Psychological Self-Help

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revolve around you, laugh at your self-centeredness, (7) relax
frequently (chapter 12) and use a cue-word, like "relax," to reduce
your irritation and anger, (8) practice trusting and being tolerant of
others, (9) and (10) learn active listening, "I" statements, and
assertiveness skills (chapter 13), (11) tell yourself that getting riled up
and criticizing others can kill you, so it is better to replace your anger
with optimistic, tolerant understanding before the heart attack occurs
rather than after it, and (12) forgive those (method #4 in chapter 14)
who have angered you and, thereby, free yourself from resentment
and wanting to get even--and from heart disease. What a
smorgasbord of self-help techniques! Undertaking these be-kind-to-
your-heart treatment efforts would surely bring more happiness to you
and more kindness to others and, therefore, lighten your mood as
Williams (1989) and Williams & Williams (1993), who believe
hostility is the villain, aren't the only ones to treat heart disease
successfully using psychology. Volumes of research over 20 years have
studied the relationship between Type A personality and heart disease.
Type A's are not just angry, they are tense, hurried, pressured,
impatient, competitive, and irritable. They are twice as likely to get
heart disease as less anxious persons. Several recent studies have
clearly shown that extensive (40+ hours spread over 1 to 3 years)
treatment can cut Type A's risk of a second heart attack nearly in half
(Blanchard, 1994). That's impressive. What treatment works? Stress
management skills to change the core personality: relaxation training,
self-observation to help recognize and reduce emotional over-
reactions, communication skills training, cognitive therapy (see the
several methods above), and training in problem-solving, including
determining values and goals. In short, the Type A's were taught self-
help skills and, thus, changed. Why isn't the medical establishment
encouraging this treatment? 
Recent research has continued to confirm the role of psychological
factors in heart disease. John Hopkins University(Archives of Internal
Medicine, April, 2002) has confirmed that medical students who (a)
expressed or concealed their anger, (b) were irritable, and (3) griped a
lot were 3 times more likely to develop early heart disease and 5 times
more likely to have a heart attack than their calmer class mates.
Likewise, another study at University of North Carolina (Williams,
2001) found that people with high anger scores (quick tempered with
frequent, intense rages and urges to hit people, etc.) were three times
more likely to have a heart attack or cardiac death. Early measures of
hostility (mistrust, aggression, cynicism) are good predictors years
later of heart disease so early intervention is possible. High stress
reactions have been shown to trigger a heart attack. Depression
increases the likelihood of death from heart disease. It seems likely
that heart patients might benefit from anger, depression, and/or stress
management. Several publications have already suggested that more
complete psycho-educational programs would be beneficial and a
couple of major studies of extensive psychological treatment are now
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