When Status Feels Unsafe: Stress, Cortisol, and the Psychology of Social Rank
A social endocrinology lens therapists are rarely taught, but often need. Especially when anxiety is driven by comparison, visibility, and perceived status.
Many therapists (like myself) are trained to think psychologically: beliefs, schemas, systems, attachment, learning histories, trauma, behaviour.
Far fewer of us are trained to think endocrinologically about social experience.
Endocrinology: the branch of physiology and medicine concerned with endocrine glands and hormones.
Social endocrinology is a field that sits at the intersection of biology, psychology, and social context.
It examines how hormones, particularly stress hormones like cortisol, respond to social conditions such as hierarchy, power, status, control, and belonging.
Despite its relevance, social endocrinology is rarely taught in clinical training. By chance one of the leading social endocrinology researchers was a teacher on my MSc course and I was hooked ever since. Over the last few months, I’ve been revisiting social endocrinology research on stress, hierarchy, and social rank in regards to workplaces in order to aid clinical work.
This article is a summary and if you’re a clinician I hope it helps with understanding clients, and if you’re a client, I hope it helps in understanding yourself!
Cortisol, Stress, and Hierarchy: A Brief Overview
Research into stress hormones and social hierarchy began in the 1980s, initially through studies of non-human primates living in stable hierarchies.
A consistent finding1 emerged:
High status is associated with lower cortisol - but only when that status is stable.
Low status and/or or threatened status, is associated with elevated cortisol.
Quite terrifyingly, or liberating, depending on which way you see it, Sapolsky, one of the early leaders of the research, concluded: ”I don’t think it’s possible to look at this whole range of ways in which our behaviour is being shaped by biology and see a shred of possibility of free will sitting in there.”2
The research has since spanned into humans and workplaces, which is incredibly helpful for understanding a range of mental health difficulties.
Across multiple studies:
Individuals higher in organisational hierarchies tend to show lower baseline cortisol and lower anxiety, when their position feels secure3. Importantly, this is a felt sense. For those with imposter syndrome, social anxiety, self esteem difficulties and more, it could be theorised that the felt sense of security is never felt despite high status.
When high status is unstable or under threat (e.g. restructures, big tasks going wrong, other people being promoted, lack of growth) cortisol increases, recovery from stress slows, and the physiological response begins to resemble that seen in chronically low-power positions4
Unstable power and status reliably triggers a threat response5.
The positive impact of status was meditated by a psychological sense of control that status often (but not always) confers.6
This particularly matters because cortisol influences:
attention and threat scanning
memory consolidation
emotional reactivity
behavioural inhibition or freezing
As therapists, we often see the symptoms of this in our therapy rooms, combined often with cognitions that sound like:
“I’m not doing good enough”
“I don’t belong here”
“I’m an imposter”
“One mistake could cost me everything”
The moment I used to hear ‘I’m not doing good enough’ I had a tendency to move towards a core belief or self esteem issue. Social endocrinology suggests this is how we are wired when it comes to these specific hierarchical environments. When this threat response combines with social/performance anxiety, low self esteem, anxiety in other difficulties, it likely enhances their intensity and symptoms.
It is also important to acknowledge that some environments exploit these biological threat responses on purpose, particularly where discrimination, exclusion, or unequal power are present, by keeping certain individuals or groups in a chronically low-status or unstable positions.
Hierarchy Is Not Always Obvious or Real
One important nuance is across literature is that hierarchy is not always specific, it can be:
Structural (job titles, authority, seniority)
Relational (friendship groups, family systems, society, community)
Symbolic or projected (“everyone here is more competent than me”)
Two people can occupy the same objective position and experience entirely different biological stress responses, depending on their perception of the situation. This is where our work often comes in.
The Role of Control: External and Internal
The research consistently highlights sense of control as the key mediator between status and stress7.
Although not always explicitly defined, clinically this seems to include at least two dimensions:
External control
“I have some influence over outcomes.”
“There are actions I can take.”
“I can prove myself and recover.”
Internal control
“I can cope if this goes badly.”
“I can regulate myself.”
“I won’t collapse or be overwhelmed.”
When compromised, cortisol remains elevated - regardless of objective rank.
In my own clinical work, this understanding has been especially useful when working with clients in high-visibility or evaluative roles, including leadership positions, public-facing work, professional performance, or roles where credibility feels constantly under review. Positions where one’s performance or competence feels consequential, regardless of actual seniority.
Importantly, similar dynamics often emerge within family systems where status is implicitly organised around roles, comparison, or achievement. Some families operate with clear (if unspoken) hierarchies, such as the “successful one,” the “responsible one,” etc. However, most of the social endocrinology hierarchy research is focused on workplaces, due to the quantifiable hierarchical nature making it easier to evaluate.
Nonetheless, in these contexts, status evaluation can feel ongoing, and a person’s position in the family may feel constantly unstable. For individuals who grew up needing to maintain a particular role to preserve belonging, approval, or status, not only is this likely often attachment trauma that we’re used to working with, it also activates the endocrinological response we’re already programmed for.
What do you think? Does this resonate in your work, or with clients you see? Do you think we should have more training on these responses? I’m curious to hear your thoughts!