Tag Archives: stress

A Question of ‘Public Engagement’

Ayesha Nathoo

 

Over the last year, I have been involved in a number of public events related to my work on the history of therapeutic relaxation. These have included talks, displays and practical workshops at the “Being Human” festival of the humanities, the “Secret Garden Party” and the “Wilderness festival” (in collaboration with Guerilla Science and NOW live events), a “Friday Late Spectacular” and a discussion evening on “Rest and Relaxation in the Modern World” as part of Hubbub, at the Wellcome Collection, London.

 

 

The aims, scale, content and audiences varied for each of these events, but together they have left me reappraising my role as a historian, and reflecting on notions of expertise in such public forums. The central topics which comprise my research – ‘rest’, ‘balance’, ‘stress’ and ‘relaxation’ – affect us all, and many audience members were drawn to the events because of pre-existing interests in these matters. Others stumbled across the events by chance with little idea of what to expect or gain from them. In the music festivals, the historical material distinguished my workshops from the myriad other practice-based workshops on offer (such as yoga, mindfulness and massage); elsewhere the practical content differentiated my work from other more traditional academic contributions.

 

I am particularly interested in understanding relaxation as a taught practice, and the material, audio and visual culture that has furthered its development over the last hundred years in Western, secular, therapeutic contexts. Aural instruction given in classes or on cassettes were key methods for teaching and learning relaxation in the post-war decades and are central to understanding the growth of such practices in both clinical and domestic settings. As well as the instructions, the tone of voice, pace, pauses, and type of medium would have affected how relaxation was understood, distributed and practiced, so I have been keen to track down and share some of the original audio recordings to better understand these experiential and pedagogical aspects. If these have been unavailable I have instead endeavoured to recreate the ways in which different protagonists have taught relaxation, piecing together printed publications, archival material and oral historical resources to do so.

 

Many of those who participated in the workshops were curious to learn more about the techniques that I discussed – such as yoga, meditation or autogenic training – and their relationship to health and wellbeing. Yet as I was presenting the material primarily as a historian, rather than as a practitioner or advocate of any particular therapeutic practice, some unexpected tensions seemed to arise. Whilst the historical material inspired much interest, most centrally I found that people wanted to evaluate the specific techniques: What was going to work best for them for particular ailments or for general wellbeing? What is the best strategy for alleviating anxiety or chronic pain? Would I recommend relaxation for childbirth? Did I have copies of relaxation instructions that they could take away? Why was I talking about Progressive Muscle Relaxation, one lady asked, when the Alexander Technique (which she had taught for 20 years) was far superior? Was mindfulness meditation really a form of relaxation? Was it best to concentrate on relaxing the mind or the body? What is the evidence base for therapeutic relaxation? Why bother with daily relaxation training if there is a more accessible pharmaceutical option?

 

Although comparable questions have partly spurred my own interest in this research area, speaking as a historian I have felt uneasy about offering responses. The short, practical, personal questions are not compatible with in-depth answers that address broader medical, social and political contexts, such as the rise of individualism and the mass media, and changes in healthcare, lifestyle and biomedical models. Yet that is what has created and shaped successive demands for and critiques of therapeutic relaxation; contemporary concerns and understandings derive from these past contexts. This is the long and complex narrative that I am researching and whilst I certainly hope that it will have policy implications and be relevant to today’s medical landscape, I do not feel equipped to offer personal advice. Neither am I sure that I should be doing so.

 

I would speculate that this kind of professional reticence is a majority view amongst historians, and yet it is somewhat frustrating for interested lay audiences. If a professional researcher is investigating a particular subject, then why should they not state their opinions based on the knowledge gained from the research? I have come across this at various other points during past research, on topics ranging from the media coverage of the possible link between autism and the MMR vaccination to organ transplantation and donation. ‘Should I give my child the vaccination?’, mothers repeatedly asked me. ‘Were there any reasons not to sign the organ register?’ ‘Did I think there should be an opt-out clause to increase donation rates?’ It is not that I had not given enough thought to these matters – I had extensively mulled over them – yet I questioned my role as a historian to authoritatively influence other people’s present-day decisions, certainly without allowing the time and space to substantiate my points of view. The aim, however, would not be to give a ‘balanced’ view in the sense of ‘objectively’ presenting a full range of arguments for and against.

 

The personal is the historical: Knowledge and memories of the past shape views and actions for the future. And so a historian’s personal stance can generally be inferred from their authored work, amongst the layers of interpretations and the selection of sources. Perhaps then scholars should meet the challenge of more explicitly articulating their own views in public contexts, where audience members often lead conversations and set agendas and where the boundaries of expertise are fluid. As ‘public engagement’ becomes an increasingly significant part of academic life, it seems timely and important to open up these discussions.

The Health of Pilots: Burnout, Fatigue, and Stress in Past and Present

Natasha Feiner

On 24 March 2015 a Germanwings Airbus crashed 100 kilometres northwest of Nice in the French Alps after a constant descent that began one minute after the last routine contact with air traffic control. All 144 passengers and six aircrew members were killed.

The crash, tragic as it was, attracted significant media attention and it was not long before attention turned to co-pilot Andreas Lubitz. German prosecutors said that they found indications that Lubitz had concealed an illness from his employer, hiding a sick note on the day of the crash. Whilst some media coverage looked to Lubitz’s history of depression, others investigated ‘burnout’. Der Spiegel reporter Matthias Gebauer tweeted in March that Lubitz was suffering with ‘burnout-syndrome’ when he took time out of pilot training in 2009.[1]

The term ‘burnout’ was coined by Herbert Freudenberger in 1974 and is still widely used in Germany (and to a lesser extent, the UK and America) today. Symptoms include long-term exhaustion and diminished interest in work, which is often assumed to be the result of chronic occupational stress.

The recent media discussion of burnout among pilots as a result of the Germanwings crash has brought the issue of pilot health into sharp relief. Several countries have implemented new cockpit regulations and there has been significant discussion of how pilots (and the airlines that employ them) should best deal with stress, personal problems, and exhaustion. These issues have their historical antecedent in late-twentieth century discussions of ‘pilot fatigue’.

It is widely acknowledged today that commercial airline pilots are employed in one of the most stressful occupations of the modern age. Before the Second World War this issue was rarely discussed outside academic circles. Traditionally conceived by the public as heroic and superhuman, early pilots were held up as paragons of masculine strength and vigour, able to manage great responsibilities with little (if any) impact on their physical or mental health.

Although fatigue was first recognised as a potential problem in the 1950s, it was not until the 1960s that the relationship between flying, fatigue, and the health of pilots was first discussed in the mainstream media. A number of newspaper articles highlighted the stressful nature of the pilot’s job and (from the early 1970s) a number of alarmist articles reported incidents of pilots falling asleep at their controls. In one report a pilot flying over Japan was said to have “nodded off” and then woken to find the rest of his flight crew asleep:

‘In the report… the BOAC captain said that when he felt himself dozing he shook himself, looked around the flight deck and found his two co-pilots and flight engineer asleep. “I immediately called for black coffee to bring everyone round” [he said]’.[2]

The increased media interest in ‘pilot fatigue’ coincided with a period of industrial strife amongst pilots who were experiencing radical changes not only in the type of aircraft they were asked to fly, but also in terms of management and working conditions. These issues came to the fore in 1961 when airline BEA released their summer flying schedules. The proposed schedules were intensive and many BEA pilots questioned the implications for safety. Long duty periods and inadequate rest breaks would, it was argued, cause dangerous fatigue that may increase the likelihood of accidents.

BEA relented and allowed an investigation of ‘pilot fatigue’. Carried out by physician of aeronautics H. P. Ruffell Smith, the investigation used a system of points for measuring flight time limitations, replacing the traditional hours system. The subsequent report suggested that BEA pilots should not fly more than 18 points per day, and extra points were awarded for especially stressful or fatiguing operations, such as take-off and landing. Ruffell-Smith’s report was never published and BEA did not enforce his recommendations. The problem of ‘pilot fatigue’ was not solved.

In the years that followed a number of high profile air disasters occurred, many of which were later attributed to ‘pilot fatigue’. In 1966 a Britannia plane crashed in Ljubljana, Yugoslavia, killing 98 people. One year later another plane crashed, this time in Stockport, killing 72 people. Then, in 1972 a BEA Trident plane crashed in Staines, killing 118 people. The Trident crash, in particular, caught media attention as the pilot in charge of the plane, Stanley Key, had made ‘numerous complaints’ about the length of the working day prior to his death.[3]

As a result of this, in 1972 pilots’ union BALPA revived its campaign to reduce working hours, shifting their focus to the dangers ‘pilot fatigue’ posed to passengers. By emphasising the potential dangers of fatigue, BALPA was able to convince airlines to carry out a further investigation into flight time limitations and pilot workload. Based on the results of the investigation, in 1975 the Civil Aviation Authority published strict regulations on flight times with the aim of avoiding ‘excessive fatigue’[4].

Whilst the problem of ‘pilot fatigue’ did not come to a neat conclusion in 1975 (BALPA continues to campaign on the issue to this day) the working conditions of pilots were drastically improved by the introduction of strict flight time limitations.[5] Such drastic changes would not, arguably, have taken place without the support of the British media. The alarmist nature of newspaper reports on the subject of ‘pilot fatigue’ forced airlines to take the health of pilots seriously, for fear of further frightening (and consequently losing) customers.

One would hope that the British media could play a similarly positive role today, following the Germanwings tragedy, by encouraging a re-evaluation of mental health policy by airlines (as well as by employers more generally). Although many initial newspaper reports about Lubitz were (sadly) insensitive and stigmatising, several recent articles have used a of discussion the Germanwings crash as a platform for encouraging greater awareness and understanding of mental health.[6] The tragedy may yet engender a re-evaluation of mental health and stress in the workplace, as the Trident crash did for ‘pilot fatigue’ in 1972.

 

[1] Gebauer is quoted in this news report: http://www.independent.co.uk/news/world/europe/germanwings-crash-copilot-andreas-lubitz-who-crashed-plane-suffered-burnout-says-friend-10137076.html [last accessed 23/06/15]

[2] The Times, Dec 13 1972, page 1.

[3] The Times, Nov 29 1972, page 4.

[4] The Avoidance of Excessive Fatigue in Aircrews: Requirements Document, (London, 1975), p. 1.

[5] For more information on BALPA’s current ‘Focus on Fatigue’ campaign see: http://www.balpa.org/Campaigns/Focus-on-Fatigue.aspx [last accessed 23/06/15].

[6] Alastair Campbell (‘Time to Change’ ambassador) on the stigma and taboo surrounding mental health: http://www.huffingtonpost.co.uk/alastair-campbell/andreas-lubitz-would-we-be-blaming-cancer_b_6961386.html [last accessed 23/06/15].