Chapter Introduction

“I HAVE A KNIFE TO YOUR NECK. Don’t make a sound. Get out of bed and come with me or I will kill you and your family.” These are the words that awoke 14-year-old Elizabeth Smart in the middle of the night of June 5, 2002 while sleeping in her bedroom next to her 9-year-old sister Mary Katherine. Fearing for her life, and that of her family, she kept quiet and left with her abductor. Her little sister, terrified, hid in her bedroom for several hours before waking the girls’ parents, who awoke to their daughter saying: “She’s gone. Elizabeth is gone.” Elizabeth was kidnapped by Brian David Mitchell, a man Elizabeth’s parents had hired previously to do some roof work on their home. Mitchell broke into the family’s home in Salt Lake City through an open window, abducted Elizabeth, and he and his wife Wanda Ileen Barzee held her in captivity for nine months, during which time Mitchell repeatedly raped her and threatened to kill her and her entire family. Mitchell, Barzee, and Smart were spotted walking down the street by a couple who recognized them from a recent airing of the television show America’s Most Wanted and called the police. Mitchell and Barzee were apprehended and Elizabeth was returned to her family.

Elizabeth suffered unimaginable circumstances for a prolonged period of time in what can be thought of as one of the most stressful situations possible, especially for a 14-year-old girl. So what became of Elizabeth? Fortunately, she is now safe and sound, happily married, and working as an activist and commentator for ABC News. She endured life-threatening stressors for months, and those experiences undoubtedly affected her in ways that will last her entire lifetime. At the same time, hers is a story of resilience. Despite the very difficult hand she was dealt, she appears to have bounced back and to be leading a happy, productive, and rewarding life. Hers is a story of both stress and health.

This smiling young face is that of Elizabeth Smart, who, between the times of these two photographs, was kidnapped, raped, and tortured for nearly a year. Stressful life events often affect us in ways that cannot be seen from the outside. Fortunately, there are things that we can do in response to even the most stressful of life events that can get us smiling again.

SLCPD UPI PHOTO SERVICE/NEWSCOM
MICHAEL LOCCISANO/GETTY IMAGES

FORTUNATELY, VERY FEW OF US WILL EVER HAVE TO ENDURE the type of stress that Elizabeth Smart lived through. But life can present a welter of frights, bothers, and looming disasters that can be quite difficult to manage. A reckless driver may nearly run you over; you may be discriminated against, threatened, or intimidated in some way; or a fire may leave you out on the street. Life has its stressors, specific events or chronic pressures that place demands on a person or threaten the person’s well-being. Although such stressors rarely involve threats of death, they do have both immediate and cumulative effects that can influence health.

In this chapter, we’ll look at what psychologists and physicians have learned about the kinds of life events that produce stress, the physical and psychological response to internal or external stressors; typical responses to such stressors; and ways to manage stress. Stress has such a profound influence on health that we consider stress and health together in this chapter. And because sickness and health are not merely features of the physical body, we then consider the more general topic of health psychology, the subfield of psychology concerned with ways psychological factors influence the causes and treatment of physical illness and the maintenance of health. You will see how perceptions of illness can affect its course and how health-promoting behaviors can improve the quality of people’s lives.