Monday, August 3, 2009
In my most recent blog piece, I touched on a topic I admittedly know very little about - happiness. The piece stemmed from my latest reader poll which unambiguously validated our expertise in its diametric opposite - misery.
Boy, can we do misery (trust me, I can teach the subject on a graduate level). But what about happiness? Two months ago, I came across a terrific feature article in Atlantic Monthly by Joshua Shenk (author of Lincoln’s Melancholy), entitled, What Makes Us Happy? I’d been meaning to blog on the piece ever since, so better late than never:
Mr Shenk’s article is a tribute to the dedication and persistence of Harvard psychiatrist George Vaillant (pictured here), who accomplished the impossible by keeping what had been a 30-year longitudinal study going for an additional 42 years.
In 1937, a team of researchers recruited 268 male Harvard undergraduates, a cohort that included JFK, Ben Bradlee, and other luminaries. The original funding came from department store magnate WT Grant, and hence became known as the “Grant Study.”
Longitudinal studies - ones that track populations over long periods of time - typically die of neglect. Funding sources dry up after say five or ten years, and researchers have no choice but to turn off the lights. This is one reason we know so little about mental illness. If you want to know whether, say, depression is bipolar waiting to happen you need to follow the same people around for at least two decades. Try getting funders to commit to that.
Dr Vaillant took over the Grant Study in 1967 when it was on life support, but with the best years of life just ahead. The subjects were men of privilege destined to great lives, but by 1948 twenty of them displayed severe psychiatric difficulties. By age 50, nearly a third met Dr Vaillant’s criteria for mental illness.
Dr Vaillant is no stranger to mental illness. When he was 10, his father stuck a gun in his mouth and pulled the trigger. His mother immediately pulled up stakes and moved the family to Arizona. A clean break. No memorial service. No seeing the house ever again.
According to Shenk:
“His central question is not how much or how little trouble these men met, but rather precisely how—and to what effect—they responded to that trouble. His main interpretive lens has been the psychoanalytic metaphor of ‘adaptations,’ or unconscious responses to pain, conflict, or uncertainty.”
“Vaillant explains defenses as the mental equivalent of a basic biological process. When we cut ourselves, for example, our blood clots—a swift and involuntary response that maintains homeostasis. Similarly, when we encounter a challenge large or small—a mother’s death or a broken shoelace—our defenses float us through the emotional swamp. And just as clotting can save us from bleeding to death—or plug a coronary artery and lead to a heart attack—defenses can spell our redemption or ruin.”
The least healthy responses, according to Vaillant, include psychosis, which may make reality tolerable to the person experiencing them. A step up are “immature adaptations” that include various forms of acting out (such as passive-aggression). “Neurotic” defenses such as intellectualization, repression, and disassociation (removal from one’s feelings) are quite normal.
Healthy (mature) adaptations include altruism, humor, anticipation (looking ahead to future discomfort), suppression (a conscious decision to address issues later), and sublimation (finding outlets for feelings).
According to Mr Shenk:
"Much of what is labeled mental illness,” Vaillant writes, “simply reflects our ‘unwise’ deployment of defense mechanisms. If we use defenses well, we are deemed mentally healthy, conscientious, funny, creative, and altruistic. If we use them badly, the psychiatrist diagnoses us ill, our neighbors label us unpleasant, and society brands us immoral.”
This perspective is shaped by a long-term view. Whereas clinicians focus on treating a problem at any given time, Vaillant is more like a biographer, looking to make sense of a whole life—or, to take an even broader view, like an anthropologist or naturalist looking to capture an era. The good news, he argues, is that diseases—and people, too—have a “natural history.”
In their youth, the men were twice as likely to engage in immature defenses over mature ones, but as they grew into middle age they were four times more likely to use mature ones, a pattern that continued into old age.
As well as healthy adaptations, education, stable marriage, not smoking, not abusing alcohol, some exercise, and healthy weight proved reliable indicators for happy lives. As Shenk describes it:
“Of the 106 Harvard men who had five or six of these factors in their favor at age 50, half ended up at 80 as what Vaillant called ‘happy-well’ and only 7.5 percent as ‘sad-sick.’ Meanwhile, of the men who had three or fewer of the health factors at age 50, none ended up ‘happy-well’ at 80. Even if they had been in adequate physical shape at 50, the men who had three or fewer protective factors were three times as likely to be dead at 80 as those with four or more factors.”
And this sobering nugget: “Of the men who were diagnosed with depression by age 50, more than 70 percent had died or were chronically ill by 63.”
Ironically, according to Vaillant, positive emotions make us more vulnerable than negative ones. Whereas negative emotions tend to be insulating, positive emotions expose us to rejection and heartbreak.
Perhaps it takes a brave individual to be happy. Perhaps happiness does not elude us so much as we elude it. Food for thought ...
Much more in future blogs ...