Staying Healthy, Happy Across the Years: A Longitudinal Study

Is there a formula—some mix of love, work, and psychological adaptation—for a good life? For 72 years, researchers at Harvard have been examining this question, following 268 men who entered college in the late 1930s through war, career, marriage and divorce, parenthood and grandparenthood, and old age. Here, for the first time, a journalist gains access to the archive of one of the most comprehensive longitudinal studies in history. Its contents, as much literature as science, offer profound insight into the human condition—and into the brilliant, complex mind of the study's longtime director, George Vaillant.

--"What Makes Us Happy?" by Joshua Wolf Shenk, The Atlantic

I like The Atlantic magazine because it so often offers me articles like this one. It is interesting, even compelling, not just because of the case studies and findings, but because of the story of the study itself, and the medical researcher who carried on this very personal relationship with both the longitudinal research and the people who were the subjects of it. And I suppose it should surprise no one that even among such a gifted, privileged, and initially healthy population, the study of their lives was as much the chronicling of failures, deteriorating health, and emotional distress, as it was of successes, health and happiness. From the article:

And as the Grant Study men entered middle age—they spent their 40s in the 1960s—many achieved dramatic success. Four members of the sample ran for the U.S. Senate. One served in a presidential Cabinet, and one was president. There was a best-selling novelist (not, Vaillant has revealed, Norman Mailer, Harvard class of '43). But hidden amid the shimmering successes were darker hues. As early as 1948, 20 members of the group displayed severe psychiatric difficulties. By age 50, almost a third of the men had at one time or another met Vaillant's criteria for mental illness. Underneath the tweed jackets of these Harvard elites beat troubled hearts. Arlie Bock [who initiated the study] didn't get it. "They were normal when I picked them," he told Vaillant in the 1960s.

In approaching the study and the subjects, Vaillant was focusing on what he calls "adaptations," or unconscious responses to pain, conflict or uncertainty--what others have called "defense mechanisms." According to the author and Vaillant:

At the bottom of the pile are the unhealthiest, or "psychotic," adaptations—like paranoia, hallucination, or megalomania—which, while they can serve to make reality tolerable for the person employing them, seem crazy to anyone else. One level up are the "immature" adaptations, which include acting out, passive aggression, hypochondria, projection, and fantasy. These aren't as isolating as psychotic adaptations, but they impede intimacy. "Neurotic" defenses are common in "normal" people. These include intellectualization (mutating the primal stuff of life into objects of formal thought); dissociation (intense, often brief, removal from one's feelings); and repression, which, Vaillant says, can involve "seemingly inexplicable naïveté, memory lapse, or failure to acknowledge input from a selected sense organ." The healthiest, or "mature," adaptations include altruism, humor, anticipation (looking ahead and planning for future discomfort), suppression (a conscious decision to postpone attention to an impulse or conflict, to be addressed in good time), and sublimation (finding outlets for feelings, like putting aggression into sport, or lust into courtship).

"What allows people to work, and love, as they grow old?" the author asks. By the time the study's subjects entered retirement, Dr. Vaillant had identified seven factors that best predicted both physical and psychological health as the population aged. From the article:

Employing mature adaptations was one. The others were education, stable marriage, not smoking, not abusing alcohol, some exercise, and healthy weight. Of the 106 Harvard men who had five or six of these factors in their favor at age 50, half ended up at 80 as what Vaillant called "happy-well" and only 7.5 percent as "sad-sick." Meanwhile, of the men who had three or fewer of the health factors at age 50, none ended up "happy-well" at 80. Even if they had been in adequate physical shape at 50, the men who had three or fewer protective factors were three times as likely to be dead at 80 as those with four or more factors.

Are there overarching factors or concerns that should be highlighted? Yes, says Vaillant: on the positive side, the power of relationships; on the negative side, the destructiveness of alcoholism. From the article:

One is alcoholism, which he found is probably the horse, and not the cart, of pathology. "People often say, 'That poor man. His wife left him and he's taken to drink,'" Vaillant says. "But when you look closely, you see that he's begun to drink, and that has helped drive his wife away." The horrors of drink so preoccupied Vaillant that he devoted a stand-alone study to it: The Natural History of Alcoholism.

Vaillant's other main interest is the power of relationships. "It is social aptitude," he writes, "not intellectual brilliance or parental social class, that leads to successful aging." Warm connections are necessary—and if not found in a mother or father, they can come from siblings, uncles, friends, mentors. The men's relationships at age 47, he found, predicted late-life adjustment better than any other variable, except defenses. Good sibling relationships seem especially powerful: 93 percent of the men who were thriving at age 65 had been close to a brother or sister when younger. In an interview in the March 2008 newsletter to the Grant Study subjects, Vaillant was asked, "What have you learned from the Grant Study men?" Vaillant's response: "That the only thing that really matters in life are your relationships to other people."

So then, "What factors don't matter?" asks the author. I have to give you some incentive to read and enjoy the whole article, don't I? Perhaps learning of things that don't appear to matter and some other interesting findings will be incentive enough.

http://www.theatlantic.com/doc/print/200906/happiness