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How is it, you may be wondering, that a particular woman develops a particular stress symptom at a particular time?

One theory is that anxiety and stress aggravate problems that already exist because of our genes, prenatal environment, diet, or earlier diseases, damage, or accidents. These vulnerabilities are the weak links —symptoms waiting to happen.

Another, similar, theory hypothesizes that each organ and system has lowered resistance levels when the body is subjected to a high enough degree of anxiety or stress. When this happens, a virus, disease, or disorder is more likely to appear.

A third theory claims that a particular woman will develop a particular symptom because she has been reinforced or rewarded for it.

Every time her husband gave her an angry look, Christine's stomach flip-flopped, her knees felt weak, her hands became clammy, and her heart raced. Without realizing it, she would clutch at her chest and press her hand over her heart. She felt all four symptoms, but her husband was only aware of the last one. His angry look would change to a look of concern whenever her hand flew to her heart, and a particular organ-response was thus reinforced. Soon both Christine and her husband worried about her heart rate when she was under stress.

Perhaps, however, each woman has a unique set of responses to each emotion. Five women could react physiologically with five different response patterns when experiencing similar stress. Each might call her own pattern "anxiety," but the different patterns would, of course, produce different symptoms.

Although there is not much research to support it, there is a theory that the fight, flight, or fright response is not as nonspecific as Selye described it. This suggests that there are subtle differences in the body's responses to different kinds of stresses. Fright situations could be stressing different organs or systems than fight situations, and so on. Thus, particular stresses might lead to particular symptoms.

Historically, many theories have tried to associate certain stress symptoms with certain personality profiles. Even Sigmund Freud agreed with this approach. In fact, he thought that both a particular personality profile and a particular stress symptom resulted from the same early childhood experiences. A woman with unfulfilled dependency needs, for example, might show more eating and gastrointestinal disorders than is usual, whereas a woman who has difficulty expressing her anger directly might have a tendency to develop sexual dysfunctions.

Two famous women explain female stress symptoms in yet another way. The psychiatrist Karen Horney and the anthropologist Margaret Mead both trace particular symptoms back to anxiety-provoking communications from mother to child—subtle messages conveyed during feeding, discipline, and emotional demonstrations.

The psychoanalytic schools would argue that a particular organ in a particular woman is affected at a particular time because it is symbolic of a particular conflict she is experiencing. In the following case history, for example, Robin had both a wish and a fear concerning pregnancy.

Although she worried that she and her husband were not ready for parenthood and its responsibilities, Robin and her husband decided to try to start their family while he was in the Army and had excellent medical coverage. She became more and more excited about the idea of having a baby, and rationalized that she might never feel ready, so why wait? Soon after the decision, Robin stopped menstruating. At first, she assumed she was pregnant. Later it became clear that she was not. The symptom of amenorrhea (lack of menstruation) under stress conditions relieved her of the conflict by eliminating the fear and making the wish "safe."

Many theories about why women develop the symptoms that they do focus on the importance of individual differences among women under stress. It is as if each has her own threshold for psychosomatic reactions, and her own combination of variables that can push her over that threshold.

The amount of stress needed before a symptom is produced can vary.

The number of times the same or similar stress is experienced may affect women differently.

The physical condition of each woman, and her emotional state preceding and during exposure to a stressful situation may influence her threshold.

The significance of age to stress symptoms varies from woman to woman, as does the readiness to cope or capitulate.

Every one of these theories attempts to explain why a specific stress symptom appears in a particular woman at a particular time. It is most likely, however, that the factors mentioned are interacting to produce the various stress symptoms. As you begin to understand your own stress patterns, bear in mind the multi-faceted nature of the Female Stress Syndrome. You can learn to recognize your own physical and psychological vulnerabilities, your reinforcement history, your areas of conflict, your reaction patterns, and your personality profile. You can sort out the symptoms that have symbolic meanings from those that reflect physiological predispositions; and you can learn to differentiate the symptoms you have learned from those you have inherited.

One of the most alarming aspects of the Female Stress Syndrome is that it starts shaping itself almost immediately after we are born! In the next chapter, we will look at the world into which girls are born and see how the groundwork is laid for future stress patterns.