The American Institute of Stress HEALTH AND STRESS Your source for science-based stress management information VOLUME 28 ISSUE 4 October 2016

THE LEGACY OF

October 2016 AIS Health and Stress www.stress.org The mission of AIS is to improve the health of the com- munity and the world by setting the standard of excel- lence of stress management in education, research, clini- cal care and the workplace. Diverse and inclusive, The American Institute of Stress educates medical practitio- ners, scientists, health care professionals and the public; conducts research; and provides information, training and techniques to prevent human illness related to stress.

AIS provides a diverse and inclusive environment that fosters intellectual discovery, creates and transmits inno- vative knowledge, improves human health, and provides leadership to the world on stress related topics. Your source for science-based stress management information HEALTH AND STRESS We value opinions of our readers. Please feel free to contact us with any comments, suggestions or inquiries. Email: [email protected]

Editor In Chief: Associate Editors: Paul J. Rosch, MD, FACP Helen M. Kearney, PhD Donna Telyczka, B.A.

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AIS Board of Directors Chairman: Paul J. Rosch, MD, FACP

President: Daniel L. Kirsch, PhD, DAAPM, FAIS

Distinguished Members: Robert Bisaccia Holger Wrede, Esq. Tracey B. Kirsch

Alvin Toffler And The Legacy of Future Shock

By Paul J. Rosch, MD, FACP

Alvin Toffler, a Founding Trustee of the Ameri- Shock” and the book was the basis of John can Institute of Stress died on June 27 at the Brunnner’s 1975 “The Shockwave Rider” and age of 87. He became an international celeb- other science-fiction novels. A 1972 Future rity following the 1970 publication of Future Shock documentary, begins with a bearded Shock, which emphasized the dangerous and weary-looking , who explains: mental and physical effects of rapid socio- “In the course of my work, which has taken me cultural changes that were taking place, and to just about every corner of the globe, I see many the growing problem of informational overload. aspects of a phenomenon which I’m just begin- It is difficult to overestimate the influence this ning to understand. Our modern technologies book had here and abroad. Over 15 million copies were sold, including 5 million in the U.S.; have changed the degree of sophistication it has been translated into dozens of languag- beyond our wildest dreams. But this technology es, and is still in print almost a half century later. has exacted a pretty heavy price. We live in an It attracted millions of fans and followers, age of anxiety and time of stress. And with all our including business executives, politicians sophistication, we are in fact the victims of our and celebrities. , own technological strengths –- we are the victims and other musicians wrote songs titled “Future of shock… a future shock.”

October 2016 AIS Health and Stress www.stress.org Welles goes on to illustrate the bewildering They soon became disillusioned with various barrage of new technologies and choices we aspects of their leftist communist views, are constantly confronted with, and the lack including the promise of an impending social of permanence as we have morphed into a revolution in which oppressed workers would disposable, throw-away society. The video ends triumph. Toffler later told a reporter he would with a clip of Toffler warning college students have quit his factory job after two years, but it “We must begin to say ‘No’ to certain kinds of was during the McCarthy witch-hunt era, and technology and begin to control technological he felt obligated to stick by his organizing change, because we have now reached the point comrades, “It was one thing to change your at which technology is so powerful and so rapid ideology; it was another thing to change your that it may destroy us, unless we control it.” friends and rat on them.” He also experienced the dangers of physical labor when a steel Why Did Toffler Write Future Shock And How beam he was helping to unload twisted unex- Accurate Were His Predictions? pectedly and fell on him breaking one of his Alvin Toffler was born and raised in Brooklyn. vertebrae. At night, he wrote poetry and fiction, His parents were Jewish immigrants from and although the results were disappointing, Poland, his father was a furrier, and he had a he still aspired to be a writer. In 1954, soon after younger sister. They lived with an uncle, Phil the birth of their only child, Karen, he Album, an editor, and an aunt Ruth Album, a persuaded the editor of Industry and Welding, poet, both of whom had a strong influence. As a Cleveland trade magazine, to hire him as a Toffler later explained “They were Depression- reporter. In 1957, he was reporting for Labor’s era literary intellectuals and they always talked Daily, a national trade newspaper published in about exciting ideas.” He began composing Charleston, West Virginia on labor news in poetry and stories soon after learning to read, Washington. Two years later, Fortune and by age 7, had decided to become a writer. He entered in 1946, but magazine hired him comment as its labor was not a stellar student since he was much editor and columnist. more interested and actively involved in political activism. During a 1948 trip back to He left Fortune in 1962, and with Heidi as his college from helping to register black voters editor and adviser, became a freelance writer in North Carolina, he met Adelaide Elizabeth covering politics, technology and social science Farrell, known as Heidi, the daughter of Dutch for scholarly journals, and writing long Jewish immigrants, who was enrolled in a interviews for Playboy magazine. His 1964 graduate linguistics program. They had similar interview with the Russian novelist Vladimir strong left wing political views and both Nabokov that explored the creation of dropped out of school to work for Henry as a nymphet, was considered one of the Wallace’s Progressive Party, in his failed bid for magazine’s best. the Presidency. In 1950, they moved to Cleveland, which was then the center of indus- The following year, he wrote an article for trial America, where they married and found Horizon, a glossy monthly, on “The Future as a employments in different factories. Alvin Way of Life,” in which he introduced the concept learned to weld and repair machinery, Heidi of what he called “future shock”. He described became a union shop steward in an aluminum this as “the growing feeling of anxiety brought foundry, and both spent the next five years on by the bewildering and ever-accelerating pace organizing workers in Ohio. at which life was changing.” It resulted in a October 2016 AIS Health and Stress www.stress.org $15,000 book contract from Random House, if I was aware of any recent developments in and he spent the next five years writing Future this field. I started to explain the exciting Shock. research of Lennart Levi, another Founding Trustee, who established the Laboratory for I first met the Tofflers shortly after the forma- Clinical Stress Research at Karolinska Institute, tion of The American Institute of Stress. I was but they were well aware of this and had invited to have dinner at their home in Ridge- recently met with him in Stockholm. It was a field Connecticut, which was only a 45-minute delightful and low-keyed evening, we talked drive. As acknowledged in Future Shock, both about many other things ranging from Selye, and their latest book, The Third Wave, to inter- had been strongly influenced by Hans Selye’s esting movies and cars. Alvin admired my BMW concept of “stress” and his “General Adaptation convertible, which was a few months old, got Syndrome”. I include Heidi since it soon became in to study the dashboard, and then asked if obvious that she should have been listed as he could drive it around the block. Apparently co-author. It was also obvious that they were enjoyed it, since when he returned, told me he very familiar with other pioneers in stress would discuss purchasing one with Heidi. They research, such as Harold Wolff, who had did everything together, and the tremendous emphasized that health depended on the success of The Third Wave that was largely due individual’s ability to adapt to environmental to Heidi’s efforts. She should have been changes. Wolff’s group at Cornell Medical included as co-author of this and probably also Center in New York included Lawrence Hinkle, Future Shock, but the following dedication who focused on environmental factors in heart acknowledges this and she was listed on disease and sudden death, Stewart Wolf, the subsequent books. “Father of Neurocardiology” and Thomas Holmes, who postulated that the degree and FOR HEIDI rate of change in a person’s life could predict Whose convincing arguments helped me to future illness. Wolf and Holmes, who were also decide to write The Third Wave. Her tough, Founding Trustees of the American Institute of tenacious criticism of my ideas and professional- ism as an editor are reflected on every page. Stress went on to continue their research elsewhere. Wolf was appointed chief of Her contributions to this book extend far beyond Medicine at the University of Oklahoma Medical those would expect of a colleague, and intellec- School and Holmes headed a psychiatric tual companion, a friend, lover and wife. division at the Washington School of Medicine. They subsequently moved to Los Angeles but Alvin was particularly impressed with Tom we corresponded and our paths crossed several Holmes, who with the assistance, and often times after that. The last occasion was at the guidance, of Richard Rahe, a young psychiatrist, legendary Imperial Hotel in Tokyo in the early had developed a Life-Change Units scale to 1980s. It was after the publication of The Third measure the magnitude of change a person Wave, which made Alvin a celebrity in Japan was subjected to over a certain period of time. and China. People in the hotel recognized him This resulted in their 1967 Social Readjustment from his numerous TV interviews and he was Rating Scale, commonly referred to as the often surrounded by autograph seekers and Holmes-Rahe Stress Scale. Alvin had allocated paparazzi in the lobby. My wife and I happened several pages of Future Shock to this and Rahe’s to be there at the same time as guests of SONY, subsequent studies and was anxious to know as they had arranged a series of events for me

October 2016 AIS Health and Stress www.stress.org to promote a stress reduction videotape. We Beard, a New York neurologist, warned that ran into Alvin and Heidi in the lobby and they many Americans were suffering from suggested we join them for dinner the follow- neurasthenia (nervous exhaustion) due to rapid ing evening. Heidi called the next day to cancel social and technological transformations. In since Alvin had a fever and symptoms suggest- 1954, the anthropologist Kalervo Oberg had coined the term “culture shock”, which was “pre- ing a urinary tract infection. Fortunately, cipitated by the anxiety that results from losing Marguerite had packed some antibiotics that all our familiar signs and symbols of social inter- were usually effective for this and we brought course”. Although there were similar symptoms, them over to the lavish suite Heidi told us they “culture shock” was seen primarily in travelers usually occupied whenever they were in Tokyo. who were suddenly force to adapt to a new We spent an hour or so talking about things of and very different culture and lifestyle. Nor did mutual interest. Alvin said he rarely got sick Toffler invent the phrase “future shock”, but related this interesting anecdote. During since Neil Postman and Charles Weingartner a visit to Mexico, he suffered a severe case of used it in a 1963 presentation to the National “Turista”, also known as “Montezuma’s Revenge” Council of Teachers of English to refer to “the social paralysis induced by and “traveler’s diarrhea.” The local doctor told rapid technological changes.” As Postman him that this was not unusual when American wrote in his 1992 Conscientious Objections, or European visitors were suddenly immersed “Of course, neither Weingartner nor I had the in a different culture and lacked sufficient time brains to write a book called “Future Shock”, to adapt to it. Alvin said that Mexico was not and all due credit goes to Alvin Toffler for unique, and the condition was called “Delhi having recognized a good phrase when one came Belly” in India or the “Hong Kong Dog” in the along.” Toffler defined “future shock” as “the Orient. shattering stress and disorientation that we induce in individuals by subjecting them to too much change in too short a time.” It differed from Toffler was not the first to describe this “culture shock” since it affected everyone and phenomenon of illness due to rapid environ- was much more difficult to adapt to since these mental changes. In 1857, John Hawkes, a British changes were accelerating due to rapid physician, expressed concerns about increased advances in diverse technologies that would “pressure on the brain” from the advancing eventually alter almost all aspects of our daily speed of societal changes. In 1881, George M. lives.

October 2016 AIS Health and Stress www.stress.org Some of the changes he predicted were the earth’s urban population within 11 years. And Internet, Prozac and other personality-altering we still don’t have underwater cities, family drugs, brain-simulating pleasure probes, owned spaceships and clothes made of paper YouTube, the popularity and power of that are disposed of after each use. On the personal , telecommuting, cable other hand, it’s not inconceivable that some of television, robots and humanoid machines, these could come to fruition over the next few cloning, and schooling at home. Armstong and decades. Aldrin had just walked on the moon, and Toffler predicted there would be further exploration of space and numerous satellites “Things: The Throw- orbiting the earth to facilitate TV and telephone reception, or navigation (GPS) as Away Society” well as provide information about global The above is the title of Chapter 4 of Future weather conditions. He also believed we would Shock, which begins with a discussion of Mat- live in a society where there was little need to tel’s “Barbie”, the best-known and best-selling own anything and that new businesses would doll in history. Since its introduction in 1959, have no formal structure or traditional hierar- some 12 million Barbies had been sold in less chy, which he referred to as “ad-hocracy”. Today, than ten years. It appealed to little girls and Uber, the world’s largest taxi company, owns doll collectors because of the huge variety of no vehicles. Facebook, the world’s most popular clothing and other apparel that were constant- media owner, creates no content, and Airbnb, ly updated. There were also periodic changes the world’s largest provider of accommoda- in the color of her skin, eyes, and hair, as well tions, owns no real estate. Several similar start- as facial expressions. The newest doll at the ups now rival or surpass some of the world’s time had real eyelashes and a twist-and-turn largest and long-established businesses in waist that made her look more realistic, and transportation, hospitality and other services. because of an aggressive publicity campaign, Such ad-hocracy companies have become very was in great demand. To make it more afford- popular and profitable, because: able, Mattel announced that anyone purchas- • They use mobile “apps” and other informa- ing a new Barbie would receive a trade-in tion technology systems that are readily allowance for their old one. This unusual offer available on the Web to facilitate transac- was an omen of things to come, and Toffler’s tions. point was that the little girl who trades in her • They rely on user-based rating systems for doll soon learns that this is not the only thing quality control that create trust between that passes in and out of her life at a rapid rate. consumers and providers who are strangers. Diapers, bibs, paper napkins, Kleenex, towels, • They offer workers flexibility in deciding non-returnable soda bottles — all are used when they will be available and rely on them up quickly in her home and ruthlessly eliminated. to furnish any equipment that might be Corn muffins come in baking tins that are thrown needed to provide a service. away after one use. Spinach is encased in plastic sacks that can be dropped into a pan of boiling Toffler’s track record is impressive, and he was water for heating and then thrown away. TV largely responsible for the subsequent wave dinners are cooked and often served on throw- of other “futurists”. Not all of his predictions away trays. Her home is a large processing have materialized, such as a doubling of the machine through which objects flow, entering

October 2016 AIS Health and Stress www.stress.org and leaving, at a faster and faster rate of speed. successful. It is estimated that over a billion From birth on, she is inextricably embedded in a Barbie dolls have been sold and that three are throw-away culture. bought every second in more than 150 nations. There are also over 100,000 Barbie collectors, The little girl who cheerfully trades her Barbie some of whom have over 1,000 dolls. The in for the latest version was in sharp contrast world’s champion according to the 2011 Guiness to her mother and grandmother, who clutched Book of World Records is a German lady with lovingly to the same doll in its original clothing, 15,000 different versions, and it has probably until it “disintegrated from sheer age.” They were increased since then. The first Barbie cost $3.00 reared in a society that emphasized the impor- and one of these in mint condition recently tance of permanence, since things were built sold for $27,540.00. Earlier this year, Barbie to last. Favorite cooking utensils and clothing made the cover of Time magazine and sales were kept and treasured, even though new increased when Mattel announced that for the ones were constantly being offered. “Even if first time in 57 years, Barbie would now also they had to be repaired now and then, the pair be available in three new shapes—tall, petite of boots costing fifty dollars could be worn for 10 and curvy. This was designed to counter years were less expensive than those that cost criticisms that Barbie could be a dangerous ten dollars that lasted only a year.” Advances in role model for young girls who tried to emulate technology lowered the prices of mass manu- her physical features. facturing goods by machines much more rapidly than the costs of repairs, which had to be done by hand by skilled workers or artisans. This throw-away culture was particularly prom- inent in America, but quickly spread to other affluent countries.

In Japan, today throw-away tissues are so universal that cloth handkerchiefs are regarded as old fashioned, not to say unsanitary. In England for sixpence one may buy a “Dentamatic throw-away toothbrush” which comes already coated with toothpaste for its one-time use. And even in France, disposable cigarette lighters are commonplace. From card- board milk containers to the rockets that power space vehicles, products created for short-term use are becoming more numerous and crucial to our way of life.

The Mattel formula of periodic updated versions of Barbie based on a new occupation, Barbies for different ethnic groups and additions like her boyfriend Ken and a host of new friends continues to be phenomenally

October 2016 AIS Health and Stress www.stress.org In 2009, it was estimated that the average Human Barbies, 11-year-old had owned 10 or more Barbies “The Swinging Sixties”, during her childhood. Many spent hours ap- plying different types of makeup and damag- The Hippies And ing their hair with dyes, straighteners and curling irons in an attempt to look like Barbie. Woodstock Some carried it to extremes by undergoing facelifts and a variety of other surgical proce- dures, as illustrated by the following: Barbie made her first TV appearance in 1959 on the Mickey Mouse Club, which reached millions of children and tweens. It featured a video that showed the various accoutrements that could be purchased, and ended with “Beau- tiful Barbie – I want to look like you.” Advertise- ments like this and similar marketing tech- niques helped to sell 351,000 Barbies in her first year, a new sales record. To put this in perspective, a gallon of gas was then 25 cents, the average annual salary was $5,000 and Barbie sold for $3.00, which would be $24.50 today. TV changed the custom of buying a doll as a Christmas or birthday present, to a steady stream by targeting a new consumer base, Cindy Jackson grew up in a small Ohio young and teenage girls. It also demonstrated farming town. When she was six, she told her how much influence children can have over parents she wanted to look like Barbie. Since their parents’ wallets. Barbie was introduced 1987 she has had 14 full scale operations as a “Teen-Age Fashion Model” to encourage including facelifts, nose operations, eye lifts, girls to believe they could be anything they knee, waist, abdomen and thigh liposuction, wanted to, from a cheerleader or flight atten- jaw surgery, lip and cheek implants, chemical dant, to a teacher, nurse or ballerina. All they peels and dozens of non-surgical procedures had to do was purchase the appropriate ward- at a cost of $200,000. These photos show her robe to see their future. This now includes over at age 23 in 1979, and in 2016, at age 60. 150 occupations, including a rock star, veteri- narian, aerobics instructor, athletic coach, There are numerous other human Barbies all over the world, some of whom are shown on police officer, Olympic gymnast, Army, Navy, the next page. The U.K.’s Sarah Burge, 55, has Air Force or Marine officer, movie star, business spent £500,000 on cosmetic surgery, including executive or congresswoman. Barbie was an nose jobs, cheek augmentations and lip astronaut four years before man walked on the enhancements, and gives herself Botox moon, and in the 1990’s, she ran for President, injections. Brazil’s 23-year-old Andressa long before a female was on a presidential Damiani, has a 20-inch waist and 32F bra size ballot. and wears contacts to achieve a “blank stare”.

October 2016 AIS Health and Stress www.stress.org Despite the fact that she has had no plastic a woman could be; she was attractive, famous, surgery and doesn’t diet, she often frightens wealthy, and popular. Nevertheless, many people because she seems so Barbie-like. parents were incensed because she looked too Valeria Lukyanova, 30, from the Ukraine, states “sexy”, especially in her lingerie, which sent the she has barely changed since being a 14-year- wrong message. old teenager and credits her 19” waist to a diet of fruit and fish and a vigorous exercise regimen. However, a revolution was taking place with Angela Kenova, a 28-year-old Moscow model the advent of the hippie counter culture move- with a 20-inch waist and a 32E bra size, who is ment that believed the purpose of life was to 66” tall and weighs 97 lbs. also claims that her be happy, so, “if it feels good, do it”, regardless appearance is “100% natural” because of the of the consequences. They championed free strict control of her parents, with whom she love and sexual liberation, particularly for still lives. They select all of her clothes, control women, and used psychedelic drugs to expand her diet, provide a personal trainer to supervise their consciousness, especially LSD, due to the her exercise, and do not allow her to date or popularity of Timothy Leary’s “Turn on, tune in, even go out alone. drop out.” They opposed governmental author- ity, nuclear weapons and the Vietnam war, Few people would adopt these drastic demanded more freedom and rights for minor- measures, but all girls would like to be as at- ity groups and women and started the Gay tractive as possible. As they matured, many rights and LGBT social movements. Betty experimented with makeup and changing their Friedan’s 1963 revolutionary book, The Feminine hair color or style in an attempt to resemble Mystique, which began by declaring “We can Barbie. But it was also essential to be very no longer ignore that voice within women that slender, since it was assumed that the thinner says: ‘I want something more than my husband you were, the more appealing and desirable and my children and my home’” sold more than you would be. The original Barbie was the first 3 million copies and was translated into numer- American doll with an adult body. She was ous foreign languages. In 1996, she helped intended to be “a model of bubbly teenage found and was the first president of the not for innocence” that also “projected every little girl’s profit NOW (National Organization of Women), dream of the future.” Barbie represented all that which demanded “ true equality for all women”

October 2016 AIS Health and Stress www.stress.org and the removal of all barriers to “equal and entire West Coast as well as in England. Prob- economic advance”. NOW launched the female ably the most famous was the 1969 Woodstock rights movement and is currently the largest Festival held in an upstate New York dairy farm feminist organization in the U.S., with over in the Catskill Mountain Borscht Belt. It featured 500,000 paid members in more than 550 “3 Days of Peace & Music” performed by 32 chapters in every state and the District of Co- acts, including Jimi Hendrix, Janis Joplin, Joan lumbia. Baez, Grateful Dead, and Crosby, Stills, Nash and Young. Tickets cost $18 in advance and This decade was later labeled the “Swinging $24 at the gate (equivalent to $120.00 and Sixties” because in addition to promoting sexual $150.00 today) and approximately 186,000 promiscuity, gatherings of hippies were often advance tickets were sold. It was anticipated characterized by irresponsible excesses, that an additional 14,000 would purchase flamboyance and disregard for social order. tickets at the gate. The 1967 “Summer of Love” on the West Coast was anticipated to attract 3,000 to San Fran- However, well over 400,000 showed up and cisco’s Golden Gate Park, but 30,000 hippies numerous enthusiasts arrived several days showed up, there and in Haight-Ashbury to before the event to insure being close to the celebrate. LSD was surreptitiously slipped into performers. Traffic began to pile up, and the

the free turkey sandwiches that were handed small roads leading to the farm looked like a

out to everyone, which livened things up even parking lot as thousands of cars were aban- more. Three months later, 10,000 hippies doned and their occupants had to hike 10 or crowded together in Manhattan’s Central Park more miles to the event. Residents of the and there were similar events all along the nearest town, Bethel, population 4,200, were

October 2016 AIS Health and Stress www.stress.org

trapped, and performers had to be helicoptered in. The concession service ran out of food Dying To Be Barbie; and water the first day, replenishment trucks Anorexia, Bulimia couldn’t get through, so food and other supplies had to be airlifted in from a nearby air And Twiggy force base. Since there were only 3 portable toilets for every 10,000 concert goers, the lines While most girls wanted to be just like Barbie, were very long and many had to relieve them- save from the neck up, it would be impossible selves in public. To make things worse, because for anyone to duplicate her other physical features. Since she was intended to be a 1/6th of torrential rains, the toilets overflowed, there scale model, a life size replica would be 69” tall were frequent prolonged interruptions and and weigh 110 lbs., with a 39” bust, 16-17” waist, the event lasted an extra day. There were few 33” hip, size 4 dress and size 3 shoe That would on site ticket sales, since the gate for this and leave room for only half a liver and a few inches the surrounding fences had been destroyed of intestine; her long skinny neck would make the first day, and anyone could easily get in it difficult for her to lift her head, and 6” ankles without paying. and stick-like legs would not only prevent heavy lifting, but might necessitate walking There had been a similar teenage female frenzy on all fours. In contrast, the average American in the early 1940s, when tens of thousands of woman is now 64” tall, weighs between 140-150 “bobbysoxers” routinely jammed Frank Sinatra lbs., has a waist size of 34-35” and wears a 12-14 concerts. However, this paled in comparison size dress. The message is quite clear. If you to the Beatles, who made their first live U.S. want to look like Barbie, you had to be as thin television appearance on the Ed Sullivan Show as possible. in 1966. According to the Nielsen ratings, it was watched by 73 million (about two-fifths of the It is estimated that of the 8-10 million people total American population) – the largest in the U.S. who have anorexia, bulimia or some number of viewers ever recorded for a U.S. other eating disorder, 85-90% are females and television program. John Lennon subsequent- 80% of these are under the age of 20. Some ly told a reporter “We’re more popular than Jesus stated that they started worrying about their now. I don’t know which will go first, rock ‘n’ roll weight when they were 4 to 6-years-old, about or Christianity. Jesus was all right but his disciples the age a girl usually gets her first Barbie doll. Many who have or had an eating disorder also were thick and ordinary. It’s them twisting it that admitted that Barbie had a huge influence on ruins it for me.” There was a violent reaction to why they wanted to be thin. In one, survey, 4 this, particularly in the Bible Belt and there out of 5 10-year-olds said they were afraid of were so many death threats, their tour had to being or becoming fat, 42% of girls in first be canceled. In an attempt to calm things down, through third grade wished they were thinner, Lennon later explained “If I’d have said television and half those aged 9 or 10 claimed they felt is more popular than Jesus, I might have got away better about themselves when they were with it . . .., we meant more to kids than Jesus did, dieting. In another, when teenage girls were or religion at that time.” He predicted his own asked what they would wish for if they had death, “I’ll probably be popped off by some loony” three magical wishes for anything in the and was also correct about the enormous world, the number one response by far was influence of television, especially on young “To lose weight, and keep it off.” And the best girls. way to do that was to starve.

October 2016 AIS Health and Stress www.stress.org It is not generally appreciated that eating Many young women believed the only way to disorders have the highest death rate of any be happy and enjoy life was to be just like mental illness, including major depression. Barbie. Some craved not only her wardrobe, The estimated death rate for anorexia is 8 but if they were rich enough, spent millions to 10 percent and anorexics diagnosed in just to have their homes look like Barbie’s, with their teens or early 20s are 18 times more chandeliers in the bathrooms, pink swimming likely to die prematurely compared to pools and a light pink Corvette convertible. controls. Mortality rates for bulimia are double There was also a pink Beetle and Jeep, and Paris those for controls. Since anorexics starve them- Hilton, a devoted fan, chose a $220,000 pink selves, they frequently suffer from various Bentley Continental for her “Barbie car”. nutritional deficiencies. Bulimics who binge eat and then purge, are at increased risk for But the greatest influence Barbie had was in gastrointestinal disorders and heart disease. promoting weight loss by starvation. In 1965 These and related eating disorders are notori- Mattel came out with a “Slumber Party ously difficult to treat and relapses are common. Barbie” that included a pink bathroom scale That’s because these patients have a distorted permanently set at 110 pounds, a book body image of being too fat, even when they “How to Lose Weight“, and some hair are emaciated. In addition, 83% of adolescent accessories. The book only had one page with girls read fashion magazines for an average of one simple rule in large capital letters, 4 hours every week. In these teen and women’s “DON’T EAT!” A previous “Barbie Baby-Sits” magazines, advertisements for diets and weight doll also came with an ultra-thin Barbie and loss programs and pills are 10 times more the same book with the same single page as common than they are in men’s magazines. also shown below. Unfortunately, too many They feature models wearing attractive cloth- children and teens began to take this advice. ing that women are persuaded to believe are There was also a matching Ken doll with essential to their appearance. But the average slumber party accessories, but his included model is 70” tall and weighs only 107 lbs., and milk and cookies, sending a very different since you can’t change your height, the only message about body image and weight for option is to be as skeletal as possible. Mattel males. was not the first to promote the belief that you have to be thin to be beautiful. As the average weight of American women has increased over the past few decades the weight of models has been steadily decreasing. Idealized body images of women in the media reached an average of 13% to 19% below their expected weight, and a weight 15% below what would normally be expected is a major criterion for the diagnosis of anorexia nervosa.

Wallis Simpson, the divorcée for whom King Edward VIII abdicated his throne in 1936, main- tained that “No woman can be too rich or too thin.

October 2016 AIS Health and Stress www.stress.org The following year, 16-year-old Leslie Hornby international Vogue editions and was often on was approached by a London celebrity hair the cover. Her boyfriend, who was managing stylist who was looking for models to her affairs, persuaded her to change her name demonstrate his new crop haircut and hired a to Twiggy, and her career skyrocketed with professional photographer to take pictures of requests for her to model in England, France, her to display in his salon. They attracted the Japan and America at what would be $800/ attention of a fashion editor from the Daily hour today. Her arrival at Kennedy Airport in Express who arranged to meet her and took March 1967 created a media frenzy that in- additional photos. A few weeks later the cluded national magazines like Life, Newsweek, publication featured an article and pictures of and The New Yorker, which devoted almost 100 Hornby, calling her “The Face of ‘66.” With her pages to what was described as the “Twiggy” boyish thin build, crop haircut and heavy false phenomenon. In addition to her Twiggy en- eyelashes (wearing three pairs at a time), she dorsed or inspired dresses and all sorts of represented the teens of the swinging sixties. apparel, there were also skinny little Twiggy She was described as “The Cockney kid with a pens, Twiggy lunch boxes, Twiggy lashes, per- face to launch a thousand shapes... and she’s only fumes and cosmetics. All of this was quite 16.” She was also voted British Woman of the amazing considering her 66”, 112 lb. frame since Year. One month after the article, she posed she was originally considered to be too short for her first shoot for Vogue, and over the next to be a model except for head shots. Instead, year, was featured in over a dozen different she turned out to be the world’s first super model.

Twiggy was also the first Barbie doll to be fashioned after a real person as shown below. However, the Twiggy craze only lasted another year, and Toffler considered her to be another example of our “throw away” society. He listed several other instant celebrities who quickly became internationally famous, only to be replaced after a year or two by the latest fad.

Twiggy in 1967 1967 Twiggy Barbie Doll

October 2016 AIS Health and Stress www.stress.org the World Wide Web is what enables you to Information Overload, retrieve this information. The Internet And Google Nobody knows the size or scope of the Web is Future Shock also popularized the term “infor- since it is constantly growing. It is estimated mation overload”, which had been defined that every second, at least 7,000 Tweets are several years previously as a situation that sent, 1,140 Tumblrs are posted online, 733 occurs in organizations when “the amount of photos are posted on Instagram, in addition input to a system exceeds its processing capacity.” to 2,207 Skype calls, 55,364 Google searches, In recent years, variants of this such as “infor- 127,354 YouTube videos viewed, and over 2 mation glut” and “data smog” have emerged million e-mails sent. That’s the average for just to describe similar problems in other settings. one second, so you can imagine what it would Toffler correctly predicted that the exponential be for a week or a month. You would have to growth of electronic communication would multiply those numbers by 31,536,000 to get increase and result in an overwhelming accu- the figures for one year. There are now well mulation of data that would be difficult to over one billion sites on the Web, and as of July manage. An entire Newsletter could be devoted 2016, the Indexed Web contained at least 4.75 to this topic but a brief summary of the present billion pages. And that’s just the activity on the status of the Internet and The World Wide Web visible Web that is searchable via browsers. The should suffice. Although these terms are often Invisible Web is many thousands of times larger used interchangeably, the Internet connects than the Web content that can be retrieved networks at different physical locations, such with popular search engines. The reason it’s as office, home, satellites and even cell phones. called “invisible” is that search engine spiders The World Wide Web (www) is the system we meander throughout the Web, indexing the use to access information from the Internet by addresses of pages they discover. When these browsers like Explorer, FireFox, Safari or Google software programs run into a page from the Chrome. You can also access the Internet Invisible Web, they can record the address, but without a browser via e-mail and instant can’t access the information the page contains messaging. In other words, the Internet consists because university library and other sites of the machinery, hardware and data, and require passwords, or the content is in a pro-

October 2016 AIS Health and Stress www.stress.org prietary script that cannot be deciphered. The generates about 104,000,000 replies and Invisible Web contains approximately 550 “stress and cancer” retrieves approximately billion individual documents compared to the 173,000,000 listings. Since it takes at least a one billion of the searchable Web. Since so minute to view 5 or 6 of these, it would take much data is added to both Webs daily, it is you more than three hours to evaluate 1,000, impossible to determine their size, although and that’s only a minuscule fraction of what’s you can estimate their content. available. As a result, most searches involve Assuming that each website has an only a few pages. Fortunately, Google lists these average of 6-8 pages, there are an estimated sites according to a rating system based on an 305,500,000,000 pages online, so printing algorithm that includes over 200 factors and them would require enough paper for 305 the websites ranked on the first page are the billion pages. And if you tried to download the ones they consider to be the most relevant and Web from your , it would take ap- useful. There is no manual intervention. Google proximately 11 trillion years. Google states the constantly reviews, adjusts and updates its Web has 30 trillion unique individual pages search results, so a website that is ranked 1st with information that is stored in the Google today could potentially not even make the 1st Index, which is now at 100 million gigabytes, page the following week. The American or a thousand terabytes. With respect to traffic, Institute of Stress has been on the first page the Internet is now in the “zettabyte” era. To for searches on stress and stress related topics put this in perspective, each zettabyte is 1,000 since its inception because the content is exabytes, one exabyte=1,000 petabytes, one constantly updated and considered to be petabyte=1,000 terabytes and one tera- authentic. byte=1,000 gigabytes. By the end of 2016, global Internet traffic will reach 1.1 zettabytes per year and since the Web has nearly doubled Prior to the widespread use of personal com- in size every year since 2012, it will likely reach puters, searching the literature required access 2 zettabytes by 2019. One zettabyte is the to the Index Medicus, a yearly publication which equivalent of 36,000 years of high-definition began in 1879. These huge bibliographic tomes video, which is the equivalent of streaming could usually be found only in medical school Netflix’s entire catalog 3,177 times in three libraries. Selected periodicals and books were minutes. Put another way, the amount of data reviewed but in some instances, only the titles travelling over the Internet in just three minutes and authors were listed and it was necessary is the digital equivalent of every motion picture to locate a library that had the particular issue ever made in the last 120 years. It is estimated of interest to obtain a copy. This could take that there are currently over 3 billion people weeks or months and was limited to publica- getting online worldwide and this will also tions that were at least a year or two old. In increase. Google processes over 40,000 search contrast, most Google searches take less than queries every second, which translates to over 45 seconds and access several databases, in- 3.5 billion searches per day and 1.2 trillion cluding MEDLINE, with its 26 million abstracts searches per year worldwide. and thousands of full-text biomedical articles from over 500 key English and foreign journals, If you did a search for “stress”, you would receive some of which may be only one or two months some 588,000,000 results, “what is stress” old.

October 2016 AIS Health and Stress www.stress.org phones enable us to not only take pictures but The Third Wave, automatically develop and send them to others Powershift And at no additional charge, we pump our own gas, and stores like Home Depot allow us to pur- Revolutionary Wealth chase and install many products that previ- ously required professional services. Toffler Future Shock was published in 1970 and was predicted that this “Third Wave” would be a followed in 1980 by The Third Wave, which powerful tide of sweeping social revolution as warned that drastic and rapid changes in we evolved into an information-age society. lifestyles, work ethics and sexual attitudes While Future Shock was about the process of threatened entrenched economic and political change, The Third Wave dealt with the struc- practices that would tures of change. He warned that it was essen- strain coping mecha- tial to design systems that would prepare us nisms. From Toffler’s for changes, but there appeared to be little perspective, the first interest in this, as noted in the following: wave or major change in civilization came from In education, we need to begin paying attention the agricultural revolu- to matters routinely ignored. We spend long hours tion that began around trying to teach a variety of courses on, say, the 10,000 years ago with structure of government or the structure of the the transition from amoeba. But how much effort goes into studying hunting and gathering the structure of everyday life — the way time is to the ability to farm crops. This progressively allocated, the personal uses of money, the places expanded and was followed by the second to go for help in a society exploding with com- wave of in the late 18th plexity? We take for granted that young people and early 19th century with the development already know their way around our social struc- of machinery to supersede hand production, ture. In fact, most have only the dimmest image the increasing use of steam and water power of the way the world of work or business is orga- and the advent of the factory system. Newt nized. Most students have no conception of the Gingrich, the former Republican speaker of the architecture of their own city’s economy, or the House, said The Third Wave had immensely way the local bureaucracy operates, or the place influenced his own thinking and was “one of to go to lodge a complaint against a merchant. the great seminal works of our time” and Steve Most do not even understand how their own Case said “It really inspired me to start what schools — even universities — are structured, let became AOL five years later.” In 1985, it was the alone how much structures are changing under 2nd best seller in China and retained this the impact of The Third Wave. ranking for decades. The third book in this trilogy was Powershift: The Third Wave also introduced the term Knowledge, Wealth and Violence at the Edge of “”, when Toffler predicted that the the 21st Century, published in 1990. It defined role of producers and consumers would begin power as the ability to make people or nations to blur and merge as people were doing more act in any way you chose, and suggested we tasks that were traditionally done by others. were undergoing a major transformation of ATM machines have replaced tellers, smart- the traditional relationships between the three

October 2016 AIS Health and Stress www.stress.org forms of power: violence, wealth and knowl- research and innovation were devoted to labs for edge. The most basic form is violence by phys- designing and testing new organizational and ical domination from armies and police forces, institutional structures, we might have a much or superior weaponry. Violence prevailed in broader range of options to head off the looming ancient times and the Middle Ages but has implosion.” now lost much of its utility since it can only be used to punish, which often precipitates Toffler wrote 13 books and many articles that revenge. Wealth can be utilized to both punish made numerous accurate predictions. In or reward, since money can be exchanged for addition to his influence on and almost all types of goods and services, but like Steve Case he also inspired other powerful violence, its availability is limited. Toffler political leaders and entrepreneurs, including explains that the highest form of power is Chinese prime minister and former knowledge which can be used to acquire both violence and wealth, is able to reward as well Soviet leader . J.D. Power as punish, is freely and instantly accessible, and cited Toffler as a mentor and has unlimited availability. “The illiterate of the credited Toffler with motivating him to start 21st Century are not those who cannot read and CNN in 1980. It is therefore difficult to write but those who cannot learn, unlearn and determine the range and magnitude of Toffler’s relearn.” His last book, Revolutionary Wealth: legacy, but it will likely be far greater than even How it Will BeCreated and How it Will Change he could have forseen. our Lives, published in 2006 significantly expands on this. “If just a tiny fraction of the Paul J. Rosch, MD. FACP sums spent on scientific and technological Editor-in-Chief

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