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Your Attitude May Be Killing You
Do You fret that you are always falling behind in the things you should or could do,
and do you try to do more and more things in less and less time?
Do you become highly irritated when you aren’t seated in a restaurant immediately,
or when your plane is delayed, or when traffic holds you up?
Are you so competitive that you get angry when a child beats you at a game?
Do you clench your jaws thinking and double your fists during ordinary conversations?
If this sounds like the real you, research at Mount Zion Hospital and Medical Center
in San Francisco suggests you are a heart attack waiting to happen. For many years. Dr. Meyer
Friedman of Mount Zion’s Harold Brunn Institute and Dr. Ray Rosenman, now of Stanford Research International, have studied the relationship between personality and heart attacks.
They’ve concluded that personality traits are a major factor in heart attacks-more important than obesity, high blood pressure and even cigarette smoking.
The two cardiologist have dubbed people whose personality traits put them at highest risk Type A, and those at lowest risk Type B . Says Friedman, “At least 90 percent of all patients having heal-t attacks under age 60, we’ve found, exhibit a Type A behavior pattern.” This means that heart disease involves psychological, social and environmental factors that have been inadequately explored. “The physician must look at the patient as well as his cholesterol,” say the two researchers. Most Americans are a combination of Type A and Type B behavior patterns; the more Type A an individual is, the greater the risk. Friedman and Rosenman estimate that ten percent of urban males are severe Type A and ten percent pure Type B. Women until recently were more often Type B. “By custom they are not put in a socioeconomic milieu that encourages speed and aggression,”
Friedman explains. But as times change, so does the role of women in society, and women’s liberation has produced a corresponding jump in heart attacks among women.
The idea that a life-style and its stresses can be a factor in heart disease is far from universally accepted. But it is winning converts as other researchers confirm these statistical and bio-chemical findings.
Friedman and Rosenman became interested in personality patterns in the late l950s, while both were at Mount Zion doing
research into the role of cholesterol as a factor in heart attacks.
With the cooperation of a women’s club, they tried to determine if higher coronary rates in men resulted
because their diets were different from their wives’. The study showed the diets and blood cholesterol were basically the same. The club president then suggested the two doctors look at what was really killing off males the way they drove themselves.
In 1960, the Mount Zion team screened 3524 male volunteers agcd 39 to 59 and classified them by personality types .
Some 3000 of the volunteers were studied for up to 8/2 years. Among them, Type As were found to have at least twice as many heart attacks as Type Bs. Moreover, the researchers subsequently discovered that a Type A’s coronary is twice as likely to be fatal; and As who survive their first heart attack have several times more risk of suffering a second.
Even more surprising, Type As who never smoked cigarettes had nearly the same heart-attack rate as Type Bs who smoked.
The researchers use special interviews to aid them in classifying personality types. But they find that how questions are answered-the tone of voice, volume, physical movements and expressions is a better indicator than the answers themselves.
The classic Type A personality the really high-risk individual is habitually impatient. constantly under stress from an urgent, pressing feeling that he hasn’t enough time, His body movements are brisk. He speaks in explosive, hurried speech, and his body seems always tense, never relaxed. He is often obsessed with numbers–of sales made, articles written, forms completed
and prone to vent hostility in verbal abuse, even on family or friends.
“The two characteristics of Type A behavior are ‘hurry sickness’ and ‘free-floating hostility,’ ‘’say the researchers.
Such individuals are in what they call a “chronic, continuous struggle.” If this struggle is not abated, they suspect, it will do little good to alter one’s diet, smoking or exercise habits. The behavior pattern is more a state of mind than station in life. “There are plenty of As among truck drivers,” notes Friedman.
Type B peoples by definition, have personalities that are the opposite of Type As. This doesn’t mean Type B people are incapable of hard work, achievement, and advancing to lofty positions. In fact, they generally make better executives because they don’t rush decisions, make snap judgments, or antagonize their subordinates. “The B type knows his capabilities and limitations,” says Friedman. “The A doesn’t, and doesn’t wish to.”
Type As abound among trial lawyers, TV performers, salesmen, auto racers and newspaper reporters. There seem to be more Type Bs among patent attorneys, government clerks and accountants.
The Mount Zion researchers can’t say precisely what produces a Type A personality, but they suspect that parental and social expectations play a large role. Most parents want their children to succeed, so they encourage, even force, them to
compete in school and outside. (Psychiatrists say some people spend their lifetimes trying to live up to impossible expectations instilled in them by their parents.) And Western society undeniably encourages Type A behavior by offering special rewards to those who can think, perform, communicate, and conduct their affairs more quickly and more aggressively than others. “For many, the stress has become almost unbearable ” says, Dr. Friedman. “Everybody is selling his time for money and the ‘good things’ money can buy. Many parole officers tell me they have to acclimate long-term prisoners to this increased pace of society before they are released.”
Type A behavior, then, is an outward expression of inner turmoil and desires. But the Mount Zion group has found that stress afflicting Type As apparently produces important physical changes as well, changes that may explain why Type As are far more susceptible to heart attacks. Type As have high cholesterol; increased norepinephrine, a vital chemical of the nervous system’, increased ACTH, a hormone that stimulates the adrenal glands; and low levels of growth hormone. Also, their blood clots faster than normal, and autopsy studies show that Type As average twice as much hardening of the coronary arteries as Type Bs. There is no scientific evidence as yet that changing a person’s behavior will prolong his life, although clinical impressions suggest that people who do change lengthen and improve the quality of their lives. Friedman himself suffered mild heart attacks in 1966 and 1971 and another attack in 1974. necessitating surgery. The attacks left him pondering his future. With some effort. he says, he managed to change some of his Type A behavior through what he calls ”re-engineering” and others call “behavior modification.” He and Rosenman have written a book, titled Type A Behavior and Your Heart, in which they outline some steps to help those who also want to “re-engineer”.
Curing “hurry sickness” is basic, and part of the cure lies in realizing that relaxation is not a luxury but a necessity. The Mount Zion doctors urge eliminating unnecessary events and activities; getting up 15 minutes early to give yourself more time to dress and talk with the family; slowing down your pace of eating and drinking; taking time alone to read, dream, and analyze your life. “As you sweat over something.” they say, “ask yourself if it’s really going to make a difference in your life five years from now.”
The two researchers strongly urge doing one thing at a time. “Remember,” they write, “that even Einstein, when tying his shoelaces, thought chiefly about the bow.” Make an effort to pay attention to people. Focus on what they are saying; don’t let your mind wander. If you find something you are doing tends to induce tension writing reports, balancing your checkbook, ironing take short breaks. And if a particular individual constantly angers you. find ways to avoid him or her. Perhaps the best thing to do about hostility is to keep reminding yourself you’re hostile, Friedman says.
This is a forewarned-is-forearmed approach. The thought will surface as your temper rises, and help you realize what’s happening. Then you can check your outburst.
lf all this sounds a bit like pop psychology, well, in a way it is. And if it seems rather hard to apply in real life, it is that, too. But the alternative, the doctors suggest, is even more unpleasant. ”if you don’t also change your Type A behavior patterns” says Rosenman, “other protective measures against heart attack–a healthy diet, exercises, no smoking–may be largely a waste of time.”
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