As a former staff member of the Meyer Friedman Institute, I was gratified to see your article on psychocardiology, and the recognition of psychology's valuable contribution to the treatment of our number one killer.
Before the Type A concept is discarded, factors not ordinarily recognized should be considered. Friedman's treatment research powerfully demonstrated the effectiveness of his treatment approach. The government stopped the research before the protocol was completed so the controls could also benefit from it. The diagnosis of Type A (a continuum of severity) was done by a structured clinical examination including isolating behavioral manifestations not replicated by the questionnaire method used in most if not all subsequent research. The major discrepancy with subsequent research was about "time urgency" not found to be a significant causal variable in subsequent research.
It is not time pressure in itself that is a toxic variable, but how one reacts to time pressure. Friedman was quite clear about that. People prone to frustration and anger are very reactive to time pressure. The well-established Frustration Aggression Hypothesis suggests the causal relationship between time urgency and anger. Friedman called one of the "twin pillars" of the Type A behavior pattern "free floating hostility."
Friedman was first led to examine the behavior of his cardiac patients when the upholsterer covering his worn-out waiting room chairs commented that the excessive wear pattern on the front edge of the chairs was unusual. The patients literally sat impatiently on the edge of their chairs.
Leonard Schwartzburd, PhD
Reading an article such as "Don't be mad-More research links hostility to coronary risk," by Nadja Geipert (January Monitor, page 50), regarding the effects of emotion on physical health reminds me that, while some good is bound to come from research in this field, there are also considerable limitations where strict definition of terms such as "hostility" or "anger" are concerned. Obviously, we all know what anger is in everyday life, but how does one rigorously quantize and define it for strict scientific purposes?
This isn't a new thought, I realize, but I do offer a thought: Instead of continuing to take the same tried-and-true path, sacrificing precision regarding a definition of emotion for practical gain (i.e., "don't be mad"), should we not be regarding the understanding of emotion in a systematic perspective? Each emotion has a place, does it not? And simply "negativizing" one emotion doesn't cut it in the bigger picture.
This will likely be a controversial letter, but I can't help but wonder what effect the race and gender of the candidates had on the results of the 2008 APA presidential election. How ironic that on the one hand, voters elected a Caucasian male who says he will promote diversity, but on the other hand, those same voters gave the fewest first-place votes to an African-American female candidate.
I'm sure many psychologists believe that their votes are based on rational factors such as candidates' platforms, achievements and experience, but anyone who thinks that race and gender don't influence virtually every election in the United States is either naive or self-deceiving. President-Elect Dr. Alan E. Kazdin says that diversity is more than inclusion; it is understanding. I would argue that taking action is more important than "understanding," and that truly valuing diversity would lead to a much higher rate of electing minority candidates to leadership positions. Perhaps if psychologists talked less about valuing diversity and instead chose more minority candidates as their leaders, we psychologists would have a much greater impact on promoting positive social change in our society than we currently enjoy.
Kurt D. Openlander, PhD
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