8. Vaillant, Ego Mechanisms of Defense.
9. Dan P. McAdams, The Redemptive Self (New York: Oxford University Press, 2006).
10. George E. Vaillant, “Adaptive Mental Mechanisms: Their Role in a Positive Psychology,” American Psychologist 55 (2000): 89–98.
11. George E. Vaillant and Caroline O. Vaillant, “Natural History of Male Psychological Health, XII: A Forty-Five Year Study of Successful Aging at Age 65,” American Journal of Psychiatry 147 (1990): 31–37.
12. Stephen G. Post, ed., Altruism and Health (New York: Oxford, 2007).
13. George E. Vaillant and Leigh McCullough, “The Washington University Sentence Completion Test Compared with Other Measures of Adult Ego Development,” American Journal of Psychiatry 144 (1987): 1189–1194.
14. George E. Vaillant, “Involuntary Coping Mechanisms: A Psychodynamic Perspective,” Dialogues in Clinical Neuroscience 13 (2011): 366–370.
9. ALCOHOLISM
(Epigraph) Alcoholics Anonymous (New York: Alcoholics Anonymous World Services, 2001), 58–59.
1. George E. Vaillant, The Natural History of Alcoholism Revisited (Cambridge: Harvard University Press, 1995).
2. Thomas R. Dawber, The Framingham Study (Cambridge: Harvard University Press, 1980); Lisa F. Berkman and S. Leonard Syme, “Social Networks, Host Resistance, and Mortality: A Nine-Year Follow-Up of Alameda County Residents,” American Journal of Epidemiology 109 (1979): 186–201.
3. Vaillant, The Natural History of Alcoholism Revisited.
4. Sheldon Glueck and Eleanor Glueck, Unraveling Juvenile Delinquency (New York: Commonwealth Fund, 1950).
5. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. (Washington, DC: American Psychiatric Association, 1980).
6. Vaillant, The Natural History of Alcoholism Revisited; Melvin L. Seltzer, “The Michigan Alcoholism Screening Test: The Quest for a New Diagnostic Instrument,” American Journal of Psychiatry 127 (1971): 1653–1658.
7. Vaillant, The Natural History of Alcoholism Revisited, 161.
8. William Hogarth, Engravings (Mineola, NY: Dover Publications, 1973).
9. E. Morton Jellinek, The Disease Concept of Alcoholism (New Haven: Hillhouse Press, 1960).
10. Alcoholics Anonymous (New York: Alcoholics Anonymous World Services, 2001).
11. J. Michael Polich, David J. Armor, and Harriet B. Braiker, The Course of Alcoholism (New York: Wiley, 1981); Jim Orford and Griffith Edwards, Alcoholism (Oxford: Oxford University Press, 1977); Don Cahalan and Robin Room, Problem Drinkers among American Men (New Brunswick, NJ: Rutgers Center for Alcohol Studies, 1974).
12. Vaillant, The Natural History of Alcoholism Revisited, 202.
13. Karl A. Menninger, Man against Himself (New York: Harcourt Brace, 1938), 177.
14. Robert P. Knight, “The Dynamics and Treatment of Chronic Alcohol Addiction,” Bulletin of the Menninger Clinic 1 (1937), 234.
15. Paul Schilder, “The Psychogenesis of Alcoholism,” Quarterly Journal of Studies on Alcohol 2 (1940): 277–292.
16. Jellinek, The Disease Concept of Alcoholism, 153.
17. Michael L. Selzer, “Alcoholism and Alcoholic Psychoses,” Comprehensive Textbook of Psychiatry, 3rd ed., ed. Harold I. Kaplan, Alfred M. Freedman, and Benjamin J. Sadock (Baltimore: Williams and Wilkins, 1980), 1629.
18. Ernest Simmel, “Alcoholism and Addiction,” Psychoanalytic Quarterly 17 (1948): 6–31; Howard T. Blane, The Personality of the Alcoholic: Guises of Dependency (New York: Harper and Row, 1968); George E. Vaillant, “The Natural History of Male Psychological Health, VIII: Antecedents of Alcoholism and ‘Orality,’” American Journal of Psychiatry 17 (1980): 181–186; George Winokur, Paula J. Clayton, and Theodore Reich, Manic Depressive Illness (St. Louis: C.V. Mosby, 1969); Lee N. Robins, Deviant Children Grown Up: A Sociological and Psychiatric Study of Sociopathic Personality (Baltimore: Williams and Wilkins, 1966); Vaillant, The Natural History of Alcoholism Revisited.
19. George E. Vaillant, “Is Alcoholism More Often the Cause or the Result of Depression?” Harvard Review of Psychiatry 1 (1993): 94–99; George E. Vaillant, “A Long-Term Follow-Up of Male Alcohol Abuse,” Archives of General Psychiatry 53 (1996): 243–249.
20. Vaillant, The Natural History of Alcoholism Revisited.
21. George E. Vaillant, “Natural History of Male Alcoholism, V: Is Alcoholism the Cart or the Horse to Sociopathy?” British Journal of Addiction (1983), 78: 317–326.
22. Vaillant, The Natural History of Alcoholism Revisited.
23. Marc Alan Schuckit, “Advances to Understanding the Vulnerability to Alcoholism,” Addictive States, ed. Charles P. O’Brien and Jerome H. Jaffe (New York: Raven Press, 1992), 192.
24. Lee N. Robins and Darrel A. Regier, Psychiatric Disorders in America (New York: The Free Press, 1991).
25. Vaillant, The Natural History of Alcoholism Revisited, chapter 4, Table 4.1a.
26. Ibid.
27. Keith Humphreys, “Alcohol & Drug Abuse: A Research-Based Analysis of the Moderation Management Controversy,” Psychiatric Services 54 (2003): 621–622.
28. George E. Vaillant, The Natural History of Alcoholism (Cambridge, MA: Harvard University Press, 1983), 229.
29. Vaillant, The Natural History of Alcoholism Revisited, 282.
30. Ibid., 181; Vaillant, “A Long-Term Follow-Up of Male Alcohol Abuse”; George E. Vaillant, “What Can Long-Term Follow-Up Teach Us about Relapse and Prevention of Relapse in Addiction?” British Journal of Addiction 83 (1988): 1147–1157.
31. Robb Stall and Patrick Biernacki, “Spontaneous Remission from the Problematic Use of Substances: An Inductive Model Derived from a Comparative Analysis of the Alcohol, Opiate, Tobacco and Food/Obesity Literatures,” International Journal of the Addictions (1986): 1–23.
32. Vaillant, The Natural History of Alcoholism Revisited.
10. SURPRISING FINDINGS
1. Peter Townsend, Nick Davidson, and Margaret Whitehead, eds., Inequalities in Health: The Black Report and the Health Divide (Harmondsworth, England: Penguin, 1988).
2. Marcia Angell, “Privilege and Health—What Is the Connection?” New England Journal of Medicine 329 (1993): 126–127.
3. Michael G. Marmot, Hans Bosma, Harry Hemingway, et al., “Contribution of Job Control and Other Risk Factors and Social Variations of Coronary Heart Disease Incidence,” Lancet 337 (1991): 1387–1393.
4. George E. Vaillant, Natural History of Alcoholism Revisited (Cambridge: Harvard University Press, 1995).
5. Howard S. Friedman and Leslie R. Martin, The Longevity Project (New York: Hudson Street Press, 2011).
6. David W. Baker, Michael S. Wolf, Joseph Feinglass, et al., “Health Literacy and Mortality among Elderly Persons,” Archives of Internal Medicine 167 (2007): 1503–1509.
7. John P. Monks, College Men at War (Boston: American Academy of Arts and Science, 1951).
8. Paul T. Costa, Jr., and Robert R. McCrae, The NEO Personality Inventory Manual (Odessa, FL: Psychological Assessment Resources Inc., 1985).
9. Kimberly A. Lee, George E. Vaillant, William C. Torrey, et al., “A 50-Year Prospective Study of the Psychological Sequelae of World War II Combat,” American Journal of Psychiatry 152 (1995): 516–522.
10. Mary L. Pendery, Irving M. Malzmann, and L. Jolyon West, “Controlled Drinking by Alcoholics? New Findings and a Revolution of a Major Affirmation Study,” Science 217 (1982): 169–175; Vaillant, Natural History of Alcoholism Revisited.
11. Frederick L. Wells and William L. Woods, “Outstanding Traits,” Genetic Psychology Monographs 33 (1945): 127–249; Stephen Soldz and George E. Vaillant, “The Big Five Personality Traits and the Life Course: A 45-Year Longitudinal Study,” Journal of Research in Personality, 33 (1999): 208–232.
12. Paul Heelas and Linda Woodhead, The Spiritual Revolution: Why Religion Is Giving Way to Spirituality (London: Blackwell, 2005); Richard Dawkins, “Is Science a Religion?” The Humanist 26 (1997).
13. George Gallup,
Jr., and D. Michael Lindsay, Surveying the Religious Landscape: Trends in US Beliefs (Harrisburg, PA: Morehouse, 1999); Harold G. Koenig, Judy C. Hays, David B. Larson, et al., “Does Religious Attendance Prolong Survival? A Six-Year Follow-Up Study of 3,968 Older Adults,” Journal of Gerontology, Series A, Biological Sciences & Medical Sciences, 54A (1999): M370–M376; Harold G. Koenig, Michael E. McCullough, and David B. Larson, Handbook of Religion and Health (New York: Oxford University Press, 2001).
14. Richard P. Sloan, Emilia Bagiella, and Tia Powell, “Religion, Spirituality, Medicine,” The Lancet 353 (1999): 664–667.
15. George E. Vaillant, Janice Templeton, Monika Ardelt, et al., “The Natural History of Male Mental Health: Health and Religious Involvement,” Social Science & Medicine 66 (2008): 221–231.
16. August B. Hollingshead and Frederick C. Redlich, Social Class and Mental Illness (New York: Wiley, 1958); George E. Vaillant, “Natural History of Male Psychological Health, II: Some Antecedents of Healthy Adult Adjustment,” Archives of General Psychiatry 31 (1974): 15–22; Clark W. Heath, What People Are (Cambridge: Harvard University Press, 1945); Vaillant, Natural History of Alcoholism Revisited.
17. George E. Vaillant, Stephanie E. Meyer, Kenneth J. Mukamal, et al., “Are Social Supports in Late Midlife a Cause or a Result of Successful Physical Aging?” Psychological Medicine 28, 69 (1998): 1159–1168; George E. Vaillant, “Natural History of Male Psychological Health, XIV: Relationship of Mood Disorder Vulnerability to Physical Health,” American Journal of Psychiatry 55 (1998a): 184–191; Xing-Jia Cui and George E. Vaillant, “Antecedents and Consequences of Negative Life Events in Adulthood: A Longitudinal Study,” American Journal of Psychiatry 152 (1996): 21–26.
18. Aaron Lazare, Gerald L. Klerman, and David J. Armor, “Oral, Obsessive and Hysterical Personality Patterns,” Archives of General Psychiatry 14 (1966): 624–630; Derek M. Isaacowitz, George E. Vaillant, and Martin E. P. Seligman, “Strength and Satisfaction Across the Adult Lifespan,” International Journal of Aging and Human Development 27 (2003): 181–201.
19. Vaillant, “Health and Religious Involvement.”
20. Koenig, McCullough, and Larson, Handbook of Religion and Health.
21. Sloan, Bagiella, and Powell, “Religion, Spirituality, Medicine.”
22. Marc A. Musick, James S. House, and David R. Williams, “Attendance at Religious Services and Mortality in a National Sample,” Journal of Health and Social Behavior 45 (2004), 204.
23. Vaillant, Natural History of Alcoholism Revisited.
24. Vaillant, “Health and Religious Involvement.”
25. R. Bayliss, C. Clarke, A. G. H. Whitfield, “Problems in Comparative Longevity,” Journal of Royal College of Physicians (London) 21 (1987): 134–139.
26. George E. Vaillant, Diane Roston, and Gregory J. McHugo, “An Intriguing Association Between Ancestral Mortality and Male Affective Disorder,” Archives of General Psychiatry 49 (1992): 709–715.
27. Aaron J. Rosanoff, Leva H. Handy, and Isabel R. Plesset, “The Etiology of Manic-Depressive Syndromes with Special Reference to Their Occurrence in Twins,” American Journal of Psychiatry 91 (1935): 725–740.
28. Elliot S. Gershon, “Genetics,” Manic-Depressive Illness, ed. Frederick K. Goodwin and Kay R. Jamison (New York: Oxford University Press, 1990), 373–401; Stephen V. Faraone, William S. Kremen, and Ming T. Tsuang, “Genetic Transmission of Major Affective Disorders: Quantitative Models and Linkage Analyses,” Psychological Bulletin 108 (1990): 109–127; Julien Mendlewicz, Serge Sevy, Huguette Brocas, et al., “Polymorphic DNA Marker on X-Chromosome and Manic Depression,” Lancet 1 (1987): 1230–1232.
11. SUMMING UP
1. Robert R. McCrae and Paul T. Costa, Jr., “The Stability of Personality: Observations and Evaluations,” Current Directions in Psychological Sciences 3 (1994): 173–175.
2. K. Warner Schaie, Longitudinal Studies of Adult Psychological Development (New York: Guilford Press, 1983).
3. Erik H. Erikson, Childhood and Society (New York: Norton, 1951).
4. Paul T. Costa, Jr., and Robert R. McCrae, The NEO Personality Inventory Manual (Odessa, FL: Psychological Assessment Resources, 1985); Robert R. McCrae and Paul T. Costa, Jr., Emerging Lives, Enduring Dispositions (Boston: Little, Brown, 1984).
5. Stephen Soldz and George E. Vaillant, “The Big Five Personality Traits and the Life Course: A 45-Year Longitudinal Study,” Journal of Research in Personality 33 (1999): 208–232.
6. George E. Vaillant and Caroline O. Vaillant, “Natural History of Male Psychological Health, X: Work as a Predictor of Positive Mental Health,” American Journal of Psychiatry 138 (1981): 1433–1440; George E. Vaillant, Natural History of Alcoholism Revisited (Cambridge: Harvard University Press, 1995).
7. John A. Clausen, American Lives (Berkeley: University of California Press, 1995).
8. Howard S. Friedman and Leslie R. Martin, The Longevity Project (New York: Hudson Street Press, 2011).
9. George E. Vaillant, Natural History of Alcoholism (Cambridge: Harvard University Press, 1983).
10. Vaillant, Natural History of Alcoholism Revisited.
11. Sigmund Freud, “The Neuropsychoses of Defense (1894),” in Standard Edition, vol. 3, ed. J. Strachey (London: Hogarth Press, 1962), 41–61; George E. Vaillant, “The Historical Origins and Future Potential of Sigmund Freud’s Concept of the Mechanisms of Defense,” International Review of Psychoanalysis 19 (1992): 35–50.
12. Robert V. Kail and John C. Cavanaugh, Human Development, 6th ed. (Belmont, CA: Wadsworth, 2010).
13. Kail and Cavanaugh, Human Development; William C. Crain, Theories of Development (New York: Prentice Hall, 2011).
14. Joshua W. Shenk, “What Makes Us Happy,” Atlantic 303 (2009): 36–53.
ACKNOWLEDGMENTS
The title page of this book is misleading, for it suggests a single authorship. In truth, the book represents a vast collaborative effort that has continued for seventy-five years. The effort began in the late 1930s as two separate studies: a study of juvenile delinquency by Sheldon and Eleanor Glueck at Harvard Law School, and the Grant Study by Clark Heath and Arlie Bock at the Harvard University Health Services. In 1972 the studies were brought together under the auspices of the Harvard University Health Services as the Study of Adult Development. I have written this book as one member of a very large team, on which I have had the privilege of playing for forty-six of its seventy-five years. Many others can also claim authorship.
I am most deeply indebted to the several hundred erstwhile college sophomores and Boston schoolboys who are the Study’s subjects. Since 1940, they have generously shared their time, their lives, and their experiences. This work is also indebted to the two independent teams of researchers who conceived, sustained, funded, and guided this longitudinal research for the first thirty years of the Study. For the 456 Inner City schoolboys this meant Sheldon Glueck and Eleanor Glueck and their team at the Harvard Law School. For the 268 Grant Study College men this meant William T. Grant, Arlie Bock, Clark Heath, Lewise Davies, Charles McArthur, and their team at the Harvard University Health Services.
In the forty years since the Grant and the Glueck studies were consolidated into the Study of Adult Development, many individuals have played critical roles and have been formally acknowledged in Study books. One research associate who has not been properly acknowledged is John Martin-Joy, who for almost two decades has obtained reliable evidence (as yet unpublished) that after age fifty, defenses in healthy men continue to mature until age seventy-five.
For this book I wish to acknowledge the very special contributions of five extraordinary women and one extraordinary man who in different ways played major roles in bringing this seventy-five-year study to fruition. Eva Milofsky for ten years was the keystone to the Study’s staff and conducted almost half of the Grant Study midlife interviews. Maren Batalden conducted many of the retirement interviews, and her prose is the most beautiful in the book. Caroline Vaillant labored for twenty years in countless wa
ys on the Study, giving wise advice and displaying an uncanny knack for finding “lost” subjects. For the last twenty years Robin Western has been responsible for this being a seventy-five-year, not a fifty-five-year study. Her tact and grace in contacting the men and their doctors have kept attrition to an absolute minimum, and her orderly mind has kept the vast Study archives and her boss in praiseworthy order. For more than fifteen years the internist Ken Mukamal was the extremely thorough blind rater of the men’s physical exams. Finally, I want to acknowledge the extraordinary contribution of Eve Golden, who spent hour after hour above and beyond the call of editorial duty transforming my disorderly academic prose into lucid English. Only my own greediness keeps me from acknowledging Eve as the book’s coauthor.
I hope that the many research associates who have helped me to create this book but whose names do not appear will understand that the limiting factor is space and not gratitude. I am also grateful to the thousands of physicians who generously supported our efforts without billing their medical examinations of the men to the Study.
Over the years, four broad-minded department chairmen, Paul Myerson, John Mack, Miles Shore, and Jonathan Borus, helped to ensure that I had time for this Study. As directors of the Harvard University Health Services, Dana Farnsworth, then Warren Wacker, and recently David Rosenthal have played indispensible roles as hosts and advisers.
This book is indebted to funding from the William T. Grant Foundation, The John T. Templeton Foundation, the Harvard Neuro-discovery Center, the Fidelity Foundation, the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Mental Health, and the National Institute on Aging. God bless their philanthropy.
Finally, anyone who has ever written an academic text knows that it is senior editors and critics smarter than oneself who make such books possible. My heartfelt thanks go to Robert Waldinger (Study Director), Elizabeth Knoll (Executive Editor at Harvard Press), Bob Drake, Dan McAdams, and my wife, Diane Highum, M.D.
Triumphs of Experience: The Men of the Harvard Grant Study Page 41