Review: Under Pressure

under pressure

Under PressureLisa Damour, Ph.D. New York: Ballantine Books, 2019.

Summary: A book on responding constructively to stress and anxiety so that it stretches and builds resilience in girls, and empowers them to alleviate unhealthy stress and anxiety.

School age children are reporting more stress and anxiety than ever. This is especially true among girls. Between 2009 and 2014, the number of girls reporting stress and anxiety jumped by 55 percent. Lisa Damour, a psychologist who works both in private practice, and with the Laurel School for Girls in the Cleveland area, has had plenty of experience addressing the stress and anxiety girls face, and distills the insights from her practice in this highly readable book.

Damour begins by distinguishing between stress and anxiety, and between healthy and unhealthy stress and anxiety. This in itself is important because stress and anxiety often are necessary elements in stretching experiences that result in enhanced performance, the development of one’s capacities, and the building of resilience. Unhealthy levels of stress and anxiety, by the same token, impair one’s physical and emotional well-being, and can contribute to a decline in performance.

She explores stress and anxiety through the multiple relationships girls must negotiate: with parents, other girls, boys, their school, and the wider culture. Often with parents, the key is to show care and interest without over-reacting, which only intensifies the anxiety. She reminds parents that “snit happens” and talks about “glitter storms” (remember snow globes?) that need to settle. Beginning by offering a drink, a snack and time to settle can be vital. She suggests that the monitoring of girls digital lives can lead to knowing too much, and, while not discouraging the practice, says that this is at best an adjunct to a relationship where the communication lines are open.

In beginning to talk about girls with other girls, she observes that “anxious is the new shy,” and it may not be a bad thing for girls to have a few good friends, rather than many. In fact, sometimes the larger the friend network, the more the problems. Social media creates a number of these problems, from crafting an online identity to interfering with sleep, which only intensifies anxiety. It’s a good idea to agree on turning off social media in the pre-bedtime hours, and not having phones in the bedroom.

The issues with boys range from harassment to negotiating sexuality. Damour has some of her strongest words here about the double standards in sex ed, the problems with the language of consent, and the different ways one may need to say no in different social situations. Her aim is that girls become comfortable and able to take pleasure in their bodies and make decisions about sex on the basis of when they want this intimacy with men and can enjoy it. She observes that the coupling of much casual sex and alcohol indicates girls are denying something in themselves when they engage in sex on those terms.

As she turns to school, she emphasizes that school should be stressful, that the academic challenges build capacity, and that a critical piece is ensuring that students have good recovery strategies. Also, girls tend to take school more seriously. She argues that girls often study excessively and inefficiently and need to develop more effective study strategies, particularly using practice tests and working on gaps. At the same time, she concedes that for girls with ambitions to get into elite schools, demanding schedules are unavoidable because of high admission standards and low acceptance rates. Here, I might like to have seen her ask more questions about the college admissions racket which turns high school into nothing more than college prep. Perhaps the most critical issue is that the pursuit of admission to a college or set of colleges is rooted in healthy personal aspirations rather than reputational or parent and social pressure.

Two elements in her treatment of girls in the culture stood out to me. One was the issue of “speaking while female” and the different standards girls and women face from male peers when making the same communications. She is realistic about the “verbal tool kit” girls need, including the understanding when one can be transparent, and when you are on “front stage.” The other area was the culture’s obsession with the form of a woman’s body. She observes that compliments focused on physical attractiveness may reinforce the obsession with form, and that focusing on physical function, often cultivated in team sports, enables women to feel good about what their bodies can do.

In her conclusion she suggests two questions that may helpfully be asked:

  1. “What is the source of all this stress?”
  2. Why am I anxious?”

These questions presume that stress and anxiety are messengers, and understanding the message, including when something is a challenge, and when something is not right, gives girls greater agency in their lives.

I thought this was a highly practical book that takes a thoughtful and nuanced approach to stress and anxiety–recognizing that it is a sign of something, and that one can grow when stress is at a healthy level, and needs to be heeded and addressed when unhealthy. Damour’s book lives in the tension of what is, and what ought to be, particularly in talking about issues like social media, sexuality, college admissions, and the double standards that persist in our culture. Purists who live in an “ought to be” world might not appreciate all her counsel.

I could see that this might be a book a parent and daughter might even read and talk about together to open up conversation about stress and anxiety. School staff, and those who work with youth in religious organizations will find this beneficial, especially in responding to the emotional storms that are an inevitable part of this season of life. Meeting the “rising tide” of stress and anxiety calmly and constructively is vital for this rising generation of girls.


Disclosure of Material Connection: I received this book free from the publisher via LibraryThing. I was not required to write a positive review. The opinions I have expressed are my own.

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