Hostility, not “Type A personality”, linked to heart disease

Don’t be mad

More research links hostility to coronary risk.

By Nadja Geipert

In 1959, cardiologists Meyer Friedman and Ray Rosenman observed in top medical journals that competitive, deadline-driven, hypervigilant men-so-called Type A personalities-faced a significantly increased risk for coronary heart disease.

Yet ensuing large epidemiological studies failed to confirm the connection, and most health psychologists abandoned the concept in the late 1980s in favor of a component often found in Type A people: hostility.

A meta-analysis presented by German researcher Michael Myrtek, PhD, in his chapter on heart disease, Type A and hostility in the recently published APA book “Contributions Toward Evidence-based Psychocardiology: A Systematic Review of the Literature” (see “One heart-many threats”) confirms that there is no significant association between Type A personalities and heart disease, but that there is a connection between hostility and coronary heart disease.

“The consensus is really that it is not all aspects of Type A behavior, but just the hostility component,” says Redford Williams, MD, director of the behavioral medicine research center at Duke University School of Medicine.

 

Healthy Boundaries

Healthy Boundaries

What are boundaries?

The word boundary in the American Heritage Dictionary is defined as “an indicated border or limit.” In relationships boundaries are often defined as the line that indicates where one person ends and the other begins. People with healthy boundaries have developed an identity separate and distinct from others and are not dependent upon others to nurture their personal and spiritual growth. Consider the following illustrations below:

Figure 1 illustrates healthy boundaries. In this relationship, the line between partners is easily identifiable. They are independent beings, yet they are close enough to be connected and to have an impact on each other’s life. In healthy relationships boundaries are flexible. They grow and change. Boundaries can be lowered to promote intimacy or extended to promote safety.

In Figure 2, it is difficult to distinguish one partner from the other. This is called enmeshment or collapsed boundaries. Partners in an enmeshed relationship generally try to merge with the other in order to avoid the emptiness they feel when alone. This is troublesome, because partners either seek to lose themselves in the other or expect their partner to become lost in them.

Figure 3 illustrates a relationship where each partner is completely self-contained, having very little impact on the other and very little emotional connection. This is called an emotionally detached relationship or rigid boundaries. The boundaries in this relationship tend to be more like walls and prevent intimacy.

What kind of boundaries do you have?

Look at the following characteristics to determine what kinds of boundaries you have:

HEALTHY BOUNDARIES

• You can say no or yes, and you are ok when others say no to you.
• You have a strong sense of identity. You respect yourself.
• You expect reciprocity in a relationship-you share responsibility and power.
• You know when the problem is yours and when it belongs to someone else.
• You share personal information gradually in a mutually sharing/trusting relationship.
• You don’t tolerate abuse or disrespect.
• You know your own wants, needs and feelings. You communicate them clearly in your relationships.
• You are committed to and responsible for exploring and nurturing your full potential.
• You are responsible for your own happiness and fulfillment. You allow others to be responsible for their own happiness and fulfillment.

• You value your opinions and feelings as much as others.
• You know your limits. You allow others to define their limits.
• You are able to ask for help when you need it.
• You don’t compromise your values or integrity to avoid rejection.

COLLAPSED BOUNDARIES

• You can’t say no, because you are afraid of rejection or abandonment.
• Your identity consists of what you think others want you to be. You are a chameleon.
• You have no balance of power or responsibility in your relationships. You tend to be either overly responsible and controlling or passive and dependent.
• You take on other’s problems as your own.
• You share personal information too soon. . .before establishing mutual trust/sharing.
• You have a high tolerance for abuse or being treated with disrespect.
• Your wants needs and feelings are secondary to others’ and are sometimes determined by others.
• You ignore your inner voice and allow others expectations to define your potential.
• You feel responsible for other’s happiness and fulfillment and sometimes rely on your relationships to create that for you.
• You tend to absorb the feelings of others.
• You rely on others opinions, feelings and ideas more than you do your own.
• You allow others to define your limits or try to define limits for others.
• You compromise your values and beliefs in order to please others or to avoid conflict.

RIGID BOUNDARIES

• You are likely to say no if the request involves close interaction.
• You avoid intimacy (pick fights, stay too busy, etc.)
• You fear abandonment OR engulfment, so you avoid closeness.
• You rarely share personal information.
• You have difficulty identifying wants, needs, feelings.
• You have few or no close relationships. If you have a partner, you have very separate lives and virtually no shared social life.
• You rarely ask for help.
• You do not allow yourself to connect with other people and their problems.

How do I change?

Understand that developing healthier boundaries (as with any life change) is a process, not an event. Thus, it will take time and practice. There are no quick fixes. However, healthy boundaries will lead to improved self-esteem and increased intimacy in your relationships. So the payoff is big, if you are persistent! Below are a few suggestions to help you stay on track in the process:

1. Identify the ways in which your boundaries are unhealthy. Make a list of how they express themselves in your life.

2. Write letters to yourself encouraging change and addressing the fears that work to prevent change. Nurture your right to have boundaries!

3. Make a list of personal rights (i. e. boundaries) in your relationships and paste it where you can read it often.

4. Keep a journal and record the pain associated with not maintaining healthy boundaries in your relationships. (Sometimes pain is a great motivator.)

5. Write an entry in your journal answering the question “Who Am I?” Do this periodically.

6. Look for role models of healthy boundaries in your life or in the media. When confronting a boundary challenging situation ask yourself “What would my role model do?” Better yet, if your role model is a part of your life, ask them!

7. Build in time for yourself away from your relationship on a regular basis. This will include alone time, time with your close friends, time for spiritual growth, and time to attend to life’s little responsibilities.

8. If you have difficulty saying ‘No,” look for opportunities to practice. If you have difficulty saying “Yes” to any activity that involves interacting with others, look for opportunities to practice.

9. Seek counseling to examine the roots of your unhealthy boundaries.

- author unknown at this time –

 

Time out technique for conflict reduction

THE TIME OUT

The “Time-Out” is a simple yet effective tool for changing angry violent and abusive behavior. The intention of the time out is not to offer long term solutions to conflict and anger problems. This tool is simply intended to offer a short term alternative to behavior that is no longer desirable.

The “Time-Out” is a technique that requires practice and commitment. Initial obstacles to taking a “Time-Out” may not be foreseen and so it is sometimes recommended that a practice “Time-Out” should take place before a real one is necessary.

There are four steps to the “Time-Out”

l. Identify that you are escalating to the point where you need to get out of the situation. Use the “cues” or red flags to help you get in touch with physical, emotional and situational cues that may help you to know where you are at with your anger.

2. Decide to take the time out before you become intimidating, threatening or physically abusive. Indicate to the other person/s that you are leaving. Do not make any long speeches at this point; simply say that you are taking a “Time-Out”. (Make sure that you have informed others about the “Time-Out” in advance.

3. Leave where you are and go outside. Do not simply go to another room of the house or workplace. It is important that you physically leave the site of the conflict. Don’t get “hooked” into staying in the conflict. Take one hour to calm down before coming back. lf you need longer, let the other person know this. Don’t “stomp out”!

4. Return and decide together whether or not to return to the discussion or issue that took place before you left.

DO	DO NOT
Think of other things	Drink/use drugs
Walk, cycle, run, etc.	Drive/ talk to unhealthy people
Talk to a positive support	Hit or strike anything
Come back in one hour	Rehearse the argument

Courtesy of Arla Sinclair Counselling

 

Anger really can kill you, U.S. study shows

Anger really can kill you, U.S. study shows

By Julie Steenhuysen

CHICAGO, Feb 23 (Reuters) – Anger and other strong emotions can trigger potentially deadly heart rhythms in certain vulnerable people, U.S. researchers said on Monday.

Previous studies have shown that earthquakes, war or even the loss of a World Cup Soccer match can increase rates of death from sudden cardiac arrest, in which the heart stops circulating blood.

“It’s definitely been shown in all different ways that when you put a whole population under a stressor that sudden death will increase,” said Dr. Rachel Lampert of Yale University in New Haven, Connecticut, whose study appears in the Journal of the American College of Cardiology.

“Our study starts to look at how does this really affect the electrical system of the heart,” Lampert said.

She and colleagues studied 62 patients with heart disease and implantable heart defibrillators or ICDs that can detect dangerous heart rhythms or arrhythmias and deliver an electrical shock to restore a normal heart beat.

“These were people we know already had some vulnerability to arrhythmia,” Lampert said in a telephone interview.

Patients in the study took part in an exercise in which they recounted a recent angry episode while Lampert’s team did a test called T-Wave Alternans that measures electrical instability in the heart.

Lampert said the team specifically asked questions to get people to relive the angry episode. “We found in the lab setting that yes, anger did increase this electrical instability in these patients,” she said.

Next, they followed patients for three years to see which patients later had a cardiac arrest and needed a shock from their implantable defibrillator.

“The people who had the highest anger-induced electrical instability were 10 times more likely than everyone else to have an arrhythmia in follow-up,” she said.

Lampert said the study suggests that anger can be deadly, at least for people who are already vulnerable to this type of electrical disturbance in the heart.

“It says yes, anger really does impact the heart’s electrical system in very specific ways that can lead to sudden death,” she said.

But she cautioned against extrapolating the results to people with normal hearts. “How anger and stress may impact people whose hearts are normal is likely very different from how it may impact the heart which has structural abnormalities,” she said.

Lampert is now conducting a study to see if anger management classes can help decrease the risk of arrhythmia in this group of at-risk patients.

Sudden cardiac death accounts for more than 400,000 deaths each year in the United States, according to the American College of Cardiology. (Editing by Maggie Fox and Vicki Allen)

 

Spanking can create defiant kids

Today’s issue of the *Arizona Republic* includes an article: “Spanking
can create defiant kids, report says.”

Here are some excerpts:

[begin excerpts]

Corporal punishment is not a good way to improve a child’s behavior and
might even make things worse.

The ineffectiveness of spanking or swatting may come as a surprise to
American parents, most of whom use physical punishment to teach their
children.

The findings are part of a new report that examined more than 100 years
of research and published studies on the physical punishment of children.

“The Report on Physical Punishment in the United States,” released this
week, is endorsed by the American Medical Association and the American
Academy of Pediatrics.

The study focuses not on child abuse but on spanking and other similar
punishments used by parents.

<snip>

The study is not an attempt to suggest that parents should be more lax
with their children.

“One of the last things we want to convey is that children should not be
disciplined,” said Dr. David Notrica of Phoenix Children’s Hospital.

<snip>

Gershoff’s study was a meta-analysis, meaning she statistically combined
the results of many different studies.

<snip>

She knows, however, that many parents spank or hit their children
because the parents were hit when they were kids and turned out fine.

<snip>

“(Children) learn from all the things around the spanking,” Gershoff
said. “They get how serious you are. You have their attention.
Sometimes, there is a talk after the spanking that really sinks in.”

The trick, she said, is to get the child’s attention without the spanking.

<snip>

Gershoff referred to three recent studies – in Pediatrics, Southern
Medical Journal and Psychology, Public Policy, and Law – which showed
that nearly two-thirds of parents with children 1 to 2 years old
reported using physical punishment and that 80 percent of children have
been physically punished by the time they reach fifth grade.

“Unfortunately, the fact that it is a violent act teaches the child
about violence,” said Dr. Roberta Hibbard, a member of the American
Academy of Pediatrics’ Child Abuse and Neglect committee.

“The underlying message is that violence is OK. It’s not OK.”

<snip>

In Gershoff’s reports, she says that when children were spanked, 85
percent of the studies showed there to be “less moral internalization of
norms for appropriate behavior and long-term compliance.”

There is evidence that Americans’ approval of physical punishment is on
the decline.

“The Report on Physical Punishment in the United States” points to a
long-running survey by the General Social Survey, which is funded by the
National Science Foundation.

It found that, in the 1960s, 94 percent of adults favored physical punishment.

By 1986, 84 percent of U.S. adults agreed that children sometimes need a
“good hard spanking.”

In 2004, the percentage had dropped to 71.3 percent.

Gershoff knows it will not be easy to change how parents raise their
children. She knows most parents who spank are doing so because they
think it is best for the child.

“It’s easier to see in the research because we can see so many children
and over so much time,” Gershoff said.

“I’ve read hundreds and hundreds of studies. Overwhelmingly, they find
that spankings are associated with negative outcomes. There is no
research that says spanking is good for kids.”

[end excerpt]

The article is online at:
<http://tinyurl.com/czxy2p>

[courtesy of Ken Pope]

 

On Anger

“If we could read the secret history of our enemies, we should find in each man’s life sorrow and suffering enough to disarm all hostility.”  –  Henry Wadsworth Longfellow

Speak when you are angry and you will make the best speech you will ever regret. Ambrose Bierce, THE DEVIL’S DICTIONARY

“I am beside myself”
“Move over. You’re in bad company”. Groucho Marx: A NIGHT AT THE OPERA.

It is my rule never to lose my temper till it would be detrimental to keep it. Sean O’Casey THE PLOUGH AND THE STARS.

Diplomacy is the art of fishing peacefully in troubled waters. J. Christopher Harold. BONAPART IN EGYPT.

A nation does not have to be cruel to be tough. FD Roosevelt.

 

Hostility linked to reduced lung function

*New York Times*: 6/19/2007

Hostile Outlook May Affect Breathing, Research Shows
By NICHOLAS BAKALAR

Having a hostile attitude may affect your breathing, a new study reports.

Using a sample of 4,629 healthy adults ages 18 to 30, researchers
determined hostility using a 50-item questionnaire and then administered
breathing tests to record objective measures of breathing efficiency and
lung capacity. The study appears in the May issue of Health Psychology.

After controlling for age, height, socioeconomic status, smoking and
asthma, high scores on the hostility test were consistently associated
with low scores on the measures of lung function in black men and women
and in white women. The more hostile the person was, the more lung
function declined. For each one-fifth increase in scores on the
hostility questionnaire, there was a corresponding decrease in scores on
the breathing tests. The association was not statistically significant
in white men.

The reasons for the link are unclear. The researchers did not examine
environmental influences on lung function other than smoking, so it may
be that some unknown environmental factors lead to both poor lung
function and increased hostility, or even that poor lung function causes
hostility.

“This is suggestive,” said Dr. Benita Jackson, the lead author and an
assistant professor of psychology at Smith College, “but we don’t know
for certain that hostility causes lung function decline. That’s where
more research is needed.

“The good news here is that unlike other exposures, like air pollution
or genetic predisposition, hostility is something that can be changed.”

 

Bottling up anger can shorten your life

American Association for the Advancement of
Science’s journal *Science* (Vol 319, Issue 5863, 1 Feb 2008 ) includes a
short article: “Bottling up anger can shorten your life, an unusual long-
term study of married couples in Michigan concludes.”

Here’s the article:

The study covers 192 couples in the Tecumseh Community Health Study who
were between the ages of 30 and 69 in 1971. To classify the men and
women as anger “suppressors” or “expressers,” researchers asked each of
them to imagine getting chewed out by a police officer or spouse for
something he or she hadn’t done. Anger suppressors were those who failed
to protest unfair attacks or felt guilty later if they had gotten mad.

The researchers, led by psychologist Ernest Harburg, now a professor
emeritus at the University of Michigan School of Public Health in Ann
Arbor, tracked mortality in the couples over 17 years, controlling for
age, smoking, weight, blood pressure, education, and heart and lung
problems. Among couples in which both members were anger suppressors,
the mortality rate was twice that of the other groups combined, the
researchers report in the January issue of the Journal of Family
Communication. Twenty-six of the couples (14% of the sample) were in
this category; there were 13 deaths, compared with 41 in the remaining
166 pairs.

Research on the “dyadic relationship” as a unit is rare, says Harburg,
who adds that two anger suppressors seem to have a synergistically
morbid effect on each other. Psychologist Janice Kiecolt-Glaser of Ohio
State University College of Medicine in Columbus says the data “add
weight to the growing evidence that poor emotional housecleaning has
health consequences in marriages.”

 

Men Have A Harder Time Forgiving Than Women Do

Case Western Reserve (3/4/2008 ) issued the following news release about research
published in the *Journal of Personality & Social Psychology*:

Men Have A Harder Time Forgiving Than Women Do

Forgiveness can be a powerful means to healing, but it does not come
naturally for both sexes. Men have a harder time forgiving than women
do, according to Case Western Reserve University psychologist Julie
Juola Exline. But that can change if men develop empathy toward an
offender by seeing they may also be capable of similar actions. Then the
gender gap closes, and men become less vengeful.