MARRIAGE AND TYPE A PERSONALITIES: BEHAVIOR
Type A behavior pattern has historically been observed primarily in men, but contemporary women are rapidly catching up. Type A women appear as a variation on this coping theme. Perhaps because women are traditionally socialized not to express anger openly, many Type A females show a different set of symptoms: generalized frustration, irritation, and depression. Rather than openly display hostility (like male Type A's), female Type A's are more likely to suffer the signs of holding back powerful emotions. Teeth grinding, exhaustion, and a general sense of drivenness to be all things to all people are frequently seen in Type A women. These are people who quietly push themselves with perfectionistic self-standards in all that they do.
I do not mean to imply that every ambitious, energetic, hardworking person is a Type A personality, or that everyone who is a Type A personality will develop heart disease. Many such hard drivers are exceptionally happy and healthy. The hallmark characteristic of the problem Type A behavior pattern, however, is joylessness. Extreme Type A's are said to be locked into a joyless striving for accomplishment.
This is not to say that Type A's never smile; it simply means that they are seldom truly satisfied with themselves or others for any length of time, because they are predisposed to respond in a Type A manner to situations they perceive as challenges to their need for control.
The problem is that Type A's tend to perceive most aspects of life as challenges and therefore tend to wear out themselves and others with their time urgency, perfectionism, competitiveness, and hostility as they struggle to maintain control of themselves and of the people and situations that they encounter.
Nor do I mean to imply that any individual who has heart disease is a Type A personality. Many of my heart patients are so-called Type B personalities—those who have a relaxed, unhurried, gracious, noncompetitive style of responding. Some people evidence a combination of Type A and Type B personality characteristics. When a Type B patient has a Type A spouse, then the spouse, not the patient, may react to heart illness in a Type A flurry. For such patients, dealing with the spouse's Type A reactions to cardiac rehabilitation can be the most difficult part of recovery.
How familiar do these descriptions sound to you? Is this familiarity based on what you see of yourself or on your experiences in living with your spouse? As you answer, remember that no one is an absolute Type A; not all aspects of this syndrome need be present for an individual to be considered Type A. Many of us evidence some Type A characteristic (for example, hurry sickness) in one setting (for example, at work), but not in others (for example, at home). Others consistently show some, but not all, of the Type A responses, regardless of the situation. Such a person, for example, may generally react with quiet competitiveness, perfectionism, and hostility—both at work and at home—but may not typically interact with others in a manner that is openly hostile.
It is important to be honest about whether you are stuck in Type A ways of reacting. Based both on my extensive review of many of the more than two thousand professional publications regarding the Type A behavior pattern and on my own clinical experience, I am certain that extreme, unchecked Type A reactivity on the part of either marriage partner significantly interferes with the cardiac rehabilitation process and universally disrupts marital and family intimacy.
Please read that statement again, and note two important points. First, I emphasize that the deterrent to rehabilitation for Type A's is "extreme, unchecked" reactivity. Recent research has suggested that Type A heart patients who learn to modify their typical styles of reactivity rehabilitate from heart illness more successfully than Type A's who do not modify their behavior and that these reformed Type A's may even be more successful in accomplishing cardiac rehabilitation than their Type B counterparts.
What does this mean? It means the Type A style is not necessarily deadly, but extreme Type A reactivity certainly is dangerous.
Second, I emphasize my impression that any extreme Type A reactivity within a marital team—whether that Type A-ness is shown by the heart patient or by the spouse—is detrimental both to the marriage and to the rehabilitation process. Such behavior works against the creation of emotional support and intimacy of the sort that is necessary for effective marital and family functioning and that enhances cardiac rehabilitation. Let me put it in other words:
Marital and family intimacy enhances cardiac rehabilitation.
Marital and family stress works against cardiac rehabilitation.
Extreme Type A behavior interferes with marital and family intimacy.
Therefore, extreme Type A behavior is bad for heart patients and for families.
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