Personality and Disease Continued from Week 5 Personality

Personality and Disease • Continued from Week 5

Personality and Disease • Personality: The sum total of your habits, attitudes, and traits that • make you the person you are… • The pattern of behaviors that distinguish you from everyone else… • Your unique way of responding to your environment. • The individual’s unique constellation of consistent behavioral traits… • Two qualities: consistency & distinctiveness

Foundations • The theory that personality affects health is not a new notion… • The notion that a certain “personality type” leads to heart disease dates back 2, 000 years to Hippocrates… • What is new is a recent flood of scientific data that lends more credible evidence to the notion.

Hans Eysenck & Grossarth-Maticek (psychologists) • Ronald Grossarth-Maticek (G-M), Yugoslav psychologist, claims to have shown that personality attributes lead to cancer and heart disease… • Together with Hans Eysenck, G-M has developed psychotherapy that seems to reshape personality enough to prevent the onset of both diseases and to prevent them from getting worse. • G-M claims that personality type predicts death from cancer 6 times better than smoking.

Prospective Study, mid 1960 s • In a forward-looking study, G-M measured the personality characteristics of thousands of persons and followed them for 10 years… • G-M was trying to show that personalities characterized by repressed emotions and hopelessness/helplessness are “cancer-prone personalities…” • Personalities exhibiting hostility and cynicism (free-floating hostility and non-directed anger) are “heart-disease prone personalities. ”

Personality Type & Disease: Is there a Connection? • “Most people, whether they know it or not, associate certain personality types with particular illnesses…” • Workaholics have heart attacks? • Worriers get ulcers? • Uptight people get asthma? • What we know is that personality probably plays an important role in determining our health status.

Disease and Personality: 4 -Views 1. The Generic View 2. The Disease Personality View 3. The Disease Cluster View 4. The Personality Cluster View

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

2. The Disease Personality View • This view believes that specific diseases are linked to specific personality types. There is a “coronary-prone” personality and a “cancerprone” personality. • The Type “A” personality is more likely to have a heart attack than the Type “B. ”

3. The Disease Cluster View • This view takes the position that a specific personality predisposes the person to a “cluster” of conditions, not a specific disease. • There are 3 personality types: Alphas, Betas, and Gammas. • Alphas are slow and cautious, wary in new situations, undemanding. Low probability of illness. • Betas are cool and clever, quick to respond to new situations, articulate and insightful. Healthiest group. • Gammas are moody, too careful or else reckless, generally intellectually bright, confused in new situations, either demanding or not demanding enough. Highest illness group.

• 4. The Personality Cluster View Instead of relying on specific personality types or • The Clusters: personality traits, this view focuses on “cluster groups, ” groups who have similar personality types. Five clusters have been identified: 1. Characterized by depression, hopelessness, chronic fatigue, physical weakness, severely low self-esteem. 2. People who are mildly neurotic and tend to convert psychological problems into physical problems. Prone to heart disease, asthma, arthritis, cancer, and intestinal disorders.

The Clusters 3. Tend to be angry and moody, unpredictable, nonconforming, emotionally shallow, plagued by social communication problems. Drug addiction common 4. People with serious neuroses who are bitter and pessimistic. Back pain, peptic ulcers, colitis, multiple sclerosis typify this group. 5. Closest to “normal. ” Most likely to stay healthy.

Most & Least Controversy • Most controversial is that there is ANY personality that predicts illness. • Least controversial is the view that there is an “immune-prone” personality, a personality that is “hardy” to the effects of stress; Like plant cultivars, varieties. • Most physicians today believe that emotions play a key role in the outcome (recovery rate) of illness but not in causing illness.

The Cancer-Prone Personality • An attempt to identify specific personality traits that predispose a person to cancer. • Blumberg’s research (1950 s) noted a personality characterized by an apologetic and acquiescence nature. These people were sensitive, overly cooperative, and passive. • Temoshok’s research found that cancer patients never seemed to express any negative emotions – no fear, no sadness, no anger, no denial. They were “very nice people. ” This research resulted in the so-called Type “C” personality.

Cancer-Prone Personality: “No expression of Emotion” • Le. Shan’s research showed 3 specific life events common to cancer victims: 1. A bleak childhood characterized by a tense, hostile relationship with one or both parents, feelings of loneliness and isolation, unable to feel “safe” in relationships. 2. An investment is something that became the centerpiece of their existence (a job, a cause, a subject, a person). 3. Something happened that took away their personal investment and emotional involvement and they were left with a void.

What about Cancer & Depression? • Latest research shows that depression is NOT a good predictor of who will develop cancer. • The hallmark of the cancer personality seems to be a lack of emotional expression, keeping things “bottled up” inside… • Cancer patients tend to be loners, face the world with bland, unemotional exteriors and tend to exhibit helplessness and hopelessness.

Personality & Rheumatoid Arthritis • An autoimmune disease wherein the body attacks the collagen in connective tissue. • Continuous anxiety and worry are being looked at as possible predictors… • Solomon and Moo’s study identified chronic anxiety and repressed hostility as traits as well as unassertiveness and a tendency to be inhibited. .

Personality and Ulcers • Best correlation exists for frustration, hostility, and resentment for increased secretion of gastric acidity. (In addition to tobacco, coffee, and aspirin) • The ulcer personality is characterized by excessive dependency on others and a tendency to rely on other people in ways that are not healthy.

Asthma 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 medspeak 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 v 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. v 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 v • v • 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. . . v 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/cgiwin/jtypes 2. asp