation outside the home as ‘work’ and therefore causative of ‘strain’. The public visibility of such conditions, particularly in the mid-twentieth century, was limited and likely to be managed privately, influenced by the robustly dismissive official stance towards civilian psychological problems during the Second World War and the paucity of resources afterwards.24 For many, it was often easier to identify their ill-health as physical and, particularly in the decades around the mid-twentieth century, of gastric origin as another MO observer commented, talking about her uncle in the 1930s:
I have the impression that it was the responsibilities of his position which caused him to have a stomach ailment. I never knew what that was, but there were always tins of Glaxo in the house, and he ate very little of anything else.25
Similarly, another woman growing up during the Second World War explained that her father's work was regularly interrupted by time in bed due to an ulcer: ‘He never spoke about this or theorized as to what was the cause of the illness though the doctor talked a lot about ‘bottling up emotion’ and being ‘over-conscientious’.26 Underlying cultural trends at the time favoured gastro-intestinal explanations of medically unexplained symptoms, as evidenced by their preponderance among servicemen during the Second World War.27 Indeed ulcers and stress continued to be associated with each other throughout the century, even beyond the discovery of a bacterial aetiology for ulcers in the 1980s. For patients, families, colleagues and friends, physical symptoms offered a more acceptable explanation for illness than anything psychological. Mental health issues carried a stigma that prevented people from acknowledging such experiences or identifying them directly with work or an employer.
How did people experience psychological or emotional problems relating to their work or to the work of colleagues and peers? The first source offering insight comes from Miss Richmond who worked as a welfare officer for the furniture and furnishings manufacturing company, Hunter and Sons and its subsidiaries, between 1943 and 1956. Her main responsibility was to follow up cases of employees absent from work; in 1944 alone, she carried out 570 visits, both to workers in hospital and to others at home across a large part of London and its suburbs. Miss Richmond recorded many of her visits to employees' homes and the conversations that she had with them about the causes of their absence. In 1949, Miss Richmond recounted the case of Mr S from south-east London, who was absent from work due to a ‘breakdown’:
I had a long talk with Mr S He looks very thin and said he had lost weight because he cannot eat. He has attacks of vomiting so his doctor sent him to hospital where he was examined and X-rayed. Nothing wrong was found, the verdict being that the internal trouble is due to nervous worry. I said how sorry I was to know he was ill and asked what was the matter and then listened to his story.
Mr S came to Hunters a few months ago, and was put in charge of work started by another surveyor who had left. Three orders were in a confused state and were incurring financial loss to Hunters. This worried Mr S considerably and as the financial losses increased with the progress of the work so did his worry, until it overwhelmed him and he had a nervous breakdown.28
She went on to explain that Mr S's employers had told him not to worry but, despite these reassurances, Mr S ‘knew it was foolish but the worry had taken too great a hold of him and he was now “suffering from his nerves”’.29
The case of Mr S highlights several points. Firstly, there was an initial search for a physical cause for his distress partly because it manifested itself in physical ways, such as vomiting, but also because the physical symptoms were perhaps easier to diagnose and treat and preferable to the potential stigma of psychological illness. It is also interesting that the early link between Mr S's suffering and his work shifted to Mr S himself and the suggestion that it was his own fault that he had let worry take hold of him. This tells us something pertinent about perceived causations of stress and the tendency to emphasize the individual's own role in their suffering. There was a clear preference for ‘blaming’ the individual worker rather than the circumstances of his or her work or any other potential causative or contributory factors.30 The idea that some people were more susceptible to psychological distress due to inherent weakness rather than external circumstance was by no means new, having been critical to deliberations about shell shock and debates about whether soldiers qualified for war pensions in the inter-war period.31 Arguably, similar economic considerations were also at play within a work context, as it was undoubtedly preferable to see the fault as inherent in the worker, rather than the environment or structure of the workplace.
That was not necessarily the view, however, of the worker and their family, as the wife of another employee, Mr L, who had been hospitalized with ‘nervous trouble’ in 1954 following a similar episode two years previously, told Miss Richmond:
she did not think it had been right because he was working under the man who had his old job and he had had an inferiority complex all the time: he is now ‘just a bundle of nerves, there is nothing wrong with him physically; it is something to do with his work that has got him like this.32
Aside from the interesting example of a popularized psychoanalytic concept of ‘inferiority complex’, Mrs L's view suggests that she clearly saw the job, or the social circumstances of the job, as the cause of her husband's problem. Miss Richmond's response was to tell Mrs L that ‘in the interests of both Mr L and the firm it was not possible for him to continue at his present work and they had nothing else to offer him’. Reflecting on this in her report she wrote: ‘It is a sad case and I am sorry for the Ls but, after all, Shaws is not a Psychiatric Rehabilitation Centre for the employment of “nervous trouble” cases’.33 Clearly there was a tension between Miss Richmond's human sympathy and her organizational responsibilities, but also between her perceptions of the cause of the employee's problem and the family's view.
This tension is also illustrated in Miss Richmond's report following visits to two employees absent due to ‘nerves’. The vast majority of her reports show a person with considerable compassion for the workers she visited in her welfare officer role, for in many ways she functioned as a social worker, home help and confidante to Hunter's employees. However, following her visit to Mr S and another employee, absent from work for similar reasons, she submitted the following in her report:
What a week and what an object lesson!!!!!! To listen to these two grown men telling me how their ‘nerves’ have gone to pieces because the ‘worry of their work has got on top of them’ and so on and on and on and on.
Many illnesses, pneumonia etc cannot be helped and nobody falls and breaks a leg on purpose, but I have seen so much of this ‘nervous breakdown’ line and it is a thing that the individual can prevent – if taken in time. The red light is showing when you find yourself thinking about, and talking about, nothing else than your particular worry. Mental diversion is needed: people, amusements, hobbies, anything except sitting brooding and chain smoking … To hear these ‘nerve’ people talk one would think it was a question of life or death confronting them. They are quite out of focus with reality. It is no use talking to cases like these two I have seen this week. They are too far gone.34
Miss Richmond evidently interpreted the problem as being due to the individual allowing themselves to become ill by brooding and letting worry take hold. Such a notion was not uncommon. Indeed one popular psychology book of the time suggested that ‘There must be a certain pleasure in worrying or people would not indulge in it so much’, while a household medical guide, drawing on Selye's ideas, sought to clarify the difference between normal worry and the usefulness of adrenalin to boost functioning, and abnormal worry which could cause physical disease.35 Miss Richmond's response to this perceived weakness in ‘two grown men’ is evidently gendered, her concept of masculinity clearly not encompassing these mens' experiences of psychological suffering. She demonstrated no understanding of the experiences that these two employees were going through. This could be read as a result of her having lived and worked in London for at least part of the Second World War, when ‘a question of life or death’ was perhaps experienced more literally. However, her attitude also reflected the popular view at the time that individual weakness was at the heart of many work-related health problems.
Such views mirrored pre-war organizational assumptions that persisted throughout the century. During the war and in the immediate post-war period, good employees were a valuable resource and the organizational paternalism, demonstrated by the provision of welfare officers such as Miss Richmond, reflected self-interest as much as altruism or legislative compliance. Indeed concerns about the effects on industry of sickness absence due to ‘nervous breakdown’ were the driver behind a Medical Research Council investigation in the early 1930s, specifically focusing on concerns about employees with ‘imperfect mental adaptation to conditions of work’.36 The study covered over a thousand workers and was structured to enable researchers to identify ‘recognised clinical types’, with limited concern for the industrial context in which they worked.37 This was in contrast to growing contemporary interest in psychosocial medicine, pioneered by James Halliday (1897–1983), whose work as a Regional Medical Officer adjudicating national insurance claims, in Glasgow in the 1930s, convinced him of the link between social and environmental context and psychological and physical health.38
However it was concerns about wartime production that largely underpinned the development of institutions such as Roffey Park Rehabilitation Centre. Created in 1943 under the auspices of the National Council for the Rehabilitation of Industrial Workers (NCRIW), as a result of funding from a wide variety of industrial concerns, the Centre was designed to treat employees suffering from industrial neurosis or ‘ill health arising from industrial fatigue, depression, nervous debility and other occupational or psychological disorders’.39 These criteria covered a wide range of conditions and the Centre's own advisory panel recognized privately that industrial neurosis was ‘a loose expression which has no medical significance … beyond the fact that the patient has been engaged in some form of work’.40 However, the precise terminology was of secondary importance, as the primary purpose of the Centre was simply to restore workers to sufficient health to return to work. The Centre claimed that 82 per cent of its cases returned to ‘normal fulltime employment, usually in their original capacity’.41 Miss Richmond's experience and opinions, then, might be seen as fairly common. Although there was certainly awareness of the issue of stress at work, it was seen from an institutional perspective as an issue of absence management and a problem to be overcome either by treating sick workers or avoiding the employment of those prone to stress. Within a year of opening, Roffey Park was also offering training courses to personnel and welfare officers to help them identify and deal with cases of industrial neurosis, although the focus appears to have leaned heavily towards categorizing the potentially susceptible, rather than addressing organizational shortcomings.
Positioning stress as something resulting from personal weakness was consistent with broader attitudes towards health among the immediate post-war general population. Accepting the situation, perhaps because of this personal element, appeared to be the norm. An example can be seen in the experience of Don Thompson, working for Pearl Assurance in High Holborn in the 1950s, who reported in an interview in 2006:
Oh that was terrible, you wouldn't imagine how traumatic, that was one of my worst, working experiences I've ever had … I went into the Fire and Compact section which dealt with traders things and there I don't know whether it was to do with the immediate managers or the manager but the pressure was intense, we seemed to have so much work and everybody was on top of you all the time and do you know in that time I got terrible eczema and I was off for about 5 weeks.42
Don suggested a link between ill-health and the behaviour of managers in the organization, but the focus of his interpretation reverted to his own symptoms that, in his case, were manifested in physical terms. His juxtaposition of terminology offers an interesting insight into the psychologized interpretation of such experiences. Whilst he mentioned ‘pressure’ as a cause of his ill-health, he described the whole experience as ‘traumatic’, a distinctly late-twentieth-century interpretation and indicative of the changes in popular perception of the effects of work on mental well-being. Also feeling the pressure of work in the mid-1950s was Jeff Mills, an undergraduate at Birmingham University and one of the new breed of working-class entrants to Higher Education. Jeff explained his experience in an interview in 1998:
I knew when I got to Birmingham that I was up against some cracking students in ability and I knew I would have to work me socks off and I did but unfortunately I found it got to me and I suspect it was the first sign in me life of nervous tension. Erm it did get to me and I can remember in my last year I had to go to the doctors once or twice, I didn't realise it at the time but I wasn't sleeping particularly well, but it was all, I realise now, it was all evidence of stress.43
Jeff went on to surmise that much of his stress was related to ‘expectations and hopes of meself’ and that because his parents did not understand ‘the system’ he felt ‘I was on my own you see’.44 His interpretation of his symptoms when seeking medical help privileged the physical in that he sought help for sleeping difficulties and, as he acknowledged, it was only retrospectively that he tied his symptoms together with the overall experience of the stress of studying.
It is interesting to note that, despite Jeff's experiences as an undergraduate, by the 1970s, when the stress concept was largely accepted among the medical profession at least, there was still rather more continuity than change in his experiences of mental distress relating to work. In his interview Jeff explained that he had worked as a Deputy Head in a school in the Bolton area in the early 1970s. At that time he was recently promoted and ambitious. However, he started to experience unfamiliar symptoms:
I suddenly discovered I wouldn't go into shops. I didn't want to go anywhere where there were people and yet I would go into school where there were lots of people … we'd go to Bolton on a Saturday and I would sit in the car rather than go in a shop. Um, don't ask me what it was I just had feelings of terror, me mind would go blank, it was almost a fear I suppose. And this was really getting to me and I thought, ‘I don't understand this’, and at the time I still thought it was physical.45
Although Jeff experienced his symptoms as both sudden and psychological, he attributed them to a physical cause. On another occasion his experience was completely different:
I was riding towards the traffic lights coming home one night in a place called Moses Gate and I got pains in my arms and I thought was in my chest. And I stopped the car and the lights were on red and I just opened the passenger door to ask a woman to get me an ambulance to get me some help I didn't feel well at all.46
Rather than ask for help, Jeff shut the door and broke the speed limit hurrying home, but reported: ‘I thought about it and then over the next three or four weeks I started to have all sorts of symptoms … the usual ones: couldn't sleep, bad eyes, bad head’. He kept going to work and believed that he was still doing his job adequately, but retrospectively came to see:
what I didn't realise was I was working too hard I realise it now, but it's taken a long time. I was working so hard it was unbelievable … I was almost running the school and I was obviously trying to impress and I wanted to be a Head and I was doing all sorts of courses and I did virtually everything, the school discipline, timetable, day to day cover and all this sort of business.47
The persistence of his symptoms and his growing distress eventually led Jeff to get a second opinion, after his own general practitioner (GP) prescribed medication that made his headaches worse. The second doctor diagnosed him with what he referred to as ‘complete nervous exhaustion and stress, nothing but’, prescribed tablets and told him to take a fortnight off work. Jeff summed up his experience, commenting : ‘I don't think the people at work ever knew. I don't think I ever showed it at work I just coped, but out of work things were just falling apart and I got through it thank God’.48
Jeff's inclination to explain his symptoms in physical terms reflected the ways in which his body reacted to distress, but it also highlights the privileging of physical, over psychological, explanations at this point in time. It did not occur to Jeff that his work might be affecting his health, in spite of the fact that by the early 1970s there was a growing popular discourse of stress and work, evident for example in the Daily Mirror's feature on the ‘Seven Ages of Stress’ in October 1972 and in a case reported in The Guardian two years later, in which stress was used as a defence in a murder trial, entitled ‘Man “Broken by Stress”’.49 However, as Jeff's experience suggests, popular awareness had not yet reached the point where people applied the concept to themselves. Nor was stress organizationally institutionalized. Although Jeff did not think that his stress showed at work, it seems likely that there could have been some indication, but his employers apparently were either not aware or, in keeping with ideas about personal responsibility, left it to Jeff as his problem rather than theirs. The suggestion that he was ‘working too hard’ was something that he found difficult to assimilate. There was a reluctance to ascribe his problem to his work.
Elsewhere in his life story, Jeff demonstrated an underlying sense of the world as a competitive place and this perhaps underscored his reluctance to admit that he could not keep up. It is suggestive also perhaps of the extent to which his work contributed to his self-worth and masculine identity. Jeff was a member of the post-war generation that Roper has identified as living with the ‘necessity to deny stress’ and disavow anything ‘soft’.50 Jeff's account also illuminates the ways in which his experience with his GP suggests that institutional and professional discourses on stress were being framed within the context of pharmaceutical treatments, which in his case made him feel worse, not better. Certainly the early 1970s was a period in which the prescribing of minor tranquilizers for the treatment of ‘mild to moderate emotional symptoms in primary care’ was reaching astonishing proportions.51 This reflected the fact that pharmaceutical companies were now marketing the conditions their drugs purported to treat, as much as the drugs themselves.52
Jeff's reluctance or inability to relate his illness to his work tells us something interesting about attitudes to work. His fears were not about economic survival and he was not afraid of losing his job in terms of survival: he was university-educated and was in a relatively stable profession. However, his work was clearly important to him, to the extent that its meaning could blind him to the effects it was having on him. The meaning of work for Jeff, although never expressed concretely, centred on his own sense of purpose, identity and status coupled with a sense of duty and loyalty.
A different example of the experience of stress comes from Peter Allen, born in 1950 in Yorkshire. Like Jeff Mills, Peter was taking on his first managerial role in the early 1970s.
When I was about 23/24 I was first put in charge of a lot of people and I actually had a nervous breakdown which in those days was quite a traumatic experience ‘cos nobody really understood mental health very much.53
Peter's use of language is pertinent: despite the growing popular discourse of ‘stress’, he referred to his ‘nervous breakdown’. It is also notable that he categorized this as ‘traumatic’, as Don Thompson did, using a term which was perhaps more common in the popular lexicon of the late 1990s when he was talking, than in the 1970s when he actually had the experience. However, the other key point is the lack of apparent understanding from other people – ‘nobody really understood mental health very much’.54
Peter was put in charge of sixty local authority gardeners and tried to base his management on that of his boss, whose style was to order people about and ‘shout at them’. This did not work for Peter, as he explained:
I went off, I just collapsed one day. I just keeled over one day and I went home and I was taken home and the doctor said ‘oh you've had a nervous breakdown’. I didn't know what it was, there wasn't anything broken or twisted or anything, your lungs weren't bad it was a nervous breakdown.55
Peter's experiences were physical, but he was given a psychological diagnosis, which he himself did not understand. His framework for understanding illness was based around symptoms that were visible and this left him poorly equipped to make sense of what was happening to him. Peter's GP prescribed Valium which, when he did return to work, had a detrimental effect on him as it interfered with his short term memory: ‘I had to write everything down because any time you thought of anything it was wiped off the blackboard … so that took a lot of getting over that’.56 Although Peter did not explicitly say so, he hinted that treatment was potentially as bad, if not worse, than the condition that it was designed to alleviate, something which some psychologists were beginning to argue at the time.57
Like many others, Peter found that other people did not really understand what had happened to him:
In those days well people just used to say ‘he's had a nervous breakdown’ and for the first two hours they were very sympathetic, but after that it was, you know, it's not like a broken leg if you can't see it, if it's not manifest then people, if it's in your head, can't quite understand it.58
Peter's return to work may have been made more difficult by the contemporary lack of understanding. Ten years later, a widespread familiarity with the concept of ‘stress’ might have made that return easier. However, speaking in 1998, Peter made another comment regarding the reactions of others:
I hear these days people say he's gone off with his, what do we call it now we call it pressure, stress that's it stress, gone off with stress, and people say well I don't know why he's stressed, he don't do anything. You know that sort of thing. But people don't realise that stress is brought on by a lot of different things.59
His comments suggest that even by the end of the century and two decades in which stress had become legally recognized within the framework of Health and Safety legislation, with the Health and Safety Executive suggesting in the 1990s that 5 million working days were being lost to stress each year, people generally were still suspicious of it.60 Such suspicions confirm Peter's earlier comments about the visibility of symptoms, since those which could not be seen were not only hard to understand, but also more open to question. Peter implied that people had only a limited perception of stress as something resulting simply from too much work, rather than as something arising from a more complex interplay of work, environment and person. Implicit also perhaps is the hint that claiming to be stressed might be a way of avoiding work or it might imply an unacceptable lack of stoicism. Also relevant in Peter's account is his attribution of his experience to ‘your learning curve and part of growing up’.61 He seems to be suggesting that his suffering was either a necessary formative stage in his career development, or simply due to his youth. He does not relate his experience to his actual work or the fact that he was suddenly given a set of challenging responsibilities for which he was ill-prepared. Echoing Miss Richmond, Peter attributed his illness to his own weakness. This provides an interesting contrast with twenty-first century notions that regard sufferers from stress as victims of their circumstances, where the tendency is to ‘inflate the problem of emotional vulnerability and to minimise the ability of the person to cope with distressful episodes’.62
Peter and Jeff's accounts provide descriptions of specific work-related episodes of mental distress, in the context of often wide-ranging interviews which were recorded in the late 1990s at a time when the language of stress had largely been absorbed into popular culture and usage. Thus they offer insight in two ways. Firstly, they offer recall of a time when the interviewees did not have a framework in which to understand their experiences. This is highlighted by the ways in which they described what happened and also in their accounts of other people's responses. Secondly, their stories demonstrate the ways in which, by the late 1990s, when most of these interviewees were speaking, the acquired vocabulary of stress enabled them to contextualize their memories. In particular, we hear Peter searching for the ‘right’ word when he refers first to pressure, then stress. There is a sense of being able to put the correct label on his experience now.
The examination of Miss Richmond's welfare officer reports in the 1940s and the experiences of work-related stress narrated by Peter and Jeff in the 1950s to 1970s highlight a number of key issues. Firstly, despite the popularity and adoption of the stress concept following the publication of Hans Selye's The Stress of Life, in 1956, attitudes towards causation show powerful continuity across the post-war period.63 It was the individual, rather than the external working environment that was pathogenic: it was the inherent weakness of workers that made them suffer, not the conditions in which they found themselves. Secondly, there was a lack of understanding amongst colleagues, friends and family and even the medical profession itself. People did not understand mental health issues and were suspicious, even in the early 1970s, of conditions that they could not see. While absence from work with a broken leg carried validity, a nervous breakdown did not. Thirdly, the tools that the medical profession had to tackle the mental distress of people like Jeff and Peter were scarcely better than those of Miss Richmond's colleagues. Pharmaceutical treatments were quite often blunt-edged tools, which created at least as much suffering, albeit in different ways, as that which they were supposed to alleviate. GPs relied on the sedative effects of sleeping pills and drugs such as Valium, both of which had negative effects for Jeff and Peter.64 It seems that, despite the rise in popularity of various forms of psychotherapy during the 1970s, when Jeff and Peter were experiencing stress, psycho-therapeutic treatments did not appear to have reached general practice.
The 1970s was arguably the final decade before stress became the phenomenon that we understand it to be today. The experiences of those suffering from work-related stress in the 1970s bore greater similarities to experiences in the immediate post-war period than to our contemporary stress culture. Similarly the responses of others to their experiences also seem remarkably consistent across the post-war years to the 1970s. It seems likely that multiple factors were at play here, including changes to the nature of paid employment due to the mid-1970s economic slump. Coming after a ‘golden age’ of economic prosperity, growth, powerful trade unions, workers' rights and welfare reforms, recession paved the way for considerable reforms perceived by some as increasing demands and pressures on workers, concomitant with reducing their security and requiring greater flexibility.65 At the same time, the introduction of the Health and Safety at Work Act in 1974 and the creation of the Health and Safety Executive to enforce its provisions placed more focus on the work environment and introduced greater organizational responsibilities for employees. The increasing proportion of women in the workforce contributed to changing attitudes towards, and experiences of, work among the general population. The 1970s was also a period when GPs found themselves better able to offer treatment for ‘nervous conditions’ in the form of heavily promoted minor tranquilizers such as Valium. The ability to treat effectively was positively correlated to increases in diagnosis, suggesting a tendency towards medicalizing experiences that might previously have been undiagnosed.66 Overall the ground was being laid for considerable changes in attitudes towards work, which would begin to allow people to question the role of work and stress in dictating their mental health and to ask questions about causation which might previously have been unthinkable. Increasingly psychologized interpretations of work began to engender beliefs that experiences such as those of Jeff and Peter were due to environmental and external factors. As subsequent chapters in this volume argue, it was this process that paved the way for conceptualizing workers as ‘victims’ of stress.
The Open Access version of this book, available at www.tandfebooks.com, has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 3.0 license.
Monographs, or book chapters, which are outputs of Wellcome Trust funding have been made freely available as part of the Wellcome Trust's open access policy
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