Psychological Self-Help

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that self-help efforts to reduce the major emotions of Anxiety (chapter
5), Depression (chapter 6), and Anger(chapter 7) could have
significant impact on your future health. And don't forget exercise, a
healthy diet, no smoking, and a good social life. 
A psychologist, David Abrams, testified before Congress (May 16,
2002) that good stress management and lifestyle changes, such as
healthy dieting and smoking cessation, can reduce the deaths from
heart disease by 34%! One must think in terms of life-long heart-
healthy programs, not just dieting after blockage of an artery has been
found by an angiogram. Psychologists have shown that working long
hours (over 40 or 50 hours a week), working weekends, getting little
sleep (less than 6 hours a night) doubles or triples the risk of heart
attacks. Anger combined with exhaustion is quite dangerous.
Apparently, psychological stress increases the risk of death during a
heart attack in complex ways, including actually interfering with the
flow of blood to the heart just as plaque, cholesterol, and
arteriosclerosis might do. 
The amount of fatigue you feel at work is a complex matter. For
men and women, fatigue is greater when you are not able to organize
your own work and when colleagues are not supportive. For many
men, high emotional and physical demands, plus demanding bosses,
lead to feeling tired on the job within one year. For women,
demanding work and interpersonal conflicts are the more likely causes
of fatigue. As you might guess, men who have professional jobs run
less risk of heart disease and death compared to men with less
authority, less education and lower income. Yet, women in demanding
positions with high authority were 3 times more likely to develop heart
disease than women in less demanding jobs (this tendency was not
related, according to these researchers, to having "two jobs--one at
work and one at home" or to higher levels of emotions, like anger,
depression, or tension.) Men in non-traditional roles, such as being
househusbands or living alone, had greater risk of death. You pay a
price for being different. 
For a timely and detailed review of the many mechanisms (specific
physiological pathways) by which environmental stress, emotions, and
personality characteristics affect various aspects of Coronary disease,
see Smith & Ruiz (2002). Understanding the specific heart disease
processes is complex, involving medicine, physiology, psychology and
other disciplines. The quality and precision of this research has
increased greatly in the last decade or two. Anyone realistically dealing
with the psychology-heart connections must learn about these
relationships. I can only summarize for you a few basic psychological
findings: several emotions are repeatedly shown to be related to
chronic heart disease--anger (open expression) and hostility (cynicism
and distrust), social dominance (controlling behaviors), negative
emotions (depression, anxiety, lack of energy), interpersonal isolation
and conflict (including marital strain), and job stress (high demand,
low control). Much more study is needed but this area of research is
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