THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Transcripts: 537-1 and 537-2

Week: 537.1 Guest: Dr. Redford Williams, Dir. Behavioral Medicine, Duke University Topic: Anger & Your Health, Part One of Two Producer/Host: Steve Girard

NEMA: His book is called "Anger Kills", and Dr. Redford Williams, the Director of Behavioral Medicine Research at the Duke University Medical Center is with us today to talk about the ways anger can affect us. Doctor, tell me what led you into this area of research?

WILLIAMS: I had begun doing research on Type A behavior, which most people, I imagine, have heard of...Type A's are always in a hurry, and they're also hostile. And what began to be clear, as research went on, in the late 1970's, early 80's...is that it's only the hostility and anger part of Type A that are damaging to your health.

NEMA: What are some of the ways that overall health is affected by that hostility and anger?

WILLIAMS: We have found in following up doctors and lawyers who took a psychological test when they were in law school or medical school, that measured hostility, that those who had high scores at age 25 on this hostility scale, were four to seven times more likely to develop coronary heart disease...or to die from all causes - compared to those who had low scores. So, being hostile at age 25 - having a cynical mistrust of other people, having frequent anger, particularly at everyday, petty things...and also being aggressive, is measured by this scale...being aggressive and expressing that anger openly to other people, is identifying a group of men, in these studies - women have subsequently been found to have the same effects - who are more likely to develop life-threatening illnesses and die by the time they reach age 50...or would have reached age 50.

NEMA: What can a person who recognizes this destructive type A personality do to shuffle the cards, so to speak, and come out with a different outcome...?

WILLIAMS: You can change a lot of it, and there's already evidence, at least in studies of patients who've had a heart attack, that learning to change these behaviors, to control your hostility and anger better, help you to survive longer with coronary heart disease, so whenever you feel yourself feeling angry over something that's happened, ask yourself three questions: "Is this important to me"? "If it's not, why are you being angry and going on about it"? Second question: "Is my anger justified"?...is it appropriate to the objective facts, not your interpretation of them, sometimes you will say you don't have enough information, you know, maybe the person scowling across the table is having a gas pain, and is not scowling at what you're saying. On the other hand, if the person across the table says, "That's the stupidest thing I've ever heard"?, yes, it's by all means justified and appropriate to be angry. Lastly, is you ask yourself, "Is this situation changeable, modifiable...is there anything I can do that's going to fix this situation"? Traffic, slow moving lines, teenagers that don't pick up their rooms, toddlers who have temper tantrums, etc... We can see are probably not that susceptible to our being able to change them. So if you get a no there, you can again engage in some self-talk...to talk yourself out of it - "Hey! There's nothing you can do about this traffic jam...it's important, you're going to miss an important appointment, you're certainly justified in being angry, but there's nothing you can do.

NEMA: Dr. Redford Williams will return on our next program to give more insight into hostile personalities, and how to avoid being walked on if you're the opposite type. His book is "Anger Kills", from Harper Perennial, is available at bookstores nationwide. I'm Steve Girard.

Week: 537.2 Guest: Dr. Redford Williams, Dir. Behavioral Medicine, Duke University Topic: Anger & Your Health, Part Two of Two Producer/Host: Steve Girard

NEMA: We've been talking with Dr. Redford Williams, Director of Behavioral Medicine Research at the Duke University Medical Center, and author of "Anger Kills". We found that health destructive Type A personality traits start early, and involve getting angry over petty, everyday things. Dr. Redmond, you mentioned the three questions they should ask themselves: Is this really important to me? Is my anger justified, based on objective facts? and...Is this situation changeable...can I fix it. And you said many times a person can simply talk themselves out of the rage they're feeling. What if it doesn't work?

WILLIAMS: If that doesn't completely do the job, you might try meditation...paying attention to your breathing. Every time you breathe in say, "Calm", every time you breathe out say, "Down". And do that for a minute or two, right there, sitting in that traffic jam, or in that slow moving line.

NEMA: Almost everyone has periods where they are more susceptible to being upset by normal, aggravating things that happen everyday...you're not talking about people who are mostly calm about those things....

WILLIAMS: People who, day in and day out, seem to find themselves getting angry over and over again, and the reason there's some of us who do this more often than others is because we have this cynical mistrust of other people. We're always kind of looking out for other people to somehow be screwing up, or being selfish or somehow mistreating us. So that we are very vigilant for the misbehavior of others, and like most things, if you look for it, you're probably going to find it...or at least find things that you're going to interpret as their being inconsiderate. There's always something that's happening up ahead, the traffic, that you could fix on if you care to. And that's probably why they're going to be subjecting themselves to this anger stress, and the biological effects of it...the adrenaline surges, the blood pressure surges, and those sorts of things day in and day out, for the rest of their life - unless they do something about it.

NEMA: And it seems that this type of person might have a very hard time coming to the point where he or she realizes they can't rid themselves of the behavior by themselves....

WILLIAMS: They should get some counseling...there are wellness programs, and very often these include stress management, and anger coping skills training, like we're talking about here. There will be times when you get three yes's to those questions, it's important, it's justified, and I should be able to change this other person to keep them from saying my idea was stupid, let's say. And that's where assertion is called for... but to be appropriately assertive in that situation. To ask for what you want...."When you say that my ideas are stupid, it really makes me angry with you, it hurts my feelings...I need you please to not use words like stupid when we're trying to have these planning meetings". It almost always will work, and get the other person to change, at least for a little while....and when it completely bombs out, then you've learned something about that other person.

NEMA: In my case, I just don't get angry at people...always giving the benefit of the doubt...and sometimes that doesn't always work out best, either....

WILLIAMS: If you find yourself getting walked over by other people, all the time, you may need to use this hostility road map with the three questions I just mentioned, to identify sometimes when you should be, perhaps, a little bit more active, in being assertive. That's the purpose of evaluating your anger.

NEMA: You can control your feelings...that's the message from Dr. Redford Williams, of Duke University, the author of Anger Kills, from Harper Perennial. I'm Steve Girard.