Posts tagged “cohort”
Kottke.org posted a link to the an excellent piece by David Brooks entitled “The Heart Grows Smarter” at the NYT opinion pages. Brooks describes the Grant Study, a longitudinal evaluation of mental and physical health status. It tracked 268 Harvard students for upwards of 50 years, beginning in the 40s and following the participants through war, marriage, divorce, failure, success, and death. Brooks draws some pleasant and hopeful conclusions from the study:
The men of the Grant Study frequently became more emotionally attuned as they aged, more adept at recognizing and expressing emotion. Part of the explanation is biological. People, especially men, become more aware of their emotions as they get older.
Part of this is probably historical. Over the past half-century or so, American culture has become more attuned to the power of relationships. Masculinity has changed, at least a bit.
The so-called Flynn Effect describes the rise in measured I.Q. scores over the decades. Perhaps we could invent something called the Grant Effect, on the improvement of mass emotional intelligence over the decades. This gradual change might be one of the greatest contributors to progress and well-being that we’ve experienced in our lifetimes.
Partly because of Brooks’s writing on the topic, and partly because of the topic (longitudinal cohort studies are super interesting… and super difficult to pull off), I spent a few minutes using google to find out more. One of the most accessible pieces that popped up about the study was Joshua Wolf Shenk’s beautiful and long 2009 essay from The Atlantic (interestingly, Brooks wrote about Shenk’s essay in a separate NYT op-ed piece from 2009).
Shenk’s piece is stunning. He reveals, for instance, that JFK was part of the Grant study — and that his files from the study are sealed until at least 2040. Other participants went on to be in a Presidential cabinet, or run for Senate, or become the editor for the Washington Post, or to write best-selling novels. But the really fascinating stuff arose from Shenk’s juxtaposition of stories of the study participants and descriptions of the study’s brilliant, quirky lead investigator, Dr. George Vaillant.
The study started by collecting every bit of anthropometric data imaginable on the study subjects, including
everything from major organ function, to the measure of lactic acid after five minutes on a treadmill, to the size of the “lip seam” and the hanging length of the scrotum. Using a new test called the electroencephalograph, the study measured the electrical activity in the brain, and sought to deduce character from the squiggles. During a home visit, a social worker took not only a boy’s history—when he stopped wetting his bed, how he learned about sex—but also extensive medical and social histories on his parents and extended family. The boys interpreted Rorschach inkblots, submitted handwriting samples for analysis, and talked extensively with psychiatrists.
Vaillant continued some of the physical measures — and savvily added new ones along the way to help keep the study relevant to potential funders. His real interest, though, lay in the underlying psychology of the participants.
His central question is not how much or how little trouble these men met, but rather precisely how—and to what effect—they responded to that trouble. His main interpretive lens has been the psychoanalytic metaphor of “adaptations,” or unconscious responses to pain, conflict, or uncertainty.
Most psychology preoccupies itself with mapping the heavens of health in sharp contrast to the underworld of illness. “Social anxiety disorder” is distinguished from shyness. Depression is defined as errors in cognition. Vaillant’s work, in contrast, creates a refreshing conversation about health and illness as weather patterns in a common space. “Much of what is labeled mental illness,” Vaillant writes, “simply reflects our ‘unwise’ deployment of defense mechanisms. If we use defenses well, we are deemed mentally healthy, conscientious, funny, creative, and altruistic. If we use them badly, the psychiatrist diagnoses us ill, our neighbors label us unpleasant, and society brands us immoral.”
This perspective is shaped by a long-term view. Whereas clinicians focus on treating a problem at any given time, Vaillant is more like a biographer, looking to make sense of a whole life—or, to take an even broader view, like an anthropologist or naturalist looking to capture an era. The good news, he argues, is that diseases—and people, too—have a “natural history.” After all, many of the “psychotic” adaptations are common in toddlers, and the “immature” adaptations are essential in later childhood, and they often fade with maturity. As adolescents, the Grant Study men were twice as likely to use immature defenses as mature ones, but in middle life they were four times as likely to use mature defenses—and the progress continued into old age. When they were between 50 and 75, Vaillant found, altruism and humor grew more prevalent, while all the immature defenses grew more rare.
This means that a glimpse of any one moment in a life can be deeply misleading. A man at 20 who appears the model of altruism may turn out to be a kind of emotional prodigy—or he may be ducking the kind of engagement with reality that his peers are both moving toward and defending against. And, on the other extreme, a man at 20 who appears impossibly wounded may turn out to be gestating toward maturity.
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.”
Grab a cup of your favorite liquid and prepare to tune out for a half hour as you read the whole article.