Personality and Disease

• Continued from Week 5

Personality and Disease

• PersonalityPersonality: The sum total of your habits, attitudes, and : The sum total of your habits, attitudes, and traits that traits that

• make you make you the person you arethe person you are……

• The pattern of behaviors that distinguish you The pattern of behaviors that distinguish you from from everyone elseeveryone else……

• Your Your uniqueunique way of responding to your environment. way of responding to your environment.

• The individual’s The individual’s uniqueunique constellation of consistent constellation of consistent behavioral traits…behavioral traits…

• Two qualitiesTwo qualities: consistency & distinctiveness: consistency & distinctiveness

Foundations•The theory that personality affects The theory that personality affects

health is not a new notion…health is not a new notion…

•The notion that a certain “personality The notion that a certain “personality type” leads to heart disease dates back type” leads to heart disease dates back 2,000 years to Hippocrates…2,000 years to Hippocrates…

•What is new is a recent flood of scientific What is new is a recent flood of scientific data that lends more credible evidence data that lends more credible evidence to the notion.to the notion.

Hans Eysenck & Grossarth-Maticek (psychologists)Hans Eysenck & Grossarth-Maticek (psychologists)

•Ronald Grossarth-Maticek (G-M), Yugoslav Ronald Grossarth-Maticek (G-M), Yugoslav psychologist, claims to have shown that psychologist, claims to have shown that personality attributes lead to cancer and personality attributes lead to cancer and heart disease…heart disease…

•Together with Hans Eysenck, G-M has Together with Hans Eysenck, G-M has developed psychotherapy that seems to developed psychotherapy that seems to reshape personality enough to reshape personality enough to prevent the prevent the onsetonset of both diseases and to of both diseases and to prevent them prevent them from gettingfrom getting worseworse..

•G-M claims that personality type predicts G-M claims that personality type predicts death from cancer death from cancer 6 times better than 6 times better than smokingsmoking..

Prospective Study, mid Prospective Study, mid 1960s1960s

•In a forward-looking study, G-M measured In a forward-looking study, G-M measured the personality characteristics of the personality characteristics of thousands of persons and followed them thousands of persons and followed them for 10 years…for 10 years…

•G-M was trying to show that personalities G-M was trying to show that personalities characterized by repressed emotions and characterized by repressed emotions and hopelessness/helplessness are “cancer-hopelessness/helplessness are “cancer-prone personalities…”prone personalities…”

•Personalities exhibiting hostility and Personalities exhibiting hostility and cynicism (free-floating hostility and non-cynicism (free-floating hostility and non-directed anger) are “heart-disease prone directed anger) are “heart-disease prone personalities.”personalities.”

Personality Type & Disease:Personality Type & Disease: Is there a Connection? Is there a Connection?

•““Most people, whether they know it or not, Most people, whether they know it or not, associate certain personality types with associate certain personality types with particular illnesses…”particular illnesses…”

•Workaholics have heart attacks?Workaholics have heart attacks?

•Worriers get ulcers?Worriers get ulcers?

•Uptight people get asthma?Uptight people get asthma?

•What we know is that personality probably What we know is that personality probably plays an important role in determining our plays an important role in determining our health status.health status.

Disease and Personality: 4-ViewsDisease and Personality: 4-Views

1.1. The Generic ViewThe Generic View

2.2. The Disease Personality The Disease Personality ViewView

3.3. The Disease Cluster ViewThe Disease Cluster View

4.4. The Personality Cluster ViewThe Personality Cluster View

1. The Generic View1. The Generic View

•The generic (general, non-specific) view is The generic (general, non-specific) view is that there is a kind of personality which is that there is a kind of personality which is more prone to sickness but there is no more prone to sickness but there is no specific heart attack personality or cancer specific heart attack personality or cancer personality. There are personality. There are personality traitspersonality traits which may predispose one for illnesses.which may predispose one for illnesses.

2. The Disease 2. The Disease Personality ViewPersonality View

•This view believes that specific diseases This view believes that specific diseases are linked to specific personality types. are linked to specific personality types. There is a “coronary-prone” personality There is a “coronary-prone” personality and a “cancer-prone” personality.and a “cancer-prone” personality.

•The Type “A” personality is more likely to The Type “A” personality is more likely to have a heart attack than the Type “B.”have a heart attack than the Type “B.”

3. The Disease Cluster 3. The Disease Cluster ViewView

• This view takes the position that a specific personality This view takes the position that a specific personality predisposes the person to a “cluster” of conditions, not a predisposes the person to a “cluster” of conditions, not a specific disease.specific disease.

• There are 3 personality typesThere are 3 personality types: Alphas, Betas, and Gammas.: Alphas, Betas, and Gammas.

• AlphasAlphas are slow and cautious, wary in new situations, are slow and cautious, wary in new situations, undemanding. Low probability of illness.undemanding. Low probability of illness.

• BetasBetas are cool and clever, quick to respond to new are cool and clever, quick to respond to new situations, articulate and insightful. Healthiest group.situations, articulate and insightful. Healthiest group.

• GammasGammas are moody, too careful or else reckless, generally are moody, too careful or else reckless, generally intellectually bright, confused in new situations, either intellectually bright, confused in new situations, either demanding or not demanding enough. Highest illness demanding or not demanding enough. Highest illness group.group.

4. The Personality Cluster 4. The Personality Cluster ViewView

• Instead of relying on specific personality types or Instead of relying on specific personality types or personality traits, this view focuses on “cluster personality traits, this view focuses on “cluster groups,” groups who have similar personality groups,” groups who have similar personality types. Five types. Five clustersclusters have been identified: have been identified:

• The Clusters:The Clusters:

1. Characterized by depression, hopelessness, chronic fatigue, physical weakness, severely low self-esteem.

2.2. People who are People who are mildly neuroticmildly neurotic and tend to and tend to convert psychological problems into physical convert psychological problems into physical problems. Prone to heart disease, asthma, problems. Prone to heart disease, asthma, arthritis, cancer, and intestinal disorders.arthritis, cancer, and intestinal disorders.

The ClustersThe Clusters

3.3. Tend to be angry and moody, unpredictable, Tend to be angry and moody, unpredictable, nonconforming, emotionally shallow, nonconforming, emotionally shallow, plagued by social communication problems. plagued by social communication problems. Drug addiction commonDrug addiction common

4.4. People with People with serious neurosesserious neuroses who are bitter who are bitter and pessimistic. Back pain, peptic ulcers, and pessimistic. Back pain, peptic ulcers, colitis, multiple sclerosis typify this group.colitis, multiple sclerosis typify this group.

5.5. Closest to “normal.” Most likely to stay Closest to “normal.” Most likely to stay healthy.healthy.

Most & Least ControversyMost & Least Controversy

•Most controversialMost controversial is that that there is ANY is that that there is ANY personality that predicts illness.personality that predicts illness.

•Least controversialLeast controversial is the view that there is is the view that there is an “immune-prone” personality, a personality an “immune-prone” personality, a personality that is “hardy” to the effects of stress; Like that is “hardy” to the effects of stress; Like plant cultivars, varieties.plant cultivars, varieties.

•Most physicians today believe that emotions Most physicians today believe that emotions play a key role in the outcome (recovery rate) play a key role in the outcome (recovery rate) of illness but not in causing illness.of illness but not in causing illness.

The Cancer-Prone The Cancer-Prone PersonalityPersonality

•An attempt to identify specific personality An attempt to identify specific personality traits that predispose a person to cancer.traits that predispose a person to cancer.

•Blumberg’s researchBlumberg’s research (1950s) noted a (1950s) noted a personality characterized by an apologetic personality characterized by an apologetic and acquiescence nature. These people were and acquiescence nature. These people were sensitive, overly cooperative, and passive.sensitive, overly cooperative, and passive.

•Temoshok’s researchTemoshok’s research found that cancer found that cancer patients never seemed to express any patients never seemed to express any negative emotions – no fear, no sadness, no negative emotions – no fear, no sadness, no anger, no denial. They were “very nice anger, no denial. They were “very nice people.” This research resulted in the so-people.” This research resulted in the so-called Type “C” personality.called Type “C” personality.

Cancer-Prone PersonalityCancer-Prone Personality::“No expression of Emotion”“No expression of Emotion”

• LeShan’s researchLeShan’s research showed 3 specific life events common showed 3 specific life events common to cancer victims:to cancer victims:

1.1. A bleak childhoodA bleak childhood characterized by a tense, hostile characterized by a tense, hostile relationship with one or both parents, feelings of relationship with one or both parents, feelings of loneliness and isolation, unable to feel “safe” in loneliness and isolation, unable to feel “safe” in relationships.relationships.

2.2. An investmentAn investment is something that became the centerpiece is something that became the centerpiece of their existence (a job, a cause, a subject, a person).of their existence (a job, a cause, a subject, a person).

3.3. Something Something happened that took away their personal happened that took away their personal investment and emotional involvement and they were investment and emotional involvement and they were left with a void.left with a void.

What about Cancer & What about Cancer & Depression?Depression?

• Latest research shows that depression is NOT a good Latest research shows that depression is NOT a good predictor of who will develop cancer.predictor of who will develop cancer.

• The hallmark of the cancer personality seems to be a The hallmark of the cancer personality seems to be a lack of emotional expression, keeping things “bottled lack of emotional expression, keeping things “bottled up” inside…up” inside…

• Cancer patients tend to be loners, face the world with Cancer patients tend to be loners, face the world with bland, unemotional exteriors and tend to exhibit bland, unemotional exteriors and tend to exhibit helplessness and hopelessness.helplessness and hopelessness.

Personality & Rheumatoid ArthritisPersonality & Rheumatoid Arthritis

•An autoimmune disease wherein the body An autoimmune disease wherein the body attacks the collagen in connective tissue.attacks the collagen in connective tissue.

•Continuous Continuous anxiety and worryanxiety and worry are being are being looked at as possible predictors…looked at as possible predictors…

•Solomon and Moo’s studySolomon and Moo’s study identified identified chronic anxietychronic anxiety and and repressed hostilityrepressed hostility as as traits as well as traits as well as unassertivenessunassertiveness and a and a tendency to be tendency to be inhibitedinhibited....

Personality and UlcersPersonality and Ulcers

•Best correlation exists for frustration, Best correlation exists for frustration, hostility, and resentment for increased hostility, and resentment for increased secretion of gastric acidity. (In addition to secretion of gastric acidity. (In addition to tobacco, coffee, and aspirin)tobacco, coffee, and aspirin)

•The ulcer personality is characterized by The ulcer personality is characterized by excessive dependency on others and a excessive dependency on others and a tendency to rely on other people in ways tendency to rely on other people in ways that are not healthy.that are not healthy.

Asthma PersonalityAsthma Personality

A 2005 study shows the predominance of neurotic characteristics and lowered Extroversion, Openness to Experience, Agreeableness and Conscientiousness were characteristics in asthmatics as compared to the general population.

Decreased Extroversion and Openness to Experience are observed as the severity and duration of the disease increases.

Further studies are necessary to clarify the relationships between personality and the severity and duration of the disease.

The Language/Meaning of Disease

• Christian: The fundamentalist message: Illness is basically a punishment from God for some sort of sin. The worse the illness, the more unspeakable the sin.

• New Age: Illness is a lesson. You are giving yourself this disease because there is something important you have to learn from it in order to continue your spiritual growth and evolution. Mind alone causes illness and mind alone can cure it. A yuppified postmodern version of Christian Science.

• Medical: Illness is fundamentally a biophysical disorder, caused by biophysical factors (from viruses to trauma to genetic predisposition to environmental triggering agents). You needn't worry about psychological or spiritual treatments for most illnesses, because such alternative treatments are usually ineffectual and may actually prevent you from getting the proper medical attention.

More Meaning...

• Karma: Illness is the result of negative karma; that is, some nonvirtuous past actions are now coming to fruition in the form of a disease. The disease is "bad" in the sense that it represents past nonvirtue; but it is "good" in the sense that the disease process itself represents the burning up and the purifying of the past misdeed; it's a purgation, a cleansing.

• Psychological: As Woody Allen put it, "1 don't get angry; I grow tumors instead." The idea is that, at least in pop psychology, repressed emotions cause illness. The extreme form: Illness as death wish.

• Existential: Illness itself is without meaning. Accordingly it can take any meaning I choose to give it, and I am solely response for these choices. Men and women are finite and mortal, and the authentic response is to accept illness as part of one's Finitude even while imbuing it with personal meaning.

Even More...

• Holistic: Illness is a product of physical, emotional, mental, and spiritual factors, none of which can be isolated from the others, none of which can be ignored. Treatment must involve all of these dimensions {although in practice this often translates into an eschewal of orthodox treatments, even when they might help.

• Magical: Illness is retribution. "I deserve this because I wished So-and-so would die." Or, "I better not excel too much, something bad will happen to me." Or, "If too many good things happen to me, something bad has to happen." And so on.

• Buddhist: Illness is an inescapable part of the manifest world; asking why there is illness is like asking why there is air. Birth, old age, sickness, and death - these are the marks of this world, all of whose phenomena are characterized by impermanence, suffering, and selflessness. Only in enlightenment, in the pure awareness of nirvana, is illness finally transcended, because then the entire phenomenal world is transcended as well.

Finally, Science say:

• Scientific: Whatever the illness is, it has a specific cause or cluster of causes. Some of these causes are determined, others are simply random or due to pure chance. Either way, there is no “meaning" to illness, there is only chance or necessity.

Page 218 Mind Matters

• Head-migraine is sexuality inappropriately displaced

• Lungs-capacity to take in life

• Bladder-”pissed off” at partner

• Genitals-rejecting our sexuality, sexual guilt

The Therapeutic Alliance

A doctor or practitioner who is a good communicator:

•Has respect for her patient. Good doctors understand that a sick or injured patient

is highly vulnerable. Being respectful goes a long way toward helping that patient

explain symptoms, take responsibility for decision-making, and complying with

instructions.

•Has the ability to share information in terms her patients can understand . It's OK

to use med-speak and complicated terms, but they should be accompanied by an

explanation at the same time.

Good Communicator

• Doesn't interrupt or stereotype her patients. It's easy for all of us to

interrupt when we know time is short or we are in a hurry, but a

practitioner who is a good communicator knows that if it can't be

done right to begin with, it will need to be done over. Listening

carefully and respectfully will go a long way toward better outcomes

for the patient.

• Has the ability to effectively manage patients' expectations. By

helping her patient understand what the next steps will be, and what

the possible outcomes and their ramifications might be, the doctor

can go a long way toward helping that patient understand his

problem.

The Stats

Doctors do more talking than listening. A new study published in (JAMA) found that 72% of the doctors interrupted the patient’s opening statement after an average of 23 seconds. Patients who were allowed to state their concerns without interruption used only an average of 6 more seconds.

Doctors often ignore the patient’s emotional health. A study of 21 doctors at an urban, university-based clinic found that when patients dropped emotional clues or talked openly about emotions, the doctor seldom acknowledged their feelings. Instead the conversation was directed back to technical talk.

More Stats

Doctors underestimate the amount of information patients want and overestimate how much they actually give.

• In one study of 20-minute office visits, doctors spent about 1 minute per visit informing patients but believed they were spending 9 minutes per visit doing so.

Doctors who can’t communicate are more likely to end up in court.

• An analysis of 45 malpractice cases found that many of the doctors being sued delivered information poorly and devalued the patient’s views

And More...

Patients aren’t perfect either. In one survey doctors rated 15% of their patients as “difficult. ““crocks” or “turkeys”-- researchers have identified common characteristics of patients that everyone agrees are hard to manage.

Patients described as “frustrating” by doctors     do not trust or agree with the doctor.     present too many problems for one visit.      do not follow instructions.     are demanding or controlling.

What Type Are you?

http://www.humanmetrics.com/cgi-win/jtypes2.asp