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This chapter will deal with psychophysiological disorders that affect breathing and the lungs. It will use the term 'stress' to refer to a wide range of stimuli. Some of these may be imposed by the purely physical environment; for example, in a patient with emphysema and limited exercise tolerance. The vast majority, however, are social and psychological stimuli. These seldom constitute direct, unidirectional loads to which an individual responds in linear fashion (as he may, for example, to an exercise challenge or to cold). Rather, such stimuli alter the symbolic environment, influence complex intermediate systems, call upon stored maps and plans, involve mixtures of activation and inhibition and learned systems of reward and punishment, often in competition with one another. This emphasis is therefore less on external 'stress' than on internal processing and resulting 'strain"; the latter occurs within individuals and may reflect itself in disease.

DOI: 10.1007/978-94-011-7289-9_2

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