Simone Hoermann, Ph.D., is a Psychologist in private practice in New York City. She specializes in providing psychotherapy for Personality Disorders, Anxiety, and Depression
I just came across the June 2009 issue of The Atlantic, which features an interesting article by Joshua Wolf Shenk entitled “What Makes Us Happy”. It is an in-depth look at the life and work of the psychiatrist George Vaillant who has been in charge of a number of seminal longitudinal studies. One of them, the so-called “Grant Study” (after one of the patrons, department store magnate W. T. Grant), followed 268 male Harvard students from the late 1930s for over 70 years, through their education and through World War II, observing their physical and mental health, life satisfaction, career, and family lives over time. Another study followed 456 socially disadvantaged non-delinquent inner-city schoolboys in a similar fashion. Shenk’s article gives a fascinating account of some of those lives and illustrates how intertwined Vaillant’s life and career have become with the subjects of his research. His studies have generated a number of illuminating and groundbreaking papers on adaptive mental mechanisms, on natural course of alcoholism, or on men’s health and spirituality, or successful ageing.
Vaillant is a proponent of Positive Psychology, maintaining that is important to not just research mental illness, but to focus significant attention to the study of mental health and factors related to resilience and coping. Vaillant emphasizes the importance of defense mechanisms as ways of coping with life’s stressors. In contrast to active coping behaviors, such as seeking help from others or such as the use of cognitive strategies for problem-solving, defense mechanisms are involuntary mental mechanisms, and they distort our perception.
Vaillant distinguishes between mature and immature defense mechanisms. Mature defense mechanisms are adaptive, allow conscious awareness, and include humor, altruism, anticipation (planning ahead), sublimation (channeling energy or conflict into a culturally or socially higher or more adaptive outlet), or suppression (intentionally postponing to deal with something at a later time). Immature defense mechanisms, for the most part, have to do with decreasing awareness, such as hypochondriasis, fantasy, dissociation, acting out, projection, and passive aggression. Vaillant contends that personality pathology has to do with the use of immature defense mechanisms and believes that these defense mechanisms allow people with personality disorders to deal with sudden stress by means of denial or self-deception. This is not dissimilar to the model proposed by Otto Kernberg, the developer of Transference Focused Psychotherapy, who uses the assessment of a person’s defense mechanisms as a diagnostic tool.
One paper stands out in Vaillant’s bibliography, namely an analysis of predictors of successful ageing published in the American Journal of Psychiatry in 2001. In this paper, “successful ageing” was defined using dimensions that have to do with ratings of physical health and disability, mental health, subjective life satisfaction, and mutually satisfying relationships. Vaillant identified protective factors that predicted successful ageing – some of them are the usual suspects: absence of alcohol and cigarette use before age 50, education, exercise, a stable marriage, use of adaptive defenses, absence of a major depressive disorder, and good physical health at age 50. Less significant were body mass index, ancestral longevity, and two childhood variables of environmental warmth and temperament. Of note, though, is that some of the factors that predicted successful aging at age 50 no longer predicted successful ageing at age 70. For instance, unhappy childhood predicted poor health at age 50 but not at age 80, or serum cholesterol levels were found to be an important predictor of heart disease in young adults, but not in Vaillant’s two study groups.
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What is unique about Vaillants work is that he has been following people over periods of time that were previously unheard of. Thus, he illustrates just what a fluid, ever-changing process life, or happiness, or successful ageing, can be.
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