Ivan Pavlov demonstrated that animal behavior could be established or erased by exposure to stress. In one experiment, he could make a dog react aggressively to caretakers with whom the dog was previously very loyal. This type of behavioral change as a result of exposure to stress has also been seen in prisoners of war.

Stress increases our suggestibility. When we feel we have lost control over the situation, what we believe and like can completely change.

In a study of 17,000 British civil servants, the workers with the lowest perceived control over their work environment had an significantly increased risk of cardiovascular disease. Those in low-grade jobs with near- zero control were more than four times as likely to have a heart attack.

When you feel you’re not in control, increased cortisol levels suppress your immune system and increase your susceptibility to disease. Stress can lower your insulin levels and slow down your body’s natural repair processes. Emotional stress can create longer recovery times in our bodies, affecting concentration and memory, increasing the risk of high blood pressure, heart disease, diabetes, back and stomach problems, headache and depression.

Zero stress does not mean you glide through every day without challenges. Dr. Hans Selye said, “The complete freedom from stress is death.” The secret is focusing on things that are within your control, versus those that are outside of your control. 13% of the population takes antidepressants, up 65% since 2002 (Source: National Center for Health Statistics). Is it possible a perceived lack of control in our lives has something to do with this explosive growth in the number of medicated Americans?

If you stress about things outside your control, you will never be happy or effective in life. However, if you focus on things that are within your control, even when challenges and emotional or physical stress arrive, you’ll be prepared to engage and learn from each experience. You can achieve happiness and effectiveness when you focus on those things that are within your control.

"I've suffered a great many catastrophes in my life. Most of them never happened."

– Mark Twain

If I had a penny for each time I sat across the table from an orthodontist or small business owner who is struggling to grow the business, only to find out the majority of his or her day is spent worrying about and focusing on things outside of their control, I’d have enough pennies to stretch to the moon and back.

Today, make a list of everything within your control and everything that is not. What areas of stress in your practice are outside your control? How can you redirect your focus away from those areas? How can you focus only on the things within your control? When I started asking myself these questions, I grew the practice dramatically and quickly. Start asking the right questions, especially when the answers can lower your stress and increase your control and effectiveness.

— Dustin S. Burleson, DDS, MBA