By Dayal Mirchandani
Overwhelming evidence proves that the state of the mind is a key factor in wellness. a happy, balanced mind leads to a healthy body
For centuries, physicians have been aware about the link between personality and disease. The famous Greek physician, Hippocrates, who lived from 460 BC until 377 BC, introduced the four human ‘temperaments’: choleric, sanguine, phlegmatic, and melancholic, and correlated them to disease. Much before this, in India, ayurvedic physicians had already recognized that one’s constitution is made up of the combination of different doshas. The proportion in which these doshas (vata, pitta, kapha), express themselves in one’s personality and body, is one’s prakruti, which is associated with susceptibility to different diseases. Traditional Tibetan medicine also relies on a typology i.e. hate/greed type, etc, to help in treatment and prevention of disease.
Of the earliest scientific studies on the role of personality and disease was that of Dr Caroline Thomas and psychiatrist Dr Barbara Betz, who, in 1948, studied a few hundred students at the John Hopkins School of Medicine and classified them as: Alpha (cautious, steady, self-reliant and non adventurous); Beta (spontaneous, clever and flexible); and Gamma (brilliant, confused and complicated). Thirty years later they found that the Gamma had the most medical problems with 77.3 per cent having some serious illness as compared to 25 per cent of Alpha and Beta. In another sample of 127 medical students, they found 13 deaths among those originally classified as Gamma compared to none in the other groups after 30 years.
Dr George Valliant, a psychiatrist at Harvard University, was another pioneer who studied the effect of mental health on physical health. Between 1942 and1944, he studied 185 medical students and followed their lives for over 40 years. He found that of the 59 men with the best mental health, only two became chronically ill or died before the age of 53. In a similar group of men with the worst mental health, 18 became chronically ill or died. He identified the ability to respond flexibly to change as a key trait that protected one from chronic illness and disease.
The last few decades the link between personality and disease has become much clearer, thanks to the research of Dr Meyer Friedman and Dr. Ray Rosenman. They proved beyond doubt that personality was an important factor in the causation of coronary artery disease. They studied 3,000 people in San Francisco in the 1970s and found that those exhibiting personality traits that they labeled Type A had a four times greater risk of developing heart disease. They found that cynicism and hostility were the most toxic traits. The increased risk for a Type A person is the same as that of someone who smokes two packets of cigarettes a day.
All these early researchers focused on pathology or the cause of disease in keeping with the traditional medical way of thinking. It has focused on the dark side of human nature. However, in the last few decades a new science of positive psychology has arisen that has focused on strengths and optimal states of fitness and performance. The focus has shifted to identifying the traits that contribute to a variety of things – remaining healthy through life, longevity, bringing up healthy well-adjusted children, marriages that last where both partners are happy, leaders who motivate people without harming them, people who are resilient and bounce back after tragedies, all types of artistic, business, creative genius…
One of the earliest studies that identified the characteristics of people who thrive on stress was in 1981 when, over the period of one year, Bell Labs downsized to nearly half its size. Dr Salvatore Maddi and his team studied the remaining executives, two-thirds of whom developed severe performance problems and health issues such as heart attacks, stroke, hypertension and depression over the next few years. There was a small group, however, that “thrived” despite the upheaval. They remained healthy, enthusiastic and performed well at work. What differentiated these two groups was their attitude. The healthy group had an inner sense of control and viewed the changes as a challenge. They were committed to mastering their work.
It is possible to learn these attitudes, as in the case of Smitha, an airhostess who experienced chronic fatigue and stress. The demands of looking after two children, a home, odd work timings and flights across international time zones left her too fatigued to enjoy her children. She enrolled in the Behavioural Science Foundation’s psychological resilience training programmed, and was surprised to find that within a few weeks she felt less stressed, more energetic. Her backache inexplicably disappeared. It had not responded to months of exercise, physiotherapy and painkillers.
As far as health is concerned, recent research shows that a happy disposition (not positive thinking), is one of the better predictors of health. Drs Dacher Keltner and LeeAnne Harker of the University of California at Berkeley studied the graduation photographs of the 1960 batch of a group of college students. Trained investigators used their smile as a guide and separated them into two groups: those that had a radiant smile (about half) and those with a perfunctory smile (those who did not smile at all were not included in the study). Follow up at age 52 revealed that women with the radiant smile were much more likely to be happily married with fewer divorces and to have a greater sense of well-being and health.
Study used the writings of 185 nuns at the time of their final vows to determine the levels of their feelings of joy and cheerfulness. This study showed that 90 per cent of the most cheerful and content were alive at age 85 compared to 34 per cent from the groups of nuns who were serious or unhappy.
Compare snippets from two nuns who lived under similar circumstances. Sr. Marguerite wrote, “I was born on September 25th ,1909, the eldest of seven children. I spent time teaching chemistry and second year Latin at Notre Dame. I intend to do my best for our order.” Sr. Cecilia writes, “God started my life off well and bestowed upon me grace of ineffable value. My years at Notre Dame were happy ones. I look forward with eager joy to receiving the holy joy in heaven of Our Lady.” Notice in her writing Sr. Cecilia used words like “happiness” and “eager joy” while the writings of Sr. Marguerite contained no such words. Sr. Marguerite died of a stroke at age 29 while Sr. Cecilia was alive and well until the age of 92.
Dr Dean Ornish has written a lot about the role of love and intimacy in preventing and healing heart disease. Research shows that people who have close relationships with many people are less likely to develop a heart attack. Loving connections are so crucial that having a dog reduces the risk of dying from a second heart attack by half in the year after a heart attack. The most telling findings about the importance of love and caring come from the Harvard Mastery of Stress study done in the 1950s on a group of undergraduate men at the university. A 35-year follow-up showed that “subjects who had illnesses such as coronary artery disease, hypertension, duodenal ulcer, and alcoholism in midlife, had used significantly fewer positive words to describe their parents (e.g., loving, friendly, warm, open, understanding, sympathetic, just) while in college. This effect was independent of the subject’s age, family history of illness, smoking behavior, marital history, and the death or divorce of the subject’s parents.” More important, 95 per cent of subjects who rated their parents low in parental caring had diseases diagnosed in midlife, whereas only 29 per cent of subjects who rated their parents high in parental caring had diseases diagnosed in midlife. Interestingly, another important factor that predicted good health was if the person perceived that his or her parents loved each other. In our busy world, we need to make time and demonstrate love and affection to our children if we want them to grow up happy and healthy.
The ability to express one’s emotions and share them with others is another determinant of health and well-being. Even writing about one’s emotions and feelings, has a positive effect on one’s health and well-being. Dr James Pennebaker at the University of Texas at Austin, is the pioneer who asked people to write about their deepest thoughts and feelings without censoring them, for 20 minutes each day, over three or four days. In one study of college students at a six-month follow-up, he found that their visits to the student health centre dropped by half. In another study, Pennebaker asked a group of executives, who had been laid off from their jobs, to write about their deepest thoughts and feelings surrounding the layoff and how their lives (personal and professional), had been affected. The participants who wrote about their feelings were much more likely to find re-employment in the months following the study than those who were asked to write about their general plans.
Other researchers such as Dr J.M. Smyth and colleagues at State University of New York reported in the prestigious Journal of American Medical Association, 1999, on a group of patients with asthma who showed significant improvements in lung function up to four months after completing a three-day writing exercise, compared to control subjects with identical illness.
After the Holocaust, thousands of Jews who had survived the German death and torture factories moved to America. Writer William Helmreich randomly chose 170 survivors and interviewed them in depth about how they rebuilt their lives. This is described in his book, Against All Odds. He identified a number of the factors that led to successful lives, like social support and optimism. He found an important factor in building a good life was to find meaning in their experience and “interpret their survival in a way to give meaning to the rest of their lives.” Dr Victor Frankl, the well-known psychiatrist and Holocaust survivor, says in his book, Man’s Search for Meaning, “There is nothing in the world, I venture to say, that would so effectively help one to survive even the worst conditions as the knowledge that there is meaning in one’s life.” Numerous scientific studies bear this out. Spiritual practice and religious faith that develops a positive compassionate view of self is one way of finding meaning in a manner that nourishes one’s life, while paths that preach hate and cynicism have a detrimental effect on one’s health and well-being.
Dr Dayal Mirchandani, MD, DPM, is a psychiatrist based in Mumbai. He can be contacted on firstname.lastname@example.org
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