Similar Feeling, Different Mechanism
The phrases “I’m very tense” and “I’m very stressed” are often used interchangeably. They evoke similar feelings. But the underlying physiological processes are different—and this difference directly affects the intervention.
An intervention targeting the wrong mechanism will be ineffective. Stress management techniques for tension, or just a massage for stress—both remain superficial.
Chronic Stress: The Hormonal Burden
Robert Sapolsky’s comprehensive research on stress (Why Zebras Don’t Get Ulcers, 2004) clarifies the physiology of chronic stress. The underlying mechanism: Chronic activation of the HPA (hypothalamic-pituitary-adrenal) axis keeps cortisol levels constantly elevated.
Cortisol is a hormone designed for acute stress. It is functional during a short-term threat response—it raises blood sugar, accelerates the immune response, and mobilizes energy. But when it becomes chronic, the opposite occurs: the immune system is suppressed, the hippocampus shrinks, the cardiovascular burden increases, and sleep is disrupted.
Sapolsky calls this “allostatic load”—the cumulative physiological debt that the chronic stress response imposes on the body.
Chronic Tension: Musculoskeletal Load
Chronic tension operates through a different mechanism. It involves muscle fibers remaining in a state of prolonged, low-level contraction. This contraction may stem from autonomic nervous system activation but can also become established as an independent, persistent process.
Thomas Hanna’s concept of “sensorimotor amnesia” (Somatics, 1988) explains this process: the brain learns to keep the muscles contracted as a neural pattern, and this pattern becomes automatic over time. Even if the source of stress has disappeared, muscle tension persists.
Bessel van der Kolk’s research shows that this tension persists chronically, particularly in the neck, shoulders, diaphragm, and hip flexors (The Body Keeps the Score, 2014).
How Do the Two Feed Into Each Other?
These are two independent processes—but they often occur together and reinforce each other.
Chronic stress increases sympathetic activation → this raises muscle tone → chronic tension sets in. But it can also work the other way around: chronic tension makes the nervous system more prone to perceiving threats through interoceptive signals → the stress response is triggered more easily.
Knowing where to break this cycle clarifies the intervention.
Different Interventions
For chronic stress: Approaches that regulate the HPA axis — regular sleep, aerobic exercise (for cortisol metabolism), social connection, mindfulness. These target hormonal balance.
For chronic tension: Direct intervention on the musculoskeletal system — somatic movement, yoga, manual therapy, breathing exercises (especially for diaphragmatic movement). These target neuromuscular patterns.
In both cases, body awareness—being able to distinguish what is being felt in which area—is the starting point for intervention.
“Stress is a physiological burden; tension is a bodily memory. The two speak different languages.” > Adapted from Thomas Hanna, Somatics, 1988
Cevvela’s Perspective
- Chronic stress is hormonal (HPA axis activation, cortisol load), while chronic tension occurs at the musculoskeletal level (neuromuscular pattern)—different mechanisms, different interventions (Sapolsky, 2004; Hanna, 1988).
- Allostatic load is the cumulative physiological burden accumulated by the body as a result of the chronic stress response.
- The two can feed into each other in a cyclical manner; knowing at which point to intervene increases effectiveness.
- Chronic tension can persist even after the stressor has been removed—the mechanism of sensorimotor amnesia (Hanna, 1988).
- In this context, coaching can integrate a somatic approach to discern bodily signals and select appropriate regulatory tools for each mechanism.
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